Prohibitions in physiotherapy and training – why this is not good

In the field of physiotherapy and training, there are numerous recommendations that can often be equated with prohibitions. Such statements about what you should do to achieve goals such as building strength, increasing endurance or reducing body fat create a lot of uncertainty, fear and even failure. Whether it’s avoiding certain exercises or training methods, bans can do more harm than good.

Patients often come to us and mention: “He said I’ll never be able to ski again and I should accept that!” or “I was told I’m not allowed to lift weights during pregnancy?” or “Jogging is bad for your knees, isn’t it?”

Let’s take a look at a concrete example. Lisa* comes to us. She has been suffering from knee pain for two years and has not yet had a satisfactory treatment result, in fact there is not even a proper diagnosis. She was told “Don’t do squats because they hurt and crunch in the joint. Don’t do these exercises for a while and then you’ll feel better”. No sooner said than done. Lisa is actually feeling better. The swelling has gone down and the pain has virtually disappeared. She starts strength training again. One day later, the swelling is back and the pain is even more intense than before. What did the ban achieve? Nothing. On the contrary, Lisa is now very frustrated and, above all, confused. What would be the better course of action?

Let’s come back to what happens when prohibitions are imposed on patients and customers. And then what could be done instead.

1. individual needs are ignored

Every person is unique, and this also applies to the body’s needs and response to different treatment and training methods. A ban on not performing an exercise, for example, could be unnecessary and even counterproductive . Prohibitions neglect the individuality of the exerciser and often lead to important aspects of the training not being used. Besides, how can we forbid someone who is passionate about jogging and needs it as a mental balance just because someone once claimed it leads to osteoarthritis? (The fact that this is not the case is another matter). Or how realistic is it to forbid an 80-year-old from using extra weights for exercise when she lives alone at home and has to carry the laundry to the cellar? Instead: Take a closer look at the patient, inquire about the surroundings, look at the overall picture. Offer modifications to make a certain exercise easier for the time being, if necessary, until mobility is better or the pain is less.

2. psychological effects

Prohibitions can significantly reduce motivation and the enjoyment of training. If someone is told that he or she is not allowed to do a certain exercise, this can have a mental impact. And that leads to a negative attitude towards exercise and poorer health. When exercise goals are linked to prohibitions, a sense of fear and frustration can take hold, leading to long-term avoidance of exercise. Anxiety increases further, which often leads to a deterioration in general health. A vicious circle. Instead: Define goals, find compromises that don’t harm the body or the mind.

3. lack of flexibility and adaptability

A “forbidden” training regime can lead to important aspects of training not being tried out. This limits the versatility that is often necessary to overcome plateaus or make new progress. If you only ever do the same things, you won’t see any progress in the long term. Prohibitions prevent people from functioning in everyday life. Instead: Treatments and training should be a dynamic process that adapts to the development and needs of the individual.

4. promotion of extreme positions

Another problem with bans is the tendency to take extreme views. Instead of taking a balanced approach, some tend to think in black and white categorizations: “This exercise is bad and should never be done”, “Fat should be completely eliminated from the diet” or “Only very high weight training is effective”. Instead: Be open to new ideas. Always ask questions, listen and discuss, look for a solution together. Keeping up to date with the latest research findings.

5. risk of injury and chronic complaints due to incorrect alternatives

If certain exercises are prohibited, often no good and well thought-out alternative is offered. Instead of providing a safe and effective alternative to a prohibited exercise, this could lead to false compromises that even increase the risk of injury. If only a limited number of exercises are allowed, the body could be subjected to one-sided stress. Instead: Modify treatments and exercises. Do not leave out. Try to do fewer repetitions, incorporate more breaks, find other starting positions until you get better.

6. avoidance behavior and leaving the comfort zone

Physiotherapy and training should encourage you to challenge your body and push it to its limits (with caution). If you avoid certain techniques or exercises as a matter of principle, you prevent yourself from developing and learning new skills. Of course, some exercises are challenging and not everyone has the necessary strength or technique to begin with. However, the exercises that cause problems may be the ones that are the cause of the condition. Instead: Pushing the limits, stepping out of your comfort zone, always taking your health into account.

Conclusion: Treatments and training should be based on knowledge, not on prohibitions

Instead of establishing a rigid set of rules with prohibitions, the focus should be on understanding and individually adapting treatment and training techniques and making recommendations. A flexible approach based on goals, abilities and health condition is the key to sustainable success.

Ultimately, training is about learning and development – and this is best achieved without restrictions that hinder the natural development process.

Best, Anneke & Oliver

No 0815 exercises, no prohibitions, no boredom! But lots of fun, concentrated knowledge and lots of helpful tips for you as a mom after giving birth. With our #postnatal course we want to show you what really matters when it comes to getting back into sport after a #birth. Whether 4, 6 or 15 weeks after birth – you are very welcome!

