5 Simple Tips for Better Pregnancy Sleep

1. Minimise the Blues

We know all know that too much screen time is not a good thing (aside from the fact that we’re slowly becoming social zombies in our own home). But did you know that it’s the blue light emitted from our smart phones, laptops and TV’s that suppress the release of sleep-inducing melatonin and increases levels of wakening cortisol? The term ‘tired but wired’ can be used to sum this concept up perfectly – although we’re tired, we just can’t seem to fall asleep at bedtime especially after we’ve been watching a movie or scrolling through Instagram before bed. Increased exposure to blue wavelength light – which is great during the day if you want to increase concentration and mood – affects our circadian rhythms and prevents us from naturally winding down and becoming physiologically ready for bed if we get too much after sunset (when we naturally start releasing melatonin and decreasing levels of cortisol).

Unfortunately, most of our evening routines these days include watching Netflix series on TV, answering emails on the laptop or mobile or checking our Facebook feed, often in bed. Maybe it's not just a coincidence that sleep issues have also risen in the last few years as technology has become ever more prevalent and pervasive in our daily lives. We get that our phones have become an integral part of our society but taking a screen-time break 1-2 hours before bed can make a world of difference to improving your sleep quality.

If you can’t give up your electronic devices just yet, at very least use or install a blue light filter on your mobile and laptop that automatically turns on at sunset. Try f.lux for laptops and Twilight for Android and other mobiles. Apple phones have an in-built setting called Night Shift that you can turn on (they won’t let you install external blue light filters). You’ll quickly get used to the slightly red hue on your devices and will be shocked by the brightness of a normal screen after a few days.

2. Get Your P’s Right.

Ah, the joys of growing a human. If the morning sickness didn’t get you, then the difficulties of finding a comfortable position for your increasing bump definitely will. You can't lie on your stomach anymore, lying on your back causes reflux, and wasn’t there a side you shouldn’t sleep on as the baby gets bigger?

Our secret to sleeping better during pregnancy: Pillows, and the more the merrier. Normal ones, long ones, fat ones, skinny ones – find ones that suits your body and bed. Then use them for optimal positioning during the night.

-        Support your head: Propping your head up slightly on two flatter pillows can help to reduce reflux related to pregnancy. You can easily slip one out when you turn on your side to keep your neck in a more optimal neutral position, helping to prevent neck pain and stiffness.

-        Under the knees: For mama’s experiencing lower back pain* (who doesn’t?), slipping a pillow under the back of your knees when lying on your back is a well-known physio ‘hack’. What it does is takes your lumbar spine slightly out of extension, reducing the compression in your lower discs and aligning your spine more optimally in the supine position. A medium thickness pillow, long roll or bolster works well for this trick.

-        Between your knees: Sleeping on your side can often increase sacro-iliac/pelvic pain* that commonly occurs during pregnancy. Putting a medium thickness pillow between your knees keeps your pelvis in a more neutral position which supports your joints and ligaments and can help reduce discomfort during the night. This tip often feels more comfortable even for people without pelvic joint issues. And the side you’re supposed to sleep on during pregnancy? Experts recommend sleeping on your left side from the second trimester onwards as it may improve circulation and blood flow to your foetus (the inferior vena cava, the major vessel bringing blood to baby from your heart, is on right side of your spine). Lying on your left side may also help improve constipation and elimination as it follows the natural direction of your digestive system: waste products travel through your large intestine starting from the lower right of your abdomen, up, across to the left then back down.

-        Behind your back: Adding an extra pillow behind your back when lying on your side can help you from rolling onto your back and better support you during the night. This mini barrier between you and your partner can also prevent you being kicked or nudged accidentally during the night - NOT what you want when your sleep is already interrupted by other factors (We still love you baby daddies and second mamas!)

That said, finding the optimal position that suits YOU is the most important factor, so that you can grab as much of those precious sleep minutes as you can. Sleep is key to recovery, healing and regenerating, all of which can make the difference during this important phase of your (and your baby's) life. During the later stages of my pregnancy, I was able to sleep on my right side and back for some of the night with no issues and often found them more comfortable – listen to your body and find what works best.

*If you’re experiencing issues with pelvic or other pains that simple positioning doesn’t help, then a visit to a physiotherapist who has a holistic understanding of pregnancy bodies is highly recommended. We can assess and treat the underlying issues that may be contributing so that you can be more comfortable, stronger and better able to enjoy this wonderful time!

