Fertile Ground Health Group provides a range of services and expert practitioners to guide you through all aspects of your pregnancy journey from conception all the way through to caring for your newborn.
Are you working from home? Check out these tips for best posture with Osteopath, Dr Nicole Cukierman
Due to the outbreak of COVID-19 many of us are now working from home, making for the perfect time to look at our home workplace ergonomics!
Maintain the correct posture
Maintaining the correct posture while we work not only reinforces the natural curves of the spine but also minimises stress on the body. When seated, body weight is transferred to supporting areas, mainly the pelvis and surrounding tissues.
Prolonged sitting in a poor posture negatively effects joints and muscles in your neck, back, shoulders and wrists and can lead to various types of pain. This pain can present as headaches, backaches, disc irritation, tight hips, repetitive strain injuries and carpal tunnel syndrome. It also leads to a restriction in our movement. Try sitting in a slumped position and rotating your neck to the left and right. Now sit in an up-right position and try turning your neck again. Notice an improvement in your mobility the second time?
Leaning over while working can also affect your breathing! When seated in a slumped posture our diaphragm becomes compressed and restricted. This results in a decrease in lung function, meaning less oxygen flowing through the body and consequently less overall energy and function. When seated in an upright position and breathing through our diaphragm we are then able to activate our Parasympathetic Nervous System, otherwise known as our ‘Rest and Digest’. Diaphragmatic breathing aids in digestion, promotes relaxation, de-escalates stress, and let’s face it, we could all do with a little less stress.
Furthermore, an article published in 2018 demonstrated that an incorrect pose creates demotivation, tiredness and disinterest, compared to sitting in a positive pose which resulted in high performance, greater attention and focus.
Here are a few helpful considerations for you to try at home:
Set up your station at either a desk, kitchen table or bench
Avoid working from bed or the couch
If possible work from a computer monitor
If using a laptop ideally use a separate keyboard and mouse; and prop the screen up on some old books
Make sure that your eyes are in line with the top 3rd of the screen and that the screen is finger-tip distance away
Have your elbows rested and at 90 degree angles, maintaining this angle at your hips and knees with feet planted on the ground or on a foot stool
Alternate between sitting and standing by using boxes or books to create a standing arrangement at the kitchen bench
Schedule in phone and video meetings/coffee’s/after work drinks with co-workers to create the usual office rituals
Set a timer for regular breaks every 45-60 minutes. Get up and move during these breaks. Stretch, drink some water, honey and lemon tea or freshly squeezed orange juice to keep your Vitamin C levels up
Dr Nicole Cukierman is now available for one on one consultations in person, as well as digital consults. You’re welcome to book in with Nicole.
Pelvic girdle pain. What is it and what can be done to help?
Pelvic Girdle Pain (PGP) is a term given to describe the discomfort felt anywhere from the front of the pelvis (pubic symphysis) to the back of the pelvis (sacrum) and even around to the sides of the pelvis (hips).
During pregnancy 1 in 4 women will experience pelvic girdle pain due to changes the body will undergo in a relatively short period of time. This can occur at any stage of the pregnancy however, it is most commonly experienced in the second and third trimesters.
What causes Pelvic Girdle Pain?
Ligaments throughout the body stretch and soften to accommodate for the growing baby. When these ligaments relax our muscles are required to work extra hard which may result in pain. Additionally increases in load, changes in posture, centre of gravity, walking style and alterations in core function can contribute to pelvic girdle pain.
While some individuals accommodate well to these changes, experiencing limited or no pain, it can be debilitating for others and 7% of women will continue to suffer with this pain after their baby is born – requiring ongoing treatment.
Sharp, stabbing or grabbing pain that is aggravated climbing up and down stairs, getting dressed/undressed, rolling over in bed, getting in and out of the car, extended periods standing, sitting or walking and pain on sexual intercourse.
If you are experiencing pelvic girdle pain try these helpful hints:
Sleep with a pillow between your knees
Keep knees together when rolling in bed or getting in and out of car
Focus on maintaining good posture while standing and sitting. Avoid crossing your legs
Avoid heavy lifting (your joints are already under enough load), prolonged sitting, wearing heels, carrying uneven loads e.g. bag on shoulder or toddler on hip
Wear support bracing or garments such as tubigrip, SRC shorts or Serola belt
The specific tissues causing pain differs between individuals and it is best to seek professional advice from an osteopath with experience in this area for appropriate treatment.
The mind body connection has really caught my interest lately. It’s something that is poorly understood but can have a profound effect on your health. Take depression as an example. There are signs that most people can automatically identify with like hopelessness, sadness and anxiety, but depression can also cause unexplained physical symptoms or worsen the symptoms you already have, like pain. The two are closely linked and simply put, pain can be depressing and depression causes and intensifies pain.
In fact, vague aches and pains are often the presenting symptoms of depression, highlighting the mind-body connection. These symptoms can include back pain, gastrointestinal problems, chronic joint pain, limb pain, tiredness, sleep disturbances, psychomotor activity changes and appetite changes. Psychoneuroimmunology is what scientists are now calling the field that explains how our mind, our brain and other systems in the body all interact to have an impact on our health. Thanks to developments in MRI technology particularly over the last 5-10 years, we can actually look at what’s going on in the brain while it’s happening and see the connection between mind and body.
How the stress response works
The mind-body connection can be clearly seen when we look at the stress response (fight or flight). The stress response developed to help us deal with danger, like when a Saber tooth tiger is chasing you. When the stress response is triggered a lot of physiological processes are set off to help your body cope with the situation. Once we are stressed glucocorticoids are released to help mobilise energy, inhibit storage of energy and suppresses immune function. Adrenaline is released, increasing blood pressure, heart rate, and respiratory rate. Extra blood is pumped to the muscles so you can get away from those shiny teeth. Sugars and fats pump into the bloodstream, your metabolic rate goes up, you start to feel hot and you sweat. Blood is diverted away from the skin and away from the gut due to adrenaline’s vasoconstrictor action, so your gastrointestinal system slows down. Your blood thickens and will clot faster than normal, which could be the difference between life and death if the tiger gets a hold of you. Your immune system is activated by pumping out inflammatory chemicals, so there is a short-term burst in immunity but long term is suppressed. And you become very focused.
The problem with the stress response
Unfortunately as smart as our bodies are, we do have to consider the fact that the evolution of technology and consciousness is far faster than that of physical adaptation. Adaptations are said to accomplish a goal, however the adaptation does not have to be, nor is it in many, many situations, optimal. We activate this stress response all the time through our modern lives, by anticipating future events or replaying past events, or by becoming overly angry and reactive to normal day to day events. We end up over activating this pathway, which can have a long-term cumulative effect that’s called allostatic load. Heart disease, diabetes, ulcers and growth problems for example, can then ensue.
In the brain, chronic stress will decrease glucose delivery to the hippocampus (limbic system: emotion, memory) and cortex (neocortex and prefrontal cortex: cognitive region) to probably divert it to the more reflexive brain regions (reptilian brain: survival). These effects are measurable not just in terms of physiological, metabolic effects and immune effects but also to the very DNA. The acceleration of the rate of ageing of the DNA can be seen, which is measured by the telomeres – little caps on the end of your chromosomes.
How to reverse the effects of the stress response
A chronically activated stress response is really how we accelerate the progression of chronic illness and the effects are also observable in the brain. Thankfully these changes seem to be able to be reversed. Meditation is fantastic, as is exercise, counselling, diet and manual body therapies. A combined approach is ideal, but exercise and osteopathy are two powerful treatments to get started on.
Exercise appears to have a similar action to an antidepressant, by acting on particular neurotransmitter systems in the brain and helping patients with depression to re-establish positive behaviours. 150 minutes a week of moderate-intensity activity or 75 minutes a week of vigorous-intensity activity is all that is needed. After just 25 minutes, your mood improves, you are less stressed, you have more energy – and you’ll be more motivated to exercise again tomorrow. A bad mood no longer becomes a barrier to exercise; it is the very reason to exercise.
An Osteopath is obviously not a psychologist, however depression has important physiological and anatomical components. Many physicians consider patients to be in remission when their acute emotional symptoms have abated, but residual symptoms—including physical symptoms—are very common and increase the likelihood of relapse.