What does regression actually mean?

Postnatal recovery refers to the process by which the body aims to return to its original state after pregnancy. This mainly affects the uterus, which shrinks again after the birth, but also other physical changes such as the contraction of the abdominal muscles and the state of hormonal balance. This can be achieved with postnatal training, which serves to strengthen the muscles and help the body to recover. At Physio Restart we offer a postnatal group course as well as individual training and treatments.

Our postnatal group course is aimed at women after giving birth. The aim is to work together in a group to strengthen the body after pregnancy and birth and get it back into shape. We do specific exercises to strengthen and relax the pelvic floor, abdominal and back muscles, but also learn important theoretical content for returning to everyday life and sport. It is also important to deal with the emotional aspects and to understand that many symptoms and difficulties after pregnancy and birth are often not normal in the long term and can be treated.

Why do we recommend a postnatal course?

It is important to restore the physical changes, the muscles and the connective tissue, especially in the abdominal and pelvic floor area. This can help to prevent problems such as incontinence and restore the body’s long-term performance. Training in a group is fun and makes friends.

How is the course structured?

Our experienced course instructors offer a variety of advanced content to support the recovery process after an abdominal and vaginal birth. Using theoretical knowledge, test batteries and exercises, she accompanies you back to everyday life and sport. She attaches great importance to scientific findings and in particular to the fact that each and every one of you is monitored during your exercises.

What other offers do we have?

Physio Restart offers you an abdominal and pelvic floor check-up in which you can be examined and individually advised in a single session. Read more about this here. We also offer various physiotherapy services for other needs as well as subscriptions and other group courses at Fitness Luxor.

In this article, we would like to introduce you to the wound healing phases and treatment options for a scar after an abdominal birth.

In the healing of this tissue injury, a distinction is made between four phases that contribute to wound healing: the hemostasis, inflammation, proliferation and remodeling phases. We explain each one below.

An abdominal delivery, also known as a caesarean section or caesarean section, is a surgical method of delivering a baby. The baby is delivered through an incision in the mother’s abdominal wall instead of through the vaginal birth canal. There are many reasons for this type of delivery, which we will not go into in detail in this article.

Anneke gave birth to her first child in this way in June 2024 and can now also give you treatment recommendations from her personal perspective.

During surgery, the incision in the lower abdomen results in a scar that requires treatment after delivery. This aims to promote healing , relieve pain , avoid complications and improve the cosmetic appearance . So it’s also important for you as a mom to look after yourself so that you can take care of your little miracle. We explain below what measures can help you.

Immediately after the operation, your scar will be covered with a large plaster for the time being. There are stitches in the inner and outer area, which nowadays usually dissolve on their own and should otherwise be removed approx. 10 days after the operation. You can remove the cover (also with the help of the midwife) at the latest when the stitches are removed. There are various smaller plasters that you can use afterwards. You can use waterproof plasters for showering , but this is not absolutely necessary. You should avoid bathing for the time being, as well as bathing in public waters (the latter anyway due to the lochia, the wound secretion of the uterus, which manifests itself as vaginal bleeding for a few weeks).

Wound healing phases

Haemostasis (a few hours):

The incision causes bleeding. Blood vessels contract in order to minimize and stop the bleeding. Various cells and proteins are involved in this process.

Inflammatory phase (a few days):

Once the bleeding has stopped, the blood vessels dilate again and the immune defense is activated by the metabolism. The affected area may swell and redden. Bacteria are flushed out of the tissue by the body’s own cells.

Proliferation phase (a few weeks):

New blood vessels and tissue (collagen) are formed and scar tissue develops. During this time, it is important to find the right balance between relief and stress so that the injured area regains its functionality without becoming inflamed or sticky again.

Remodeling phase (up to two years):

The final phase is the longest. It can take up to two years until the new tissue is fully formed and consolidated.

Scar care

If there are signs of infection, such as prolonged redness, swelling or pus formation, the scar should be examined by a specialist. Regular follow-up examinations by your midwife or physiotherapist can ensure that the healing process is monitored.

 

Cleanliness:

Keep the scar clean, sterile and dry for the first few weeks to avoid infection.

Gentle cleaning:

Only use water to gently cleanse the scar. It is usually sufficient to simply run the water over the scar while showering.

Drying:

After showering, carefully dab the scar with a clean towel or allow it to air dry properly.

Cooling:

A cooling pad can relieve swelling and pain. Never use one straight from the freezer, as this can have a negative effect on wound healing as the vessels contract due to the intense cold!

