Tag: wellness

Understanding Hormonal Fluctuations in Women’s Fitness

Published on by Caroline WhitehornLeave a comment

Last week, I attended a women’s health conference. There were speakers from different elements of women’s health such as endometriosis, specialist menopause doctors and lifestyle coaches. It was great to get the most up to date information about these issues.

What is possibly most useful to my sphere of interest is the advice regarding exercise and the effect on the menopause or perimenopausal woman. It is interesting in the subtle changes that can happen where the same work out you have done for years or the same activity such as running or cycling may not cut it, when it come to weight management and maintaining fitness. Of interest to me is the effect on tendons the rollercoaster ride of hormones has.

This rapid moment by moment change in hormones explains why one day a peri/menopausal woman feels fine and the next feels awful or achy or low in mood. Our hormones don’t plummet in a linear decline over a gradual period of time, neither do they drop off a cliff in one fell swoop. No they, drop and rise and plateau and drop again. This could be over a few months or few days then even out.

I think this is worth understanding when it comes to the ability to maintain regular physical activity and healthy balanced eating habits. If you can imagine, feeling great one day so you go and work out or have the run or bike ride, have a lovely balanced meal then the next day your oestrogen has dropped. You feel basically p***ed off at the world. Who wants to exercise in that frame of mind? Will you choose the lovely nutrient filled buddha bowl for lunch or the carb and starch loaded bread roll and chocolate bar?

Then to add to the fun, we chuck in the loss of resilience of tendons. So your now erratic training or exercise sessions are inconsistent and not gradually loading the tendons, because you had 4 days off then a day exercising then another few days off. The impact of this putting you at increased risk of injury is now increasing.

This is often where I meet women, Is they have a tendon issue and wallowing around in the weeds trying to work out what went wrong and how they can resolve it. I will talk with them a lot about consistency and how tendons love predictability. They don’t enjoy or respond well to sudden loading or persistent inactivity. This is where shoulder (rotator cuff issues) pain can start or achilles or lateral hip pain. Together we work out how to manage the pain, modify activities and progress to return to previous activity levels.

Remember tendons don’t like surprises!

Dealing with hip pain – 3 ways to tackle it

Published on by Caroline WhitehornLeave a comment

Recently, I was working with a lady called Jenny. She came to see me because she was gradually getting pain around her hip and it went down the thigh a bit. She had been through a bit of a rough time. After hitting 48, she was noticing she was gaining weight. Jenny felt this was a combination of factors. She had changed jobs which meant she had to drive longer to work and was sitting at work more. In addition, due to the training required for her new role she was not able to continue her usual exercise routine. She self-reported that it wasn’t an intense work out but she had been walking for 30-40 mins most days and had a small weights routine at home. Jenny also said she thought she was beginning to show signs of being peri-menopausal. Whilst we were talking, she confided in me that the hip pain she was getting worried her, now she was 48 maybe she was starting to get arthritis in her hips.

As we continued the appointment, and I assessed I was able to reassure her that the pain was unlikely to be arthritis and more likely to be lateral hip pain or tendonitis or a bursitis (this is either an inflamed tendon around the hip or bottom or an inflamed bursa). I was able to work on her stiff back and movement through her joints and tight muscles. From here we worked out an exercise rehab programme for her to do.

I love these sorts of interactions, where someone has a fear or concern and through assessing and talking, we can work out the issue and I can give reassurance, treat and provide useful, applicable advice, exercises and management techniques. I also had the time to explain that a big part may be her lifestyle change. Due to her reduced activity levels, she may have irritated the soft tissues. We talked about things she could do to avoid this. We also discussed that this is a common issue for women around the time of menopause. We looked at different ways the menopause and change in hormone balance can effect the musculoskeletal system. (Name was not real name)

3 Ways to head off this sort of lateral hip pain can include:

Exercises that get your gluteal (buttock) muscle working

Avoiding sitting for long periods especially in low seats

Break up long periods of sitting!

Stay in touch to read the next article about how menopause can contribute to aches, pain and sports injuries.

My philosophy of care

Published on by Caroline WhitehornLeave a comment

Let’s take a break from talking about sleep, food and activity goals. I am going to bring it back to why I do what I do the way I do!

I like to spend time with my patients. My appointments are longer than typical health care practitioners in similar fields such as other osteopaths, chiropractors or physiotherapists. Having worked in this industry since 2007, I have heard a lot of feedback from patients about what they value, often they have felt unheard or rushed by a health care practitioner. I have come to learn that a lot of pain management and pain resolution starts when a patient feels heard. This works in two ways;

One, the patient feels they have the time to say what they want to say about their experience of pain.