3. Drop an F-bomb before bed.

Eating too close to bedtime, especially if you’re experiencing the joys of morning sickness that actually spans the whole day, can leave you feeling overfull and experiencing reflux at night, partly due to the growing human you have inside of you pressing up against your diaphragm.

Conversely, being hungry, or eating the wrong thing (yes, I’m talking to you ½ a block of Cadbury’s chocolate), can also leave you experiencing blood sugar drops during the night that wake you up at 1am for no apparent reason, in addition to your already increased number of toilet calls.

Having what’s lovingly referred to as a ‘fat bomb’ by Keto-fans shortly before bed can be a godsend in sending you off deeply into Slumberland without the extra wake-ups. A small bedtime snack of fat – a scoop of peanut butter, a piece of cheese, or a home-made mixture of cacao butter, coconut oil and nuts, helps your blood glucose levels remain stable over night as well as taking the edge of any hunger and cravings.

Fat is the only macronutrient that has no effect on your blood glucose levels and is essential to feeling satiety. Still attached to idea that fat is bad? That old tale has been debunked years ago (1). If that’s still not enough to convince you, then remember that fat is essential (yes, you read that right, you NEED it during pregnancy) for optimal development of your baby’s cell membranes and brain especially the frontal lobes responsible for executive & higher function. No fat = poor baby brain function and ain’t nobody that wants that.

4. The Magic M.

If we had to pick one sleep-soothing nutrient, it would be magnesium. Most of us are sadly deficient in this key mineral essential for over 300 enzymatic reactions in the body including energy production, DNA replication, insulin sensitivity, muscle function and protein formation (2). Low levels can cause muscle tension, cramping, restless legs, anxiety, insomnia and irritability… did someone say typical pregnancy symptoms?

Magnesium can be found in dark leafy greens (if you can stomach them!), seeds and nuts, legumes, dairy products, meat, unprocessed grains and chocolate (careful having too much before bed due to the stimulating effects of caffeine-containing cocoa and sugar causing late night blood glucose drops). Increasing your intake of some of these foods can be beneficial as well as being natural and in the form your body best knows how to process. There are also many supplements on the market but be aware that just like anything, not all supplements are created equal. Supplements utilising the citrate or orotate form of magnesium can have a stimulating effect on your bowels if taken in excess (not a bad thing if pregnancy constipation is raining on your parade though). For those wanting to avoid a possible laxative effect, look for a glycinate or chelate form, which are specially formulated to be more bioavailable to your body without having the concomitant effects on your bowel.

Keep in mind that with any supplement, talking to a qualified nutritionist or practitioner is best practice so that you can be advised on the best supplement for your body and condition, and so you’re not just getting ‘expensive urine’ (aka spending lots of money on supps but getting none of the benefits).

Another method of getting more magnesium that's perfect for a bedtime routine is having an Epsom salt (magnesium sulphate) whole-body or footbath. Magnesium is well absorbed transdermally ie. through the skin, especially in areas where you have many sweat glands and hair follicles (3). The soles of your feet, palms and armpits are where the majority of your sweat glands are found for example, making a foot bath an ideal solution for those not wanting, or who don’t have access or time to, a full-sized bath. It can also be the better solution for pregnant mama’s who are often advised not to spend prolonged periods in a hot bath to avoid raising a foetus’s temperature too high.

Soaking your feet in a small tub (I’ve used a mega-sized protein powder bucket in the past!) filled with warm water and ¼ -1/2 cup of Epsom salts for 20 -30 minutes can be a relaxing part of your new bedtime routine. Add in soothing music, and your fat bomb with a cup of herbal tea, and you’ll be blissed out and ready for bed in no time. Maybe something for partner to prepare?

5. Nurture Your Gut & Microbiome

Most of us these days are aware of the importance of gut health and a balanced microbiome (ie. the good and bad bacteria in your gut) on digestive issues and immunity. Some people also know about the importance of a mother’s microbiome on her child’s microbiome and their immune system and ability to fight off infection (that’s a whole other topic). But few realise that optimal gut health is a key factor in helping you sleep better, especially during pregnancy.

Remember the sleep-essential hormone, melatonin, that we need to be able to fall asleep? It’s made from another hormone called serotonin, and both are produced and found in highest quantities in our gut – yes, you read that right, our gut, not our brain or anywhere else in our body. One study reported 400 times more melatonin present in our intestinal lining compared to the brain (4) – affected primarily by food intake and fasting, not our natural circadian rhythm. Low or insufficient levels of these hormones can influence mood, conditions such as depression and anxiety which can disrupt our sleep, as well as directly impacting on our sleep ability (5). And if the health of our gut and microbiome are not optimal, then production and utilisation of these key hormones is also going to be compromised.