Scar creams or gels:

Products such as creams or gels can improve the appearance of the scar. You can gently massage the tissue after the stitches have been removed. We recommend the products from Decalys – scar-free skin regeneration.

Plaster:

There are silicone plasters that you can stick to the scar after giving birth. You can also use the products from Decalys – scar-free skin regeneration.

Sun protection:

Protect the scar from sunlight, especially for the first two years, as UV rays can darken the scar tissue. Use sunscreen with a high sun protection factor, even if the scar is covered in the sun.

Treatment

 

Physiotherapy:

In all cases, physiotherapy may be recommended to improve mobility and prevent and release scar adhesions. At Physio Restart, we use kinesiotape and cupping glasses as well as manual techniques and exercises for stretching and stabilization.

Kinesiotape:

You can use a tape application after the stitches have been removed. The tape has a decongestant effect and can reduce the firmness of the scar tissue. We physiotherapists can also help here.

Laser:

Your postpartum midwife can offer you treatment with the CO2 laser quite early on. Small pulses of energy can promote the stimulation of new collagen.

Massage:

After the stitches have been removed and the scar has healed externally (4 weeks at the earliest), a more intensive massage of the scar can help to promote blood circulation and make the scar tissue (collagen) more supple. You should massage in different directions and also pluck the scar with your fingers. Include the tissue above and below the scar. Massaging the entire abdominal wall helps to restore the internal organs and the entire fascia.

 

Important: We recommend that you always take breaks with the plaster and tape so that the scar can be treated with the other measures and also gets air. For example, you can use the plaster for 3 days, leave the scar free for 1-2 days, massage it and then use the tape for 3 days.

Do you have any questions or need support? Get in touch with us.

Author:

Anneke Penny

References:

Wallace HA, Basehore BM, Zito PM. Wound Healing Phases. [Updated 2023 Jun 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470443/

NEW HOME

Birth preparation is important for you as parents-to-be to prepare yourselves physically and emotionally as a couple and as individuals for the birth of your child. This can take place as part of group courses or individual sessions .

Anneke, CEO of Physio Restart, would like to tell you from her own experience how she prepared for the birth of her first child, partly together with her husband but also with other people. She would like to point out that this was her personal experience, which depended on her current mental and physical condition. Anneke was very fortunate to be physically free of major ailments, perhaps also as a result of her knowledge, regular exercise and healthy diet. We recommend that you consider which content is relevant for you and possible at the time .

 

Anneke:

For birth preparation, you may want to seek help from your gynaecologist, midwife, doula, specialized physiotherapist, osteopath or other specialist disciplines. It is important to know at all times how you and your baby or babies are feeling in the womb so that you can implement or omit the following measures accordingly.

 

Preparation already begins when you are trying to conceive. In this article, however, I am mainly referring to the 3rd trimester of pregnancy.

What can you do (together with the people around you) so that you (you) are stronger going into the birth and the time afterwards?

 

Where can I obtain prenatal care?

 

1. a birth preparation course: A great idea to get information about the birth process, birthplace (infrastructure, staff and mission statement), breathing and relaxation techniques and to meet other parents-to-be. Zurich offers a variety of options, from purely informative lectures to practical events in your chosen place of birth, as well as fitness classes on land and in the water.

 

2. in therapeutic sessions: Your treating doctor may give you a prescription for physiotherapy, osteopathy or chiropractic. Often due to complaints that you may have mentioned. The costs are fully covered by basic insurance from the 13th week of pregnancy. At Physio Restart you can book both, i.e. you can book appointments without a prescription and get the costs reimbursed by your supplementary insurance if necessary.

 

3. on social media, books, forums, podcasts: there are certainly great offers that you can consume easily and conveniently from home and on the go, but I recommend taking a close look at the information you are getting involved with. It’s certainly not a good idea to google and take the opinions and advice of other mothers online as a reliable source. Even your own mother or mother-in-law may often give you precocious advice. But books like Baby Years, The complete Australian Guide to Pregnancy and Birth, Midwife’s Consultation or podcasts like Keleya, From the Beginning or The Peaceful Birth are some that I have found valuable. In the end, however, the most reliable source remains your doctor, therapist and midwife. By the way, I have written an article in the Mama Guide from Let’s Family and am planning another one for the Baby Guide. You can get these books in doctors’ surgeries and hospitals, they are usually included in the mommy and baby box that they give out for free. But take a look at my story and publications here here.

 

What content is important for birth preparation?