Psychiatrists and primary care physicians are now beginning to recognise that even though symptom domains in the areas of motivation and physical illness are frequently part of depression, they are often ignored in the assessment of depression and subsequently, in the treatment goals. Often, pain is not included in the treatment goals because it is interpreted as a sign of a somatic illness. Pain and depression share common pathways in the limbic (emotional) region of the brain according to some research. In fact, the same chemical messengers control pain and mood. Many people suffering from depression never get help because they don’t realise that pain may be a symptom of depression. The importance of understanding the physical symptoms of depression is that treating depression can help with the pain – and treating pain can help with depression.
Osteopathic manipulative treatment (OMT) has been shown to improve cardiac indices, increase lymph flow rates through the thoracic duct, and decrease sympathetic tone in postoperative patients and those in intensive care. Another study has looked at how OMT can increase secretory IgA which provides our first line of defence against bacteria, food residue, fungus, parasites and viruses. A fancy way of saying there’s indications we can help with stress and actually improve immune function.
Osteopathy can also help to reduce some of the strains and stressors placed on your body in order to bring you back to equilibrium. Either through the postural compensations brought about from depression or through treating the pain-causing tissues that can lead to depression.
Posturally, there is often a shortening of the abdominal muscles and a tightening of the diaphragmatic arch which pulls the chest down and forward, limiting its ability to expand during breathing. Combined with medial rotation of the shoulders and internal rotation of the arms resulting in a increased kyphosis (mid back curve) that further restricts breathing. Without the support of the thoracic region, the head and neck will often move forward and down and further into collapse. Which can lead to follow on affects in the lower body. Through exercise prescription and treatment we can help resolve some of these extra stressors.
So yes Osteopathy can make a huge difference to your health and wellbeing, however, if we keep being overstimulated physically, psychologically or through anticipation (literally worrying ourselves sick) it will only offer short term relief. This short term relief however in the long term is not to be underestimated as it opens the gateways for new insights.
Bryden is passionate about restoring movement and function to help people achieve their optimal health. Through effective assessment, diagnosis and treatment, Bryden is able to guide an individual to a better understanding of their body and provide symptomatic relief. He uses a range of techniques including manipulation, massage, dry needling and stretching, as well as patient education and exercise prescription. He has a keen interest in treating a wide variety of musculoskeletal conditions affecting people of all ages, including pregnant women and babies.
Ouch! Pelvic Girdle Pain in pregnancy (PGP) is often referred to as ‘pelvic instability’ and affects somewhere between 20-50% of pregnancies. PGP causes mild to severe pain in the pelvis/low back that becomes worse with movement. It’s a significant source of pain and restriction for many pregnant women – but what actually is it?
The Pelvic girdle consists of seven bones – the triangular sacrum at the back (literally ‘sacred bone’ in latin, due to its role in childbirth) and three paired bones that make up the ‘hips’ – the ilia, ischia and pubic bones. Together these bones work together to take the weight of the spine, transfer and distribute forces evenly throughout the body whilst walking, and accommodate to allow the growth and passage of a baby throughout pregnancy and childbirth.The pelvis has three joints – the two sacroiliac joints at the bottom of your back (accommodating for rotation and forward/backward bending), and the pubic symphysis, located at the very front of the pelvis. If you place your hand on this joint, you can feel it performing a small scissoring motion while you walk. It is the location of these three joints that most pelvic girdle pain is felt.
While it used to be thought that pelvic girdle pain was purely due to the hormonal effects of pregnancy, it is now understood to be a mix of the slight increase in movement available in these joints (due to the relaxed ligaments), and an increase in mechanical pressure on these joints.
Biomechanics in pregnancy are a topic on their own, but it is suffice to say that a woman’s posture changes early and rapidly when pregnant. The low back increases its arch, the pelvis widens, the ribs spread at the front and the legs step further apart to provide an increased base of support. It’s a well oiled machine – until it isn’t! Just like non-pregnant people, areas of increased muscular/ligamentous tension can develop, either due to stress, sedentary/computer posture, fatigue, or a slip or fall. However, in pregnancy the musculoskeletal system is working much closer to capacity and it can have difficulty compensating for these areas, which can lead to the pelvic girdle pain of pregnancy.
While the majority of cases of PGP go away after the baby is born, during pregnancy it can lead to significant pain and disability, with women having difficulty performing their daily activities. It can negatively impact fitness, flexibility and sleep, all of which have implications for childbirth and the postpartum period. So what can we do about it?
Strengthening exercises and use of supportive ‘sacroiliac belts’ have good reports. Osteopathic management of patients with PGP includes assessment of pelvic joints, bones, muscles and ligaments and uses a range of manual techniques to balance these tensions. We also look at the biomechanics of the surrounding areas, as well as giving advice on stretches, exercises and referrals to other providers as necessary.
Pelvic girdle pain is not something you can expect during pregnancy, however it is very common. If you think you might be experiencing this, take heart – there are things to be done. See a health professional about it and don’t just suffer through nine months of pain!
A registered Osteopath and mother of two, Pria has become increasingly passionate about supporting women and their families through the intense family phase of life. She uses a wide range of techniques and loves nothing more than listening to the body with her hands and successfully working out what it’s trying to say! Always learning, she regularly undertakes postgraduate training. Previous training has been in areas such as in the treatment of pregnancy, postpartum women and cranial osteopathy and has completed a Certificate IV in breastfeeding counselling, regularly volunteering with the Australian Breastfeeding Association. She has a clinical interest in headaches as well as women’s health, including dysmennorhoea and pregnancy/postpartum care – supporting women’s bodies to move well throughout the changes associated with this period.
Back pain has to be the most common type of complaint I see in the clinic. At any one time, 26 per cent of Australians have lower back pain and 79 per cent of the population will experience it at some time in their lives. The direct costs are minor at about $1 billion annually, compared with the indirect costs of $8 billion that arise as a consequence of lost productivity and disability. However, I think the real cost comes at the expense of the people and families that are affected directly and indirectly by what can be a debilitating condition.
Staying active is an important part of managing back pain. Yet often, we don’t challenge our bodies anymore, we sit ‘comfortably’ in chairs and cars and couches and now 1 in 20 people can no longer touch their toes. Babies can eat their toes (or at least try) but it seems we have lost much of the drive to keep exploring our physical bodies or simply staying in touch with them. Preferring to get our dopamine (pleasure) hits from the control centre upstairs through such things as Facebook likes and cafe delights, which is all well and good but it’s the balance of the two that allows us to live long, healthy and contented lives.
The sad reality is that back pain is dramatically increasing and I don’t see myself running out of work any time soon. High stress levels and the sedentary nature of modern day lives can extract a heavy burden.Looking at just one consequence of a sedentary lifestyle prevalent in both young and old, is forward head posture. For every inch your head posture sits forward, the head gains 4.5kgs in weight! On top of this mechanical burden an increased forward head posture has been strongly associated with decreased respiratory muscle strength in patients , which can affect the ability to breathe and reduce lung capacity by as much as 30% . Oxygen is obviously pretty important but diaphragmatic action also helps to pump fluids around the body and assists in digestion and visceral (organ) function. Forward head posture has also been linked to tension-type headaches , as well as increased blood pressure . Long term forward head posture leads to muscle strain, disc herniations, arthritis, pinched nerves and instability .
But my real concern lies in the future. More and more studies show the importance of exercise and relaxation for maintaining a healthy existence and yet how many times have you seen an entire group of students after school looking directly down at their devices? How many kids stay at home on the X-box or watching TV versus riding to a friends’ place or playing in the park?
Last year I attended a paediatric conference in London where a paediatrician mentioned a few interesting studies. One study compared the time it took for 10 year olds today to run a mile, to how long it took for their parents to run a mile when they were 10 years old. Todays 10 year olds ran 90 sec slower (approximately 1 whole lap slower) than their parents. Another trial in Scotland tested grip strength in children now and 20 years ago indicating that today’s children are 33% weaker.
Do yourself a favour and teach your children to exercise, go to that yoga class, that stretch class, take a break every 30 minutes, every time you go to the toilet take 2 minutes to do some pec stretches. Consciously think about tucking in your chin and bringing your throat towards your spine and pinching your shoulder blades together. Breathe deeply.
Prevention is the best cure, but even if you are experiencing pain it’s never too late to implement a regular routine of exercise, good postural awareness and to seek treatment for back problems before things get complicated. Finding an Osteopath that you trust can help you to improve joint mobility, relieve muscular tension, inflammation and nerve irritation. They can also offer advice on posture, exercises and stretching, provide guidance on diet, hydration and exercise. The important message is that you don’t need to suffer through back pain and you are never too young or old to adopt life changing habits. I’ll leave you with a quote from an 8 year old patient of mine “H.O.P.E. Hold On Pain Ends”.
3. Fernández-de-las-Peñas, C., Alonso-Blanco, C., Luz Cuadrado, M., Gerwin, R.D., Pareja, J.A.. (2006) Trigger Points in the Suboccipital Muscles and Forward Head Posture in Tension-Type Headache. Headache: The Journal of Head and Face Pain 46 (3), 454—460. (FHP)
Bryden graduated from RMIT University in Melbourne after completing a Bachelor of Applied Science in Complementary Medicine, Osteopathy and a Master of Osteopathy. He is also a member of Osteopathy Australia. In addition to Osteopathy, Bryden is an experienced sports trainer and massage therapist. He is passionate about restoring movement and function to help people achieve their optimal health. Through effective assessment, diagnosis and treatment, Bryden is able to guide an individual to a better understanding of their body and provide symptomatic relief. He uses a range of techniques including manipulation, massage, dry needling and stretching, as well as patient education and exercise prescription. He has a keen interest in treating a wide variety of musculoskeletal conditions affecting people of all ages, including pregnant women and babies.
At Fertile Ground Health Group (FGHG) we love caring for you throughout your fertility and pregnancy journey and when the baby comes the care does not end there! We offer a range of approaches to help support mums as they navigate the often challenging first months with a new babe.
If you have been a patient of FGHG throughout your pregnancy why not take advantage of Osteopathic baby check to make sure bub has bounced back from the stresses and pressures of being born. And of course, we strongly believe babies need well rested, healthy mums and our “mother roasting treatment”, a regenerative massage treatment is ideal any time after you give birth – say any time in the next 12 years!
Below you will find information on how each of our modalities can help you and your family once your bundle of joy has arrived. We are here to support you through any hiccups you might encounter or just to support wellness, enhance health and prevent future health issues for both mother and baby. Prevention is key, but if either you or your baby are struggling in any way, one of our highly experienced practitioners will know how to guide you.
Naturopathic care can assist with energy and nutritional requirements needed for mothers post birth to ensure sufficient milk for breastfeeding. It also offers a range of solutions for milk supply & mastitis, low mood, fatigue, baby colic or eczema, feeding, sleeping and developmental issues. Advice on weaning, introducing solids, vaccination support and fever management is also available. Naturopathic care also provides essential support and solutions for any mum or baby struggling with digestive or immune issues.
Acupuncture and ChineseHerbal Medicine can treat many conditions including feeding problems (insufficient lactation, oversupply, mastitis, engorgement, pain, etc.), urinary incontinence, hormonal balancing, abdominal pain, back pain, post natal fatigue, mother and /or baby sleep issues, stress anxiety and depression. This ancient and traditional medicine deeply nourishes your energy like nothing else. And the Melbourne Acupuncture Multi-bed Project makes appointments super accessible – in and out in 45 minutes!
Osteopathic care is highly beneficial for both mother and baby. For mothers: helping the pelvis, spine and whole body return to the optimal position and function after the changes induced by pregnancy, labour and birth. For babies: gently releasing any tension in the head or body resulting from labour and birth can relieve or avoid reflux, colic, unexplained pain responses, altered head and neck position/development or just generally support and relax unsettled babies.
Our Massage therapists offer mums “Mother roasting” for an enriching massage and moxibustion treatment using warming and nourishing essential oils and heat pack application. This massage incorporates the use of specific acupressure points that have rejuvenating and regenerative properties for new mothers post birth. This makes it the perfect treatment to re balance new mums, increase body energy and relieve any muscular pain and tension. Appropriate for all mums, no matter how you have given birth or how long ago!
Counselling. Pregnancy and birth involve significant change in a myriad of ways, with different and often unexpected feelings surfacing. Counselling during pregnancy and / or post birth can enrich your parenting experience and ensure challenges are unpacked and moved through for personal growth and a feeling of confidence and freedom. Preparing for labour & birth or debriefing your birth experience through our specialist counselling service is an essential part of this transformative life stage as you birth yourselves as parents.
Call or email reception to book in:
(03) 9419 9988
Gift vouchers are also available if you’ve got someone in mind that would benefit from some post natal care treatments at Fertile Ground.