If you have digestive issues, bloating or pain related to certain foods, inconsistent bowel movements, history of antibiotic use or a known gastrointestinal issue such as Irritable Bowel Syndrome (IBS), Small Intestinal Bacterial Overgrowth (SIBO), then your poor-quality sleep may be related to these issues. Contacting a functional medicine practitioner or nutritionist who can properly assess and provide you with a customised treatment plan is recommended.

Bonus tip: Another Magic M

There’s good reason for all the hype about mindfulness, meditation and getting your Om on. Numerous studies have shown that meditation has a positive effect on managing stress and anxiety (6,7)

Many of us find it is the mental-emotional aspect of ourselves that refuses to let us sleep restfully at night and meditation is powerfully effective at helping us to better manage anxiety, worry and that mind that just won’t stop. Whether you use a guided meditation, simple background music, focussed breathing techniques or repeating a mantra or sound, anything that causes you to stop and observe your thoughts, rather than simply allowing them to over-run you, will be beneficial  to helping you sleep – especially during pregnancy, when our minds are often filled with other worries and concerns about parenting and what to expect.

Remember if feelings of anxiety and worry are starting to become a regular occurrence, it may be time to reach out to someone as post-natal depression can actually start during pregnancy. The Edinburgh Post-Natal Edinburgh Scale is a short self-report measure used to screen women for signs of emotional distress during this period (8). Please note that it is not to be used for diagnosis so if you have any concerns, contact a suitably qualified health professional.

Whatever you choose to do, committing to a regular bedtime routine plus a few sleep-inducing tricks is key to restful pregnancy sleep.

Soothing all aspects of body, mind and soul to get you into a relaxed, less stressful state may also help baby down the track; studies have shown that high levels of stress and anxiety during pregnancy are associated with lower cognitive scores, social/emotional and behavioural issues in infancy (9, 10)

All the more reason to get your good sleep on :)

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References

1.     Bjarnadottir, A. (2016). 5 Studies on Saturated Fat — Time to Retire the Myth?. [online] Healthline. Available at: https://www.healthline.com/nutrition/5-studies-on-saturated-fat [Accessed 10 May 2019].

2.     Osiecki, H. (2010). The Nutrient Bible (9th ed.). Eagle Farm: BioConcepts Publishing.

3.     Gröber, U., Werner, T., Vormann, J., & Kisters, K. (2017). Myth or Reality-Transdermal Magnesium?. Nutrients, 9(8), 813. doi:10.3390/nu9080813

4.     Bubenik G.A. (2002). Gastrointestinal melatonin: localization, function, and clinical relevance. Dig Dis Sci. 47(10):2336-48. 55. Rice J, Mayor J, Tucker HA, Bielski R

5.     Li, Y., Hao, Y., Fan, F., & Zhang, B. (2018). The Role of Microbiome in Insomnia, Circadian Disturbance and Depression. Frontiers in psychiatry, 9, 669. doi:10.3389/fpsyt.2018.00669

6.     Chen, K. W., Berger, C. C., Manheimer, E., Forde, D., Magidson, J., Dachman, L., & Lejuez, C. W. (2012). Meditative therapies for reducing anxiety: a systematic review and meta-analysis of randomized controlled trials. Depression and anxiety, 29(7), 545–562. doi:10.1002/da.21964

7.     Goyal, M., Singh, S., Sibinga, E. M., Gould, N. F., Rowland-Seymour, A., Sharma, R., … Haythornthwaite, J. A. (2014). Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA internal medicine, 174(3), 357–368. doi:10.1001/jamainternmed.2013.13018

8.    Blackdoginstitute.org.au. (n.d.). [online] Available at: https://www.blackdoginstitute.org.au/docs/default-source/psychological-toolkit/edinburgh-postnatal-depression-scale.pdf?sfvrsn=8 [Accessed 14 May 2019].

9. O'Connor, T. G., Caprariello, P., Blackmore, E. R., Gregory, A. M., Glover, V., Fleming, P., ALSPAC Study Team (2006). Prenatal mood disturbance predicts sleep problems in infancy and toddlerhood. Early human development, 83(7), 451-8.

10.     Talge, N. M., Neal, C. , Glover, V. and , (2007), Antenatal maternal stress and long‐term effects on child neurodevelopment: how and why?. Journal of Child Psychology and Psychiatry, 48: 245-261. doi:10.1111/j.1469-7610.2006.01714.x

Paleo Anzac Cookies

These are an amazing, healthier version of a good old traditional Aussie favourite. Completely grain and dairy free, this version keeps the coconut buttery goodness of a traditional Anzac but replaces the white sugar and flour with nuts and honey or maple syrup. YUM!

Vegan, dairy -, gluten-, refined sugar & grain-free

Ingredients

Dry Ingredients

·       1 cup unsweetened desiccated coconut

·       1 cup almond meal

·       1 cup walnuts, finely chopped

Wet ingredients

·       ¼ cup coconut oil, semi form (if melted, you may need a little more than ¼ cup)

·       ¼ cup honey or maple syrup

·       1 tsp baking powder

·       2-3 tsp water

Method

Preheat oven to 120 deg C (note lower temp than normal – too high and these cookies will burn before they’re ready- this is a case of go low and slow)

Line tray with baking paper or silicon baking sheets

In a large mixing bowl add all the dry ingredients and mix well. Set aside

Place coconut oil & honey/maple syrup in a small saucepan and melt. Watch it doesn’t bubble over. Take off heat and add baking powder and water, stirring until it foams and turns a whitish colour.

Pour this wet mixture into the dry ingredients and stir until well combined. You may need to add a little more water until it comes together. You should be able to press the mixture together and not have it crumble.

Use a tablespoon and place balls of mixture onto the tray. Flatten slightly- you can also firm up the edges where they crack if you like.

Place tray in oven and bake for approximately 12-15 minutes before checking – if your cookies are thin, this will be enough to make them firm, otherwise you may need another 5-8 minutes. You want them golden brown on top (white is not cooked enough) but not black on the edges.

These taste awesome warm out of the oven but the flavours intensify if cooled and eaten the next day!

Nourishing Notes:

·       Chop the nuts as finely as you can but you can leave some larger chunks. Too many big chunks and the bikkies will fall apart

·       Measuring coconut oil solid or melted makes a difference to the final volume so important to note what you use. Solid coconut oil will take up less volume than melted so keep this in mind when baking.

·       How flat you make them will determine how long you need to bake them for and how soft & chewy they are after baking – these cookies won’t flatten much themselves during baking so how you put them in tends to be how they’ll stay. This is personal preference!

·       Store in baking tin or container in the fridge.

Credit to The Merrymaker Sisters for the original recipe.

Absolutely Amazing Paleo Chocolate Cake

Paleo means free from gluten, grains, dairy, refined and processed sugar, white flour. It does not mean doesn’t taste good!

This chocolate paleo cake is loved by health nuts as well as those that who would normally roll their eyes at the hearing the words ‘refined sugar free’ or paleo. It really DOES taste good and if you pair it with either the creamy avocado chocolate or coconut cream icing that I’ve described below, it becomes to die for. Credit to The Loopy Whisk, whose recipe I followed (almost) to a tee – I’ve reduced the sugar slightly and tweaked the measurements to be all the same as I find baked goods tend to work better when you use either weight or volume – I’m definitely a cup/tsp type of person as I find it’s the easiest and most efficient way to measure out things, especially if you use a smaller measurement for the bigger ones ie. ¼ cup to measure out 1 cup. Just do the dry ingredients first!

Ingredients

·       6 Tbs coconut oil, melted

·       3/4 cup honey or maple syrup

·       8-9 Tbs cocoa or cacao powder *See notes on the difference between cacao & cocoa powder

·       3 medium eggs, free range and organic where possible

·       3/4 cup non-dairy milk (I use coconut milk, the one on the carton not the can)

Dry ingredients:

·       3/4 cup coconut flour

·       3/4 cup arrowroot flour

·       Pinch of sea salt

·       1 1/4 tsp bicarb soda (or baking soda as the US calls it)

·       1 1/4 tsp baking powder (gluten free) 

A little extra:

·       Handful of fresh or frozen raspberries, grated dark chocolate or finely chopped macadamias

Method

Preheat oven to 180 degrees C. Place your baking tins on an oven tray – I used three approximately 15cm wide mini tins. If using silicon tins, you won’t need to grease them as they’ll pop right out. Otherwise grease and line with baking paper so the cakes doesn’t stick.

Mix all dry ingredients except the cocoa powder in a bowl and set aside. Make sure the bicarb and baking powder are well distributed and not in chunks.

Add coconut oil and sweetener to a bowl. Slowly whisk in sifted cocoa powder or sift as you add which makes it easier to prevent clumps. It should look like liquid chocolate when finished.

Add eggs one at a time and mix well after each. Add the milk and stir evenly through.    

Add the dry ingredients into the wet chocolate batter and stir until everything is well distributed and there are no clumps. The batter should be quite dense and thick which is perfect.

Pour into your tins and flatten out the tops, spreading so there’s even a little more around the sides especially if you want to stack them as they pop up in the middle during baking.

A little extra: If using a little extra, you can add to the batter at this stage or stir through just before you pour into tins. Our favourite is with raspberries which add a fresh little pop amidst all the chocolate - I just pressed the berries into the batter once they were in their tins and roughly smoothed them over.

Bake in preheated oven for 20 mins if making 3 small tins – see notes on cooking times. A skewer should come out clean and the bottom will be firm. While undercooking is better than overcooking (which dries it out), you also don’t want the cake to not be cooked enough as it will stick to the sides and the middle will collapse. Still tastes great but not what you want in a cake!

Turn out onto a wire rack and cool before assembling and icing or freezing.

Icing

I’ve done this cake with 2 types of icing, both vegan and paleo and each complements the chocolate really well depending on what you feel like. Both are also common ‘healthier’ icings found in vegan and paleo baking that you can use for lots of other things (or eat on its own!!)

Choc avocado icing

·       1 large ripe avocado - must be soft & ready to eat but black is too ripe

·       3 1/2 tablespoons maple syrup (you can sub honey if not vegan)

·       2 1/2 tablespoons cocoa powder

·       Pinch sea salt

Place the flesh from the avocado, honey and cocoa powder in a processor and blend until smooth. Start with 1-2 tablespoons of each, blend then taste – this way you can adjust for your own preference for sweetness and chocolate-ness. Spread between the cakes and on top – the leftover can be used as a spread for toast (or simply out of the bowl :P)

Coconut cream icing

1 can of coconut cream (not milk)

¼ cup maple syrup (again you can sub honey if you’re not vegan)

1 tsp vanilla extract or essence (optional)

Put tin of coconut cream in the back of the fridge overnight – it needs to get cold but not frozen. You can put a couple of cans in the fridge just in case one doesn’t work (handy especially if you’re making it for a special occasion!). The next morning, remove the can and open the lid. Carefully scoop out the solid cream on the top into a bowl – it should have separated overnight and the liquid portion should be on the bottom, which you can discard.

Add half of your sweetener and vanilla if using and whip until fluffy and smooth. Add more sweetener until it’s sweet enough for your liking – everyone’s preferences are different so I always start with a little less then add more as needed. Store in the fridge until ready to use. You can either serve on the side or use as an icing between layers but you definitely want to wait until the cakes are cooled as this one can melt.

Nourishing Notes:

·       Best tip for baking Paleo is to bring everything to room temperature first, so get your eggs and milk out a few hours before. Otherwise when you add the oil it solidifies and goes chunky, making it hard to distribute.

·       I used 3 silicon cake tins from Daiso (they’re approximately a small dish size) and it stacked them to make a tower cake - it’s actually a pretty small cake but super cute and one I made for my little girl’s first birthday as you can see! You could also do this as muffins but will need to reduce the baking time significantly. I would start at 7 mins for a standard size muffin tin.

·       Cacao vs cocoa powder: in short, cacao is the less processed form of cacao beans (cocoa is fermented AND roasted, making is slightly sweeter). It is also usually more expensive and in regards to baking, has a stronger, slightly more bitter taste so you would usually use less. Cacao powder also tends to absorb more liquid so keep this in mind – I would add an extra teaspoon of oil or milk to the mixture and slightly reduce cooking time. Cocoa powder is more easily found and usually cheaper and less intense in taste - just make sure you select cocoa only and not one with any added sugars. They can be used interchangeably in baking depending on what you have available, just adjust amounts slightly as explained. The original recipe used approximately 10 tbs of cocoa powder but I found 8-9 give a sufficient chocolatey taste especially if using cacao powder

·       I would err on the side of undercooking vs overcooking for this recipe – I usually set the timer for 10 minutes less and check with a skewer. It can really dry out and tastes way better when slightly gooey.  You can freeze the individual cakes easily too, and they still taste great when defrosted. Sinply freeze without icing.

Five Essential Exercises to Stay Healthy, Strong and Pain-free! (and, no, it's not Crossfit)

Exercise: good. We all know that by now right? But what types of exercise are actually essential to staying healthy and should be included in all our regular training programs?

Wonder no longer, because we've come up with a sweet little infographic summarising the top five types of exercise you need to do to maintain a healthy bod, all in a neat little bundle (because we know y'all don't have much time). For those that want more information and references, check out the full length post below!

1. Weight-bearing and resistance exercise

When you lift a weight, run or walk you’re moving your body/body part against gravity. This puts stresses through your bones, muscles and tendons that help them to lay down more tissue and grow, helping to offset osteoporosis and muscle loss commonly associated with age. Both weight-bearing and resistance exercise do this to a much greater extent than non-weight bearing exercise such as swimming or bike riding, meaning you’re much less likely to suffer from fractures, muscles tears and falls (1). Increased muscle mass also improves your metabolism and ability to burn calories at rest, which means you don’t need to work as hard to look hard. Lift heavy? Yes, please (but only if you do it right!)

2. Proper core conditioning

Transversa-what they say? Your transversus abdominus, pelvic floor and multifidus form your true ‘core’, encasing your deep lower abdominal area, pelvic region and spine/back like a sling to provide essential support to your back and trunk. In tandem with a well-functioning fascial and internal pressure regulating system, this inner unit is the support you need so you can move your body without overloading the smaller joints and structures; without this, trying to perform activities like lifting or throwing a ball is like trying to fire a cannon from a canoe: you won’t be able to do the action without damaging the canoe, or be able to generate as high levels of power as you could on a solid surface. In short, proper core strength will help you perform better with more power and less injury risk, improve your posture, help you lose your potbelly and is essential before, during and after pregnancy. Retraining proper timing and activation of these muscles may also help in reducing low back pain (2), especially when accompanied by other self-administered exercises such as postural re-education, stretches and spinal mobilisations.

3. Balance training

‘Use it, or lose it’ holds true in regards to your balance and it’s a skill that needs to be practiced, especially as we need it to function day to day. The level of balance you need depends on what you need to do: walking, getting up from the toilet, motocross riding, dancing and surfing all require different types of balance as well as intensity. Make sure you train for what is relevant to you; kneeling on a Swiss ball may be appropriate to someone like a surfer who requires high levels of stability whilst on a moving surface, but for someone who mainly sits at a desk and goes for the occasional run, improving their single leg stability whilst on a stable surface will be more appropriate. Improving muscle strength and core stability (see points 1 and 2) will also help your balance immensely.

4. Shoulder stability exercises

Most of us know the importance of rotator cuff exercises to help stabilise the shoulder and for rehab post-injury. But what many of us don't realise is that it's often weakness or an imbalance in the whole shoulder complex including the deltoids (especially middle delt), biceps, triceps, lats and upper trapezius that has caused the shoulder to malfunction and the cuff muscles to become over-facilitated. Whilst your rotator cuff muscles can be regarded as the ‘core’ of your shoulder joint and have an important role in centralising your humeral head and keep it moving correctly within your shoulder socket, they are also orientated horizontally, meaning they're not in the best position to stop your humeral head from slipping out of its socket; because your socket basically faces out to the side, your arm inherently wants to slip out down to the floor (think of trying to attach a pole to a wall vs placing it on a ledge). The deltoids, especially the middle deltoid, as well as the biceps and triceps, attached to your arm more vertically, and therefore have a better line of pull to keep the shoulder in place. When they're not strong, the cuff muscles have to try and do their job, which can cause them to become overworked, less effective at their core role and can lead to injuries like tendon tears, impingement syndromes, bursitis and labral tears. This is even more pronounced in repetitive and heavy activities such as throwing sports, lifting and jobs such as carpentry, driving or loading cargo. Addressing poor endurance in the upper back-shoulder blade muscles is also essential, because the arm can only function optimally when it has a strong, correctly working base (aka your shoulder blade). A good shoulder stability program includes rotator cuff exercises but a great one will also look at the rest of the complex and how all its components work together,

5. Brain training

If you haven’t already heard, brain training, or ‘cognitive stimulation’ can positively affect our mental capacity, offset Alzheimer’s disease and improve memory. These improvements can also occur in people who already have mild cognitive impairments due to our brains incredible neuroplasticity (3). Free apps can be found everywhere (Elevate is a good one I use), but simple things like crosswords, learning a new language or skill, trying to memorise your grocery list or in-laws birthdates all help.

References:

Yung, P.S., Lai, Y.M., Tung, P.Y., Tsui, H.T., Wong, C.K., Hung, V.W.Y. & Qin, L. (2004). Effects of weight bearing and non-weight bearing exercises on bone properties using calcaneal quantitative ultrasound. Br J Sports Med 2005, 39. 547-551.

Richardson C. A., Snijders C.J., Hides J.A., Damen L., Pas M.S., Storm, J. (2002). The relation between the transversus abdominis muscles, sacroiliac joint mechanics, and low back pain. Spine, 27(4). 399-405.

Belleville, S., Clément, F., Mellah, S., Gilbert, B., Fontaine, F. & Gauthier, S. (2011) Training-related brain plasticity in subjects at risk of developing Alzheimer’s disease. Brain, 134(6). 1623-1634.

Sweet Potato and Zucchini Fritters

These sweet potato zucchini fritters are awesome and these only have 2 main ingredients so are quick and easy to make once you’ve grated the veggies (food processor would be even quicker). Doing a mix of zucchini and sweet potato lowers the starchy carb content while sneaking in more greens. Feel free to use whatever fresh herbs and spices you prefer.

Kid and baby friendly, great for post workout recovery food and leftovers can be frozen.

Ingredients

• 1 small-medium sweet potato

• 2 zucchini

• 2 organic free range eggs

• Finely chopped coriander, parsley or any other fresh herb you like

• Approx 1-2 tsp turmeric or cumin plus sea salt and pepper to season

• Coconut oil for frying

Method

Grate sweet potato and zucchini into a bowl. Add the herbs and spices then the eggs; you don't need to whisk it beforehand, just add them in directly and use your (washed!) hands or a spoon to mix everything together.

Season with some sea salt and pepper then cook heaped tablespoons in a moderately heated pan with coconut oil. Use a wide spatula to edge in underneath them and then flip. Obviously this is easier if they’re a little smaller.

I like mine big so I can put lots of stuff on them…. Smoked salmon, feta, more herbs, avo...the possibilities are endless and they make a great whole-food base for any meal. This amount made about 9 large fritters, most of which I froze for another meal!

Nourishing Notes: You don’t want to avoid using oil otherwise these fritters will be hard to flip and will stick to the pan and break up. If you use coconut oil or even a grass-fed butter then you don’t need to be scared of using a liberal amount; these fats are much better than vegetable oils or margarine which have been hydrogenated (turning them into those dreaded trans fats) and more likely to cause free radical damage in your body. You can also use a good extra virgin olive oil but just be sure not to turn the heat up too high as EVOO doesn’t have as high a burning temperature as coconut, which means it can also become oxidized at high temperatures.

Are You Training your Brain and Spirit Too?

In the physio/nutrition world we call it ‘continuing professional development’ but the basic idea of always learning, upskilling, improving your skills as well as your qualifications and self has been around for years – and for good reason.

Just like our body and the muscles we know benefit from being used and trained for our whole life, so too should we be ‘training’ our brain, and not just to prevent conditions such as dementia, Alzheimers and memory loss (1).

From a professional and personal point of view, continuing to educate ourselves (and this doesn’t have to mean going to uni or doing regulated study) is extremely important for us to become better in what we do as a profession as well as in our personal lives because the reality is that the world we live in is constantly changing and research, knowledge and best practice does too. There’s two quotes that sum this up nicely:

“Life is change. If you aren't growing and evolving, you're standing still, and the rest of the world is surging ahead.” ― Louise Penny, Still Life

“Look around you. Everything changes. Everything on this earth is in a continuous state of evolving, refining, improving, adapting, enhancing…changing. You were not put on this earth to remain stagnant.”

― Steve Maraboli, Life, the Truth, and Being Free

I love this one too:

“There are two kinds of people. One kind, you can just tell by looking at them at what point they congealed into their final selves. It might be a very nice self, but you know you can expect no more surprises from it. Whereas, the other kind keep moving, changing... They are fluid. They keep moving forward and making new trysts with life, and the motion of it keeps them young. In my opinion, they are the only people who are still alive. You must be constantly on your guard against congealing.” ― Gail Godwin

Yes, I’m a huge fan of personal and spiritual development as well, and believe we should constantly be seeking to improve ourselves so we can leave this world smarter, wiser and better than we were when we came into it – and that includes how we’ve impacted on others as well.

Some tips:

- Anything that makes you excited, eager to turn a page or wanting to know more counts as development

- At the same time, anything that makes you have to think a bit more and use that noggin is also pushing you outside your comfort zone and considered learning

- A note about comfort zones – they’re named that because they are comfortable NOT because they cause you to grow and evolve. In order to be better we need to strive for better.

- The best way to learn is to surround yourself with people that are smarter, faster, wiser and more proficient than you (this can be via books, podcasts or in person) – they will lift you up to a level you can only imagine is possible BECAUSE you have them in your life. Embracing the power in using what others have learnt to develop yourself is the biggest sign of intelligence – and passing your knowledge on to others is the greatest sign of true personal evolution.

References:

1. Gates, N., & Sachdev, P. (2014). Is Cognitive Training an Effective Treatment for Preclinical and Early Alzheimer's Disease?. Journal Of Alzheimer's Disease, 42(s4), S551-S559. doi: 10.3233/jad-141302

Tumeric Avocado Feta Smash

Not just for café-goers, this is an unbelievably easy and much cheaper version (who wants to pay an extra $3 for half an avo?) of your standard avocado & feta smash. And you can make, and eat, as much as your heart desires.

I’m all for foodhacking - adding extra ingredients that boost a meal’s superfuel properties but don’t take away from it’s essential taste or ease of making. This dish adds a pinch of Himalyan salt which is great for soothing your adrenals (the glands that help you in times of stress) and turmeric, which is a powerful switcher-on-erer of your body’s own antioxidants and anti-inflammatory. Black pepper should always be thought of when adding turmeric as it hells your body absorb it so it work its magic.

Ingredients

• 1 ripe avocado

• 30g Danish feta

• 1 tsp turmeric

• Pinch of Himalyan salt

Method

Like the name says, smash.

If you want specifics, I used a fork to roughly mash the avo with the turmeric first, then folded in the crumbled feta. If you want it chunkier, don’t mash as smoothly and just fold in the feta. For those that like it smooth, you can use the back of a spoon to really get the lumps out. You could use a food processor or blender if you want, but it’s not really necessary and just gives you more to wash up.

You can substitute any type of feta you have. As I learnt from my friendly deli manager, Danish feta is a smoother, creamier version compared to the more crumbly, firmer feta you often see in Greek salad. Both equally yummy.

I ate this on a scrambled egg but you can smear it on pretty much anything or just eat it straight out of the bowl. This dish is also great for bubba's starting to eat solids; its an awesome source of heart/brain/body- healthy monounsaturated fats and really easy for them to digest.

Nutritional info for 1 small avo (75g without skin)

778kg

7g carbs (5g fibre)

13.8g fat

3.3g protein

How to Squat (and a Simple Trick to Squat Better!)

Squatting is an essential part of our day to day life and not just relegated to the gymspace of bodybuilders and Crossfitters. Think about it: every time you sit on the toilet, get in and out of a chair or car or crouch down to pick something off the floor you're using a squat pattern, so being able to squat well, and without pain, is important for all of us, everyday and at all ages of life. Squatting is also a useful movement during late pregnancy and labour to help prepare us for birth, as well as a great movement for those with pelvic floor issues.

So what went wrong with that squat?

From top to bottom :

1. Lateral weight-shift to right (see unevenness in dowel height)

2. Loss of core activation (see pouchy tummy bulge)

3. Medial deviation of knees (see them coming towards the middle)

4. Over-pronation of ankles, right worse than left (see how the inner arches of the feet have collapsed)

Hmm, so what caused what?

There are a few possibilities:

• Ankle pronation causes medial deviation of the knees

• Weightshift to one side is usually a sign of moving away from a current or previous pain/injury

• Knees collapsing in can be due to weak gluteus medius/minimus, tight tensor fascia latae (TFL) or just badly taught technique or poor body awareness

• Tight calves or restricted ankle joint mobility will restrict dorsiflexion which causes someone to squat in this way just so they can get 'butt to ground'

Ultimately though, point number 2 is usually the root cause of most of these postural issues - a poorly activating, dysfunctional core.

Why? Without the ability to stabilise from the core out, we can't transmit/dissipate forces on our bodies optimally. Because our bodies tend to obey what we tell them without regard for how, compensations and deviations occur to let us move.

Trick Your Squat

Using a Theraband above the knees is a simple and easy 'hack' to help improve this commonly seen squat posture. It gives you tactile feedback to activate your glutes as you work to stop the band pulling your knees inwards. Switching on your side glutes will often also correct arch collapse and increase stability around the hip, pelvis and lower back which is important in being able to perform this move.

Identifying and correcