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Barcelona Well Woman Clinic moved to a new, beautiful and bigger centre in December. The inauguration party is on February 2nd. Come and celebrate with us! ((Confirmation of attendance needed, see contact details on flyer)

Course for Physiotherapists/Osteopaths in Málaga, Spain in 2012 (Mod 1-3)

Thanks to the new colaboration Fisioplus Pilates + Grupo Rehab we will have the pleasure to offer a course in Fuengirola, Málagain spring 2012.  The three modules will be distributed between March and June. Don’t miss out!

More information

Dates

Don’t let stress or pain get in the way of a good performance!

Fisioplus Pilates and The Vital Touch are collaborating to offer this very special package to performance professionals.

Discover how the new blend of  expert Physiotherapy and Therapeutic Massage will help you to get the most out of your performance, being a dancer, musician, athlete, performance artist, actor…  Click here for more information

Zoe Qually, Pilates Union’s Pilates instructor of the Month, April 2011

Read interview!

As a Physiotherapist with a particular interest in sports injuries and the clinical application of Pilates, marathon season is one of my busiest times of the year!

Across Europe tens of thousands of runners will have decided to don their trainers and begin the gruelling training regime required to successfully complete a marathon. The majority of my clientele are based in Barcelona or London so the two key dates are 6th March and 17th April, respectively. In training terms this means that currently every weekend will be dedicated to a “long run” of at least 90 minutes, on top of 5 times a week training runs of varying times, speeds and distances. This year’s London Marathon is sponsored by Virgin and they have a great training programme put together for runners of all levels. Check out their official site for more info (http://www.virginlondonmarathon.com/training-centre/training-advice/training-plans/).

Even for seasoned runners, the strains and pains caused by such a demanding training schedule start to rear their ugly and unwelcome heads and many runners find they need a bit of extra help from a Physiotherapist. Physiotherapy is vital in these final stages of training to avoid minor overuse strains becoming more troublesome injuries. Classic problems that I see commonly in runners, particularly during the couple of months prior to a marathon, include ITB syndrome (ilio-tibial band), low back pain, knee pain and groin pain. All of these problems are, in the majority of cases, due to muscle imbalances that can be simply and easily reversed using PILATES exercises. Clinically, Pilates exercises are adapted to the individual and everyone is fully assessed prior to treatment for an optimum treatment/exercise programme. However, as so many of the typical running-related injuries can be avoided using Pilates, I would like to share a few of the key clinical Pilates exercises that I have prescribed time and time again, with great success, to runners who come to see me at Fisioplus Pilates (www.fisiopluspilates.com).

There is a current wave of forward thinking therapists and Pilates instructors promoting “restorative” Pilates classes which can be incorporated between training and more aggressive workouts. The idea is to restore some of the muscle imbalances and common “overuse” patterns which occur during training. Working a muscle in a different way, throughout its length, as in Pilates, promotes the use of different muscle fibres therefore reducing the tendency of parts of the muscle to become short and bulky. Shortened muscles are far less efficient than longer, stronger, slower fatiguing muscles. In a repetitive activity such as running, improved muscle efficiency will have many positive results including a better performance or race time alongside a reduction in pain and easily avoidable overuse injuries!

Don’t just take my word for it, give it a go!

Zoe Queally

Marathon Facts:

• Last year more than 23,600 runners entered the flora London marathon
• A minimum of 41,000 steps is run in a marathon, in addition to the millions covered in training

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Marathon Special: Pilates Exercise Sheets

Tell us a bit about your marathon story.

Sunday I will be participating for the second time in the Barcelona Marathon. This will be the sixth marathon that I have completed. My marathon journey began in 2005 when I found myself overwhelmingly inspired by my sister, a mum of 3 children and with a busy schedule to manage, who successfully completed the London marathon in slightly over six hours. At that point my I found myself struggling to run 10 or 15 minutes on a treadmill in squash shoes. 18 months later I had secured a place in the London marathon and was nervously training. My footwear had improved slightly but my training schedule and techniques hadn’t moved forward at all, essentially the strategy was to run as much as possible.

Upon finishing my first marathon I immediately started to think about the possibilities of running the New York marathon. Not only had I never been to New York but I was convinced that I could improve on my 4:24hr time achieved in London, perhaps even secure a sub 4:00 hr marathon.

So what happened in NY?

Lack of planning and not allowing enough time for my body to recover from a long flight proved to be too much to deal with and I ended the marathon in lot of discomfort and just outside of the 4:00 hrs mark that I had set myself.

Next I was heading to Rome, this time with two friends. Unlike previous marathons I had done most of the training with several friends. This was to be the third marathon within a 15-month period and my body was beginning to show signs of strain, above all Knee problems. One of these friends suggested that I go to see a Physiotherapist to have a look at a few little problems that I was struggling with.

After just a few sessions with the Physio it became very clear that I had no understanding of how my body worked nor how it reacted to the stain of excessive training.

Did physio help?

Having been shown several exercises and running techniques I immediately experienced improvement in times and comfort. I began to feel very confident in my running ability and most importantly started to enjoy everything so much more.

The following year I was heading out to Tokyo for 10 days at the end of which I would be participating in my fourth marathon. Once again my time was improving so last year I decided to compete instead of participate in the Barcelona marathon. I was hoping that being on home turf would help to eliminate some of the problems incurred when travelling half way around the world to run.

My fifth saw me achieve a 3:37 hr mark. A huge drop from the first marathon but still 7 minutes short of my illusive 3:30 objective, which of course I will achieve tomorrow.

What is the greatest thing about running?

Marathon running is wonderful experience for many reasons, not least the sense of achievement once you reach the finish line. However I would have to say that in my opinion the preparation in order to achieve this goal is the real highlight for me.

Not only in terms of physically preparing your body and avoiding injuries but training your mind to deal with the long and painful 42 km journey.

And the worst thing?

The worst thing, apart from the cold and wet night during the training schedule, is the sense of emptiness as soon as you cross the finish line. Its over, that’s it, what are you going to do next, what’s going to be the driving force over the next few months.

What is important during training?

Like most things, preparation is everything. In the case of running long distances, preparation is fundamental and lack of it will result in injury.

To be fully prepared, firstly you must understand your body. This will help you to choose the right footwear and help you design the right type of training schedule, and it will help you avoid injuries. Beyond that, run and eat well.

Physically, most healthy people could complete a marathon distance. The real test is mental.

In my case, with every marathon I complete, the more confident I get about my ability to train correctly for the race. This time I have only trained about 7 weeks. My training for the first marathon latest over 8 months and eventually provoked an over running injury. I use the marathon as an excuse to stop drinking alcohol for about two months. Normally I will loss about 5 kg over that period and generally feel very healthy.

My training schedule this year has basically been 3 10 to 15 km runs during the week, followed by a 20 to 26 km run at the weekend. I have done about 4 of the longer runs. All of the organized 10km and half marathon run I have used as training exercises and I’ve been very happy with my times and physical condition after the run.

Have you had any injuries to deal with?

Apart from this marathon all of the previous marathon training schedules have provoked some sort of injury. In every case I have been helped enormously by Zoe who seems to know immediately what the problem was and more importantly know exactly what to do eleviate pain and fix the problem.

My first problems were with my knees, or at least that is what I thought. Instead Zoe seemed to think that my short legs and shuffling running motion was leading to the tightening of my quadriceps muscles. She used a variety of techniques to help stretch the muscle and gave me a set of exercises to do. These exercises essentially were designed to strengthen my bum. She suggested that strengthening the bum would help the running motion and avoid the tightening of the muscles that I used too much because my bum muscles were too slow and weak.

I have to say that while she made me stick one leg in the air while she felt my buttock for extended periods, I doubted whether this would really work or if it was just a cheap excuse to touch my arse. Either way, the injury disappeared almost immediately and my times improved immensely. That said I still insisted on her checking every now and again that my buttocks are up to the correct standards!

Nowadays I like to visit Zoe to make sure that I’m in top working order. I’ve begun to I understand the concept of preventions as appose to cure.

What do you think of the Fisioplus Pilates approach?

I really like the Fisioplus Pilates approach to treatment/management. Not only am I a living example of how it works, but its very good fun and more importantly for the first time I feel like I understand my body.

So, any last minute preparations?

An hour rub down and a general MOT from Zoe on the Friday before the marathon has put my mind at rest and prepared the muscles for another big challenge.

How are you feeling about the Marathon this weekend?

With a few hours to go before next marathon I’m feeling slightly nervous, it’s a long way and you should never lose respect of that distance but most importantly I feeling very prepared.

Thanks Lee, and BIG GOOD LUCK for Sunday!

Susan, one of our very inspiring patients, has had to work extremely hard in physio for the past six months to achieve her goal of walking a section of the “camino de Santiago”. See her interview below and symapthise about the preparations, the struggles, and of course smile at some of the amusing moments she experienced along the way!

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When did you move to Spain, why, and what do you love about living in Barcelona?

As a child I had spent many years on holiday in Ibiza with my parents so it wasn’t that strange that having met Juan, originally from Cordoba in 1968 we married soon after. My family and I moved to Barcelona in the summer of 1986 and we were living here for eight years, then we had to move around Europe for the next 10 years because of my husband’s job. We returned to live here permanently in 2001. We all felt we had returned home as we love most things about Barcelona the weather, food, arquitecture and the way of life.

Do you feel that you have integrated fully into the Spanish lifestyle?  Has anything in particular helped with this process?

I think I can say I am fully integrated into Spanish life, my friends remark that I am more Spanish in character than they are! Perhaps things were made easier for me as my husband is Spanish and the children went to bi-lingual schools, so we met mainly Spanish speaking people and when we first arrived here there were very few foreigners around, so it was adapt or die!! I seem to have adapted as I am still here.

You have recently been working with Zoe at Fisioplus Pilates, Barcelona with some chronic injuries, can you tell us a bit about the problems you have had and their limitations on your regular lifestyle?

I went to see Zoe because for over a year I had had serious problems with my hip and my back and after being treated by three traumatologists and seemed to be getting nowhere, I was recommended to see Zoe. The pain in my back hip and right knee was limiting my normal life. I love all sorts of sports but found that I was having problems in walking upstairs let alone go to step and aerobic classes. Golf was out as I couldn’t walk round the course or hit the golf ball. Skiing was a no go because if I fell down no way could I get up again. All in all, I was feeling very frustrated and miserable.

What do you especially like about working with Zoe and the Fisioplus Pilates approach?

Being treated by Zoe was a different approach from how things seem to be done here in Catalonia. Before visiting Zoe, I had been daily for three months to a rehabilitation centre. I had been given heat treatment and ultra sound, which did not seem to help at all.  Zoe takes a hand on approach and really got down to some serious massage and other manual techniques. She also suggested exercises to improve my back muscles. I was slow to respond at first. As time went by, slowly but surely things improved. Zoe always gave me encouragement, which kept my spirits up.

Your main treatment goal for the past 6 months has been to walk a section of the famous “Camino de Santiago”   Do you think that having such a specific goal has helped with your treatment?

Although I have had problems on and off with my back for many years, the last straw came two years ago when a group of us walked the Inca Trail in Peru. For the next two years I was unable to move around normally as the last part of the trail finished off my hip and knee. When we talked about doing the “Camino de Santiago” I was in no fit state to even consider it, but the idea was sown into my mind and little by little, after seeing that Zoe’s treatment was helping me I was determined to do my best and give it a try.

Tell us a bit about the run up to the “Camino” How did you prepare physically and mentally?

Light training started about six months before we were leaving, walking along the beach, every day with our trekking boots on in the midday sun. (We must have been mad!!) I kept telling myself my knee and hip did not hurt and I was making a fuss over nothing. That wasn’t exactly true.

Was there a time that you thought you may never get to start on the “camino”?

At the end of February I went to see my fourth bone specialist and after having six sessions of “factores de creciemiento” and still having problems, it was decided that I should have an arthroscopy done on my knee. I wasn’t given a time for recuperation, I was told to wait and see. The operation took place. Recuperation time was four and a half months and one week before leaving for Santiago I was still using crutches and everyone said she will never do it. I had to prove them wrong but I did wonder if I was going to make it.

Which section of the “camino” did you do? Where did you start and finish? How many of you were there and how did you feel when you all met up and were about to start your adventure.

On July 31st 19 of us met up in Leon. One couple came from England, two families from Madrid, three couples and one family from Barcelona. We were going for the last section of the French camino. We drove from Leon to Sarria, where we left our cars and started the trek. All of us were very enthusiastic, even though two of the party arrived from Morocco with upset stomachs. We were five families in all and at first we were a little worried about the youngsters getting along and not all the grown ups had met before, but we had no need to worry everyone fitted in and we all got on.

Did you have a particular strategy each day?  Any tricky moments to overcome? Any amusing anecdotes you’d like to share?

Our only strategy was, to make it to the next stop! The weather was incredibly hot so by majority vote we were up at 5.00 each morning and on the road at 6.00. The first two days were lighter; we did 22 and 24 kms. The third and forth were 28 kms each day and the last day was 10kms to reach Santiago. As were of all ages, or abilities were different. One family was very much younger and fitter. They strode off every morning and reached the goal fist. We nicknamed them the “Decathlon Family.”

What was it like finally arriving in Santiago after all the build up, months of physical preparation and days of continuous walking?

The arrival in Santiago was very emotional, we’d done it!! 115kms!! We had all had our good moments and our difficult times, but no-one had argued or lost their temper, quite strange when there were so many of us. Santiago was packed as it was the Jubilee Year and the day we arrived they were expecting 12.000 juvenile groups to appear in the town square. Most of them arrived and the town was full of music and celebration.

It has been a truly amazing achievement, would you do it again? Any other challenges lined up for the future?

The experience was unbelievable and we all felt proud to have achieved it, mind you many people have done far greater distances, but I was very content to have made it to the end without any major problems. I’m not sure that I would do it again, perhaps the route has become too commercialized. I would think about going again and trying one of the other routes that lead to Santiago out of season.

If we don’t wait too long and health and age allow us, our next project is to tackle trekking in Nepal. I wonder if we’ll make it?!!

Good Luck to Susan and Juan for Nepal!

What do you get if you cross four physios, two super fit personal trainers and a japanese speaking, lindy hopping osteopath?

It really does sound like one of those jokes and in reality there is no doubt that a lot of fun was had by all on the first ever Fisioplus Pilates combined module 1&2 course. With a definite chill in the air, continual rain showers and gusty winds outside, fleeting thought were had for the participants of the annual Jersey marathon as we happily go to work inside evaluating each others muscle imbalances and physical shortcomings (you will be delighted to hear that personal trainers have them too!)

Over the four days, between the many comedy moments and the mental and physical gymnastics we all came away wiser to the mysterious world of muscle imbalance and biomechanics having shared our cross-profssion knowledge. Luckily, having been carefully assessed, not to mention prodded, poked and closely scrutinised we also go away with the know-how of which exercices, should we choose to do them, are going to make us models of physical perfection by the time we next meet in November for module 3! Note to patients: Do as we say, not as we do!

Zoe Queally, Fisioplus Pilates

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Nathalie, personal trainer, reflects on the course in Jersey:

“My physiotherapist introduced me to Pilates a few years ago as part of my rehab for a back injury. I became a fan immediately and have been looking for a suitable course to do to complement my work as a personal trainer and sports massage therapist. I felt that the exercises on most traditional courses were too advanced for most of my clients and not suitable for exercise rehab.

Zoe’s Fisioplus Pilates course was everything that I was looking for – taking Pilates right back to the fundamentals and learning how to use assessments to prescribe suitable Pilates exercises. The course was really well presented and most importantly for me there was plenty of time to practice the assessments and exercises on each other and our very brave live case study.

I would highly recommend this course to all personal trainers who have an interest in exercise rehab.”

On 10 August 2010  Peta Bee published an article in The Times entitled “Core Stability Myth” which aggressively questioned the use and effectiveness of “core stability” techniques, including Pilates.  This article has had the entire Pilates community up in arms due to its lack of substantiated evidence and ability to overlook evidence that has been released by lead researchers in the field of core stability in the last decade.

Of course it must be recognised that the general prescription or practice of Pilates without prior assessment or guidance from a good Pilates professional can have harmful effects.  I for one have come across many patients that have tried Pilates classes and had negative experiences, some of which requiring that particular treatment episode following the afore mentioned class!  However, on further questioning the class was invariably enormous with20+ participants with an instructor demonstrating an exercise once or twice and leaving the group to get on with repetition after repetition with a “practice makes perfect” attitude.  

Pilates should NOT be practiced like this!! 

Pilates professionals worth their titles, whether they be Physiotherapists, Osteopaths or properly trained Pilates Instructors would NEVER run a class like this.  Exercises should be given that are appropriate for the individual, taking into account their pre-assessed weaknesses, pathologies and problems.  All Pilates exercises at the time of practice should feel NATURAL, FLUID, SMOOTH and only slightly challenging.  Often patients have described previous Pilates classes as extremely challenging, causing them to be very rigid or shaky and often unable to do more than a couple of repetitions without noticing stress on the neck and/or lower back. 

Practice, unfortunately in the case of “core” muscle re-training, does not always make perfect.  Practicing an incorrect movement pattern will only enable you to do this incorrect movement pattern better! The idea behind clinical Pilates should be that you practice the SPECIFIC exercises appropriate for you at the level that you CAN do.  With very little time you will then be ABLE to do a harder exercise using the correct muscle recruitment. This in turn has a positive effect on pains and problems associated with poor postures and muscle imbalances.

I would like to invite Pilates professionals amongst readers to read the response to The Times article written by Glenn Withers, one of the co-founders of the APPI (Australian Physiotherapy and Pilates Institute).  Glenn has written a fantastic scientific response to the article clearly citing the recent literature that has been released showing evidence substantiating the use of Pilates.  He has also answered, one by one, the claims published by Peta Bee in the article.  Click here  to see a link to Glenn’s response.

Zoe Queally – Fisioplus Pilates.  All rights reserved.