 

I divide them into theoretical and practical:

 

Theoretical birth preparation

1. What happens in and to my body in the last few weeks of pregnancy? How is the baby developing? Which physical and mental changes are normal for me and which are less so?
2. How do I prepare my home and my environment for the arrival of the new addition to the family?
3. How do you decide which type of birth is possible? When is an abdominal birth (caesarean section) considered?
4. Where and how can I recognize that the birth is about to start? When do I contact my midwife and/or the place where I am giving birth?
5. What is the normal birth process and what other scenarios are possible?
6. What role does my birth companion play? Do I even want my partner or someone from my family or circle of friends with me? What is important to me?

 

Practical birth preparation

By the 3rd trimester at the latest, you should know the pelvic floor in all its forms. Where it is located, what function it has when and where and how you can relax it at the end of pregnancy and during childbirth and tighten it at other times.

Practice various breathing techniques that will accompany you towards the end of your pregnancy and can then support you during the birth and postpartum period.

You can do wonderful mobilizing exercises with your partner to open your pelvis and familiarize yourself with birth positions.

Muscle-strengthening and endurance training can also often take place up to the birth and give you enough energy and strength to keep going. There are now some studies that report that the birth time is shortened and the recovery for you and your baby is faster afterwards. I am also still active (currently in week 39+0) 5-6 per week in my practice and in the fitness center.

By massaging and stretching around your perineum, vagina and anus, you can familiarize yourself with this area of your body, which unfortunately has often been taboo until then. You can also do the massage (from week 32-34+0) and stretching with a balloon (from week 36+0) in pairs, always in consultation with your doctor.

Your diet should be balanced and predominantly healthy and tasty throughout your pregnancy. A few weeks before the birth, you could follow a Louwen diet. This is not a diet per se, but rather an avoidance of foods high in sugar and carbohydrates so that you can regulate your blood sugar levels and thus release the receptors that are important for the natural onset of labor.

 

Ultimately, it’s about preparing yourself mentally and physically for the birth and strengthening your confidence in your abilities as an expectant mother. Your pregnancy is unique and an absolute miracle. Listen to your needs, take sufficient rest breaks and don’t let yourself be influenced by other opinions or supposed role models. Don’t put yourself under pressure if the day doesn’t go as planned. Pregnancy, birth and the time afterwards should be a journey with pleasure and not a ticking off of to-do lists! In the end, you certainly did your best.

If you are looking for physiotherapeutic support during your pregnancy and would like to have the above questions answered, you can contact us at any time with your concerns or book an appointment directly. book an appointment.

Author:

Anneke Penny

Endurance training, also known as cardiovascular training, refers to activities aimed at improving endurance and the cardiovascular system. It includes movements such as running, cycling, swimming and other forms where the heart rate increases. According to the health organization WHO, 150 minutes (2.5 hours) per week is recommended.

Do you have questions about your individual endurance training? Or even received a doctor’s recommendation to do one? There are various reasons why a doctor may give you this prescription: for cardiovascular complaints or after heart surgery, for lung diseases, for weight control (both overweight and underweight), for mental impairments (e.g. depression, burn-out) and many more. At Physio Restart, we are happy to support you during your rehabilitation or prevention phase.

Here are some important points you should know about endurance training

1 Cardiovascular function: Endurance training increases your heart rate over a longer period of time and strengthens your cardiovascular system. This naturally improves your heart health.

2 Endurance: Regular endurance training improves your body’s ability to work for longer periods of time without feeling fatigue. This can be noticeable in various areas of life, from sporting activities to everyday tasks.

3 Fat burning: Endurance training is an effective way to burn calories and lose or maintain weight. It boosts your fat burning and can help reduce body fat by stimulating your metabolism.

4 Stress reduction: Regular endurance training can reduce stress and improve your general well-being by promoting the release of endorphins, which are responsible for your sense of relaxation and well-being.

5 Mental health: There is strong evidence that regular endurance training can improve mood and even help to alleviate symptoms of depression and anxiety. Hormones such as dopamine, endorphin and serotonin are released, which lead to your feelings of happiness.

6 Prevention of physical complaints: Problems and pain associated with your posture, for example, can be reduced. Appropriate endurance training helps to regulate your back pain, especially if your working day is predominantly sedentary. Even small interruptions of just a few minutes a day can help to provide your muscles with sufficient blood flow.

7 Social interaction: Endurance training is also ideal when done in company or in a group. Cycling tours, Nordic walking but also joint hikes with inclines promote a social get-together and can also increase your self-esteem, especially if you find it difficult to perform sports.

Types of endurance training with different metabolic activation

Depending on the intensity, you make use of a different metabolism that depends on your individual heart rate. Your metabolism involves a series of complex biochemical processes that take place in your cells and are responsible for converting nutrients into energy and maintaining vital functions.

1 Aerobic area (fat): Nutrients such as carbohydrates, fats and proteins are converted into energy (ATP) using oxygen. You can talk normally during activity, breathing is almost normal, only slightly more difficult. Fats serve as your main source of energy in aerobic metabolism, especially at lower intensities and longer durations of activity.

2 Anaerobic area (carbohydrates): For shorter, more intensive loads, the sole supply of oxygen is not sufficient to provide you with energy. Glucose is therefore obtained from carbohydrates, which produces lactate (lactic acid). You will probably no longer be able to talk fluently, only a few words and more intensive, shorter and shallower breathing will occur.

Structure training

To maximize the benefits of endurance training, it is important to develop a balanced exercise routine that combines regular endurance exercises with strength training and mobility exercises. It is also advisable to work with a therapist to develop your individual training plan that meets your own needs and goals. Endurance training can be divided into different intensity levels, from light to high intensity. Choosing the right training plan depends on your individual goals, fitness level and health. As with all training, recovery is also crucial for endurance training. Sufficient rest between training sessions is important to avoid overload and injury.

Important: Endurance training alone is not enough for your health. Strength exercises should also be done to stabilize joints, maintain bone health and prepare the muscles for the stresses and strains of everyday life.

Author:

Oliver Penny

The female menstrual cycle is a natural process in the body that usually lasts around 28 days, but can also vary (24-35). It comprises four main phases: Menstruation, follicular maturation, ovulation and the luteal phase.

Menstruation occurs at the beginning of the cycle (day 1 of bleeding is day 1 of the cycle), followed by the maturation of an egg in a follicle. Ovulation is the time when the egg is released and the luteal phase prepares the body for a possible pregnancy. If fertilization does not occur, the cycle begins again. The menstrual cycle is regulated by hormones such as oestrogen and progesterone.

Swiss Olympic 2020

Phase 1 Follicular phase

The follicular phase is the first phase of the female menstrual cycle. It begins on the first day of menstruation and usually lasts around 14 days, but can vary from woman to woman. Important: Day 1 is described as only the real bleeding, and not the brownish discharge or so-called spotting, which can occur a few days before. During the first phase, small structures called follicles develop in the ovaries, each containing an egg. Under the influence of hormones such as FSH (follicle stimulating hormone), a follicle matures and usually one of the eggs is selected for ovulation. The follicular phase ends with ovulation, when the selected follicle releases the mature egg.

 

Ovulation

Ovulation is the time in the female menstrual cycle when a mature egg is released from a follicle in the ovary . This normally occurs in the middle of the menstrual cycle, about 14 days before the start of the next menstruation. Ovulation is triggered by the rise in luteinizing hormone (LH), which causes the follicle to rupture and allows the egg to be released. The egg can then be absorbed by the fallopian tubes and is ready for fertilization by sperm. Ovulation is a crucial step in the reproductive cycle and a key factor in conception.

Luteal phase

The luteal phase is the phase of the female menstrual cycle that follows ovulation. It normally lasts around 14 days, regardless of the total length of the cycle. During this phase, the empty follicle from which the egg was released transforms into a temporary gland called the corpus luteum. The corpus luteum produces progesterone, a hormone that prepares the lining of the uterus for a possible pregnancy.

If fertilization has not taken place, the corpus luteum recedes, progesterone production decreases and the uterine lining is shed, leading to menstruation. However, if fertilization has taken place, the progesterone supports the implantation of the fertilized egg and helps to maintain the pregnancy until the placenta is sufficiently developed to take over this function.

 

Training

Cycle-controlled training refers to adapting the training plan to a woman’s menstrual cycle. Some research suggests that women respond differently to exercise during certain phases of their cycle and their performance may vary .

Follicular phase

In the first phase, women are often more powerful, especially in terms of strength/muscle building. Studies describe a 40-45% higher strength potential at this time. This is supported by the higher increase in the hormone oestrogen. It is recommended that training is organized so that intensive strength training takes place every two days or eight sessions in the first phase of the cycle. Of course, it is important to remember that the first few days of your period can also bring symptoms and the sessions may need to be adjusted accordingly.

Ovulation

Women are much more sociable in the days around ovulation, as nature can guarantee a possible pregnancy. Preventive training should include components such as stability and coordination, as the ligaments, muscles and tissue are somewhat more unstable and softer than usual at this time.

Luteal phase

In the second phase of the cycle, recovery sessions and moderate exercise are more likely to be tolerated. Strength training should not be the focus of training, but can still be carried out once a week or with a total of two sessions during this time. With the increased progesterone, the body temperature rises by approx. 2°C and metabolic activity increases.

 

Cycle-driven exercise takes into account hormonal changes in the menstrual cycle to optimize exercise and better support a woman’s individual needs and goals. However, it is important to note that the effects of the menstrual cycle on exercise can vary from woman to woman, and there is not (yet) enough consistent scientific evidence to provide clear recommendations for all women. It is advisable to listen to your own body and make training adjustments according to your personal needs, preferably with a specialized professional and all parties involved (trainer, therapist, family).

Swiss Olympic 2023

Nutrition

Cycle-controlled nutrition refers to the adaptation of nutrition to a woman’s menstrual cycle. During the cycle, energy requirements, hormone levels and nutritional needs can change. Some women report different preferences, appetite changes and metabolic variations during the different phases of their cycle.

In the follicular phase, which begins with menstruation, there may be a greater need for iron and protein to support blood loss and muscle recovery.

During the luteal phase, which follows ovulation, an emphasis on a nutrient-rich diet, particularly complex carbohydrates, may be useful to cope with the possible increased energy requirements and emotional changes.

It is important to note that needs vary from woman to woman, and there is limited scientific evidence to support specific recommendations for cycle-managed nutrition. Individual preferences and needs should be considered, and it may be helpful to work with a dietitian or health professional to develop an appropriate dietary strategy.

Do you have any questions on this topic? Do you need more information about your cycle, the associated training and/or do you have any problems? Please contact us info@physio-restart.ch.

Author: Anneke Penny

References:

1.Swiss Olympic. Women and elite sport. https://www.swissolympic.ch/athleten-trainer/frau-spitzensport

Webinar by SART Impact of the menstrual cycle on prevention and rehabilitation. 25.11.2023

2.Kiesner J, Eisenlohr-Moul T, Mendle J. Evolution, the Menstrual Cycle, and Theoretical Overreach. Perspect Psychol Sci. 2020 Jul;15(4):1113-1130. doi: 10.1177/1745691620906440. Epub 2020 Jun 15. PMID: 32539582; PMCID: PMC7334061.

3.Carmichael MA, Thomson RL, Moran LJ, Wycherley TP. The Impact of Menstrual Cycle Phase on Athletes’ Performance: A Narrative Review. Int J Environ Res Public Health. 2021 Feb 9;18(4):1667. doi: 10.3390/ijerph18041667. PMID: 33572406; PMCID: PMC7916245.

4.Rogan MM, Black KE. Dietary energy intake across the menstrual cycle: a narrative review. Nutr Rev. 2023 Jun 9;81(7):869-886. doi: 10.1093/nutrit/nuac094. PMID: 36367830; PMCID: PMC10251302.

5. https://www.nhs.uk/conditions/periods/fertility-in-the-menstrual-cycle/

6. https://my.clevelandclinic.org/health/articles/10132-menstrual-cycle

The triathlon is a demanding sport that requires endurance, strength and mental fortitude. It combines swimming, cycling and running to create an exciting and challenging competition. In this article, you will learn more about the different distances, the equipment and the basic aspects of triathlon. We also want to give you a brief overview of what Physio Restart has in common with the sport of triathlon: Oliver has been an enthusiastic participant for a few years now.

1. distances: The triathlon offers various distances to suit both beginners and experienced athletes. The disciplines are usually structured as follows:

• Sprint distance: 500-750 m swim, 20 km bike, 5 km run
• Olympic distance: 1.5 km swim, 40 km bike, 10 km run
• Middle distance (also known as “70.3”): 1.9 km swim, 90 km bike, 21.1 km run
• Long distance (also known as Ironman distance): 3.8 km swim, 180 km bike, 42.2 km run

2. equipment: The right equipment is crucial for a successful triathlon:

• Wetsuit: Helps with swimming and provides buoyancy. Depending on the water temperature and distance, a decision is made as to whether to swim with or without a wetsuit.
• Bike: A light, aerodynamic bike is an advantage. The prices for a good bike can quickly slip into the 5-digit range.
• Running shoes: Comfortable, well-padded shoes make running easier. Carbon shoes may be useful at certain speeds.
• Triathlon one-piece suit: A special suit that can be worn in the water as well as on the bike and while running.
• Goggles, helmet, sun cap if necessary, race number: Essential accessories for the race and the race number can be obtained on site shortly before or on the evening before the race. You will need to purchase the appropriate tape to attach your number in advance and bring it with you.

3. transitions: The changes between the disciplines are referred to as “transitions”. T1 is the change from swimming to cycling, while T2 is the change from cycling to running. Efficient transitions can save valuable time, so the triathlete has done their thing properly on the spot.

4. training and preparation: Triathlon training requires a balanced mix of swimming, cycling and running. Here are some important aspects of training:

• Brick training: Combine cycling and running to prepare for the transition between disciplines.
• Interval training: Improve your speed and endurance with intensive intervals.
• Long-distance training: Get your body used to the longer distances of the respective disciplines.
• Mental training: Develop mental strength to overcome challenges during the race.

5. nutrition and hydration: During the triathlon, adequate nutrition and hydration is crucial. Experimenting with different energy bars, gels, salt tablets and drinks in preparation training will help to find out what suits the athlete best. Breakfast before the competition should also be carefully considered, as should sufficient carbohydrate intake the evening before.

Oliver’s achievements to date

Where / What Discipline

Tour de Carinthia

Road bike 468km – 8800hm – 15h

Result in his age group 51

Total result 95

Eberbach

swim 700m

cycling 22.2km

run 6km

Result in his age group 4

Total result 23

Zurich

swim 1.5km

Cycling 40km

run 10km

Result in his age group 4

Total result 117

Schaffhausen

swim 2.3 km

Cycling 35.4km

run 9.8km

Result in his age group 9

Total result 33

Zurich

swim 1.5km

Cycling 40km

run 10km

Result in his age group 29

Total result 58

Schaffhausen

swim 4km

Cycling 70.7km

run 19.8km

Result in his age group 7

Total result 13

Zurich – Zermatt

Road bike 280km – 6000hm

Result in his age group 5

Total result 9

Training overview from Oliver

Fall / Winter: 5-6x/week on the indoor bike roller with Zwift (training app recording) 1-3h

Swim 1-2x/week 0.5-1h

Spring / summer: in good weather, cycle to work 5 times a week for 45 minutes each way

2x/week 10km runs at low intensities

1x/week >10km or <10km but high intensities

Cycle 200-300km 1-2x/week

Swim 1-2x/week

The triathlon offers a unique opportunity to overcome physical and mental limits. Whether you are a newcomer or an experienced athlete, the challenge of the triathlon can be incredibly rewarding. If you commit to varied training sessions, good equipment and a smart race strategy, you will experience the fascination of this demanding sport up close, just like Oliver, and Anneke as team supporters on the roadside and poolside.

Book an appointment here.

Author:

Oliver Penny

The Functional Movement Screen (FMS) is a screening tool used in the field of sports medicine and physiotherapy to assess a person’s movement patterns and identify possible imbalances or limitations. It is designed to capture basic movement patterns that are essential for normal daily activities as well as athletic performance.

The FMS consists of a series of seven basic movement tests that assess mobility, stability and symmetry of movement. These tests are:

1. Deep squat: Assesses bilateral mobility and stability of the hips, knees and ankles as well as core stability.
2. Hurdle step: Evaluates the bilateral mobility and stability of the hips, knees and ankles during a step movement.
3. Inline Lunge: Assesses the unilateral mobility and stability of the hips, knees and ankles as well as trunk stability.
4. Shoulder mobility: Assesses the bilateral mobility and stability of the shoulders and thoracic spine.
5. Active Straight Leg Raise: Evaluates the mobility of the thigh muscles and hips while maintaining core stability.
6. Trunk Stability Push-Up: Evaluates trunk stability and upper body strength.
7. Rotational stability: Evaluates the multiplanar stability and mobility of the trunk and shoulders.

Each test is scored on a scale of 0 to 3, with 3 indicating optimal movement and 0 indicating pain or inability to perform the movement. The results of the individual tests are then combined to give an overall FMS score.

The main purpose of the Functional Movement Screen is to identify movement disorders or imbalances that could increase the risk of injury or impair performance.

It helps professionals such as physiotherapists, athletic trainers and strength and conditioning specialists to develop appropriate training programs and corrective strategies tailored to an individual’s specific needs.

It is worth noting that the FMS is not a diagnostic tool, but a screening tool.

If problems or limitations are identified during the screening, further assessment and evaluation may be required to determine the underlying causes and develop an appropriate treatment plan. We will be happy to refer you if additional medical intervention is required.

You can find more information about the FMS here: Functional Movement Systems.

Are you interested in a measurement? Feel free to contact us.

Author:

Anneke and Oliver Penny

New at Physio Restart: Performance analysis. We would like to expand our physiotherapy services by assessing your mobility, strength and posture using various methods so that we can treat you more precisely and also optimize your health and training design.

An intervention includes screening using Kinvent: deltas, pull and push. With the help of these three devices, we can now measure your performance, your training progress and your rehabilitation and prevention success. We will introduce you to all three in this article. In the last section, you can find out how to register and what the measurement process looks like.

Kinvent is based in France and offers various products that can make our collaboration with you as a physiotherapist even more precise, varied and successful.

1st K-Deltas Elite Force Plates

These are two measuring plates that measure your jumping ability and load distribution on your feet or hands during different positions. For example, during an upright two-legged stance, we can assess how you distribute your body weight on your feet and where on the foot you place your center of gravity (more in the front, middle or back, inside or outside?). We can do the same for the one-legged stand or with eyes closed. It is also possible to perform jumps. Jumps from the squat position, jumps from an elevation, one-legged jumps and landings and more.

By using it, we can evaluate your rehab progress: where are you currently at? What deficits can we still take into account? How close are you to returning to sport and competition? We can also screen you preventively to identify any asymmetries that you should take into account in your training.

https://physio.kinvent.com/product-page/k-deltas

2. k-pull

This device is attached to a belt and a fixed object (on the training area at fitness luxor). The latter makes it possible to test your maximum strength potential without us therapists having to offer resistance. Using various movements, we can assess your isometric strength, your strength ratios in a lateral comparison (for example, left and right front thigh muscle) and endurance. The K-Pull is particularly suitable for the lower extremities. As an evaluation, you receive the measured strength, but also data on the second in which you reach your peak, when you tire and how you stand in comparison to people of the same age, height and weight.

https://physio.kinvent.com/product-page/k-pull

3. k-push

The lightweight and versatile K-Push is designed to meet the need for quick assessment. With its accessories, the maximum and isometric strength of almost 40 muscle groups can be measured without the need for an object. We tend to use it for the upper extremity (trunk, shoulder, arms and head).

https://physio.kinvent.com/product-page/k-push

Measurement procedure

You can make an appointment for the measurement by booking online(here). Click on: Performance analysis. We ask you to let us know in advance which test you would like to take. You can specify this in your booking or let us know separately by email or on site. We ask that you warm up thoroughly before the start of the appointment, as the measurement will include questions about your maximum strength potential. Use the endurance area on the first floor and choose a machine suitable for the muscle group being tested. Your warm-up should increase your heart rate (HR average of approx. 50-60% of your maximum heart rate). We will send you a document with further information by email in advance.

Do you have any questions? Feel free to contact us.

More information about the devices: Homepage – Kinvent Physio.

Author:

Anneke and Oliver Penny

Physio Restart attended the 38th annual congress of the Society for Orthopaedic Traumatologic Sports Medicine (GOTS) to find out about the latest findings in sports medicine .

The congress is a meeting of all members and interested persons in sports medicine, including doctors, physiotherapists, trainers, sports scientists, nutritional therapists, etc. Over three days, various topics will be addressed, with experts giving an insight into their work and the state of scientific research. There will be discussion rounds and the opportunity to expand your network. There will also be an opportunity to get to know the latest products that may be relevant to us in practice at the industry exhibition. We also find it exciting to look into the work of the doctors so that we know which surgical techniques they may use on our patients.

Below you will find a brief overview of the program items.

Top topics

• Sports injuries from head to toe – from prevention to diagnosis and treatment
• Focus: cycling, triathlon, Olympic martial arts
• “My most difficult case in sports orthopaedics/traumatology”
• Sports physiotherapy and sports science
• Competition medicine
• Ethics and safeguarding in sport

Further highlights

• Updates from the GOTS Committees Spine, Prevention, Pediatric Sports Orthopaedics, Register, Functional Diagnostics, Muscle/Tendon, Concussion, Disabled Sports
• GOTS meets Scientific Partners
• Top international athletes
• Hands on workshops and instruction courses
• Nutrition strategies in sport
• Re-Live-Surgery

Another highlight for us was the visit to the Coque: Coque Luxembourg – piscine, sauna, fitness et hôtel au luxembourg with the Young Academy (picture below).

The Coque is the national sports and cultural center in Luxembourg. At the moment, they are still building the recovery center, where there will be a cold chamber, saunas and other facilities to promote regeneration. At the Coque, we were given an insight into performance diagnostics: into the strength area with instructions on how to perform the squat with a barbell, into bike training in an altitude chamber, how to measure lactate on the ergobike and how to set up change of direction training as a return to sport on the speed court.

Right: Speed Court. Practical tool for training control when it comes to returning to sport (braking, accelerating, changing direction)

Left: Strength area where we learned / repeated the techniques of the squat with the barbell.

On Thursday, Anneke took part in the first aid course, which gave her theoretical and practical instructions on resuscitation and defibrillator training on the sports field (we still hope never to have to use this, of course). It is important to know what we can do in an emergency and we therefore see it as our duty to regularly educate ourselves, especially about the practice.

Finally, we visited the IRONMAN 70.3 Luxembourg – Région Moselle – Anything is Possible. Oliver took part as a relay team, together with Nicole and Elena. Oliver completed the 3rd discipline, running, after he had already ridden his racing bike from Basel to Luxembourg on Thursday and gone on a racing bike tour with the former Tour de France and Tour de Suisse winners on Saturday. The result of the Ironman was great, 5:14:47, 428th place. of the 2,078 participants.

Author:

Anneke and Oliver Penny