Two, as a practitioner it allows opportunity to really understand someone’s pain and their personal values and attitudes towards life, lifestyle choices and any treatment or rehab I suggest.

I see what I do as a partnership with the patient. We discuss and share the decision making of how to manage and treat. I want patients to feel empowered by what we discuss and how I treat. This enables me to help a patient develop the tools to often help themselves and really understand what is going on with their injury or issue.

My initial appointment, if we have never met, I allow an hour. This gives time for the niceties and a full assessment with lifestyle choices and previous history included, It allows for a thorough physical assessment. This may include special tests, recognised by any healthcare practitioner, range of movement, replicating things that aggravate the issue. Finally, I summarise what I have found or assessed for, and treat with manual therapy (AKA hands-on treatment ) and advice on appropriate rehab exercises to do. Because I allow a good length of time we have chance to really get to grips with more nuanced lifestyle choices and personal values.

A follow up appointment is up to 40 minutes. I give this time to be able to really check in with the patient and understand what has worked, how they feel they have improved and how the exercises went. I see a lot of people that in life just feel rushed and enjoy wanting to provide that extra time. This is about patients being individuals and having their own story to tell and I want to hear it.

SLEEP

Published on by Caroline WhitehornLeave a comment

In appointments, I tend to bang on to patients about how important sleep is. Lots of people realise at a superficial level it is important because we have all had that late night and felt tired or irritable the next day. But over time a sleep deficit can cause longer term problems to our general health and recovery from injuries.

The sleep we get between 10pm and 2am are key for repair. This is repair from injury, from day to day functioning of our bodies and organs creating free radicals which can be unhelpful lingering in our body. This time is optimum for beneficial hormone secretion such as growth hormone which is key in repair and growth or adaptation from exercise. A one-off night of poor sleep results in reduction of healing capabilities so over a consistent picture of repeated nights of low sleeping hours will magnify this.

Sleeping for more hours, the current recommended amount is between 7-8 hours, allows more sleep cycles including deeper more restorative period of sleep.

There are some severe issues affecting sleep and this often needs to be supported by a medical professional but if you are someone that recognises you have poor sleep habits but not due to a medical issue then some of these tips may be helpful to you and help you recover from injury, feel more refreshed and alert day to day.

Tips for healthy sleep:

Wake up at the same time every day – work out what time that means you need to go to bed each night. Often waking the same time every day helps create a bed time because if you aren’t having lie-ins (to make up for the missed sleep) then you can have a wake up and a bed time. As an early morning runner, I have quite consistent wake up routine, evenings have been more difficult just because having children and wanting some ‘grown-up’ time means my bed time slightly changes. 

Reduce caffeine intake after midday or, if you think you are particularly sensitive to it, after 10am. After 6 hours of consuming caffeine half of it is still present in the body. 10 hours later it may not have cleared entirely. I love a good coffee. I now limit myself to two cups in the morning before midday. I don’t think I am particularly sensitive to caffeine so I don’t seem to get affected by a late morning one. But I do know people that have one cup on waking and that is it!

Avoid screens for an hour before bed time – try not to use your phone, computer or TV. Give your brain a break from that rapid movement, flickering lights, constant feed. Also the light from screen acts like daylight on our brains and helps it believe it is daylight and time to still be awake. This can then have an effect on melatonin production which then effects getting off to sleep and remaining asleep. I find this one can be particularly difficult because I like to watch films and series in the evening. What I have found though is if I give myself 45 mins of screen free time before bed, by prep for bed and then reading I can manage that.

Limit alcohol – I like a drink in an evening but what I personally found was that if I had a glass of wine several nights in a row (and I am talking a 175ml size, not consuming excessive) I was waking during the night for no particular reason. When I made the connection and reduced it so only had a glass or two at the weekend my sleep improved significantly. But what I did notice is it wasn’t immediate. I stopped drinking for Dry January and I would say it took a good week or so to consistently have better nights sleep. So, don’t immediately assume that because you didn’t see a difference two nights in that it isn’t the alcohol. Hang on in there.

Avoid or limit naps – I love this one! if only I had time for a nap!! But I think this is probably more of an issue if you are trying to organise your sleeping pattern and it is a bit all over the place. Trying to establish a routine can throw thing off a bit, so if you are working on waking at 6.30am every morning but you still go to bed at midnight this may be how you manage by napping. If so, limit the nap to less than 90 mins (ideally no more than 20-30mins) and not in the mid-afternoon.

Being physically tired is important. Do you get enough exercise or activity during the day? Are you limited by injury or illness in what activity you can do? Is there something stopping you get out for a 30 min walk or bike ride? Can you do exercise at home, a YouTube video or some resistance exercises using body weight. Anything that gets your body active through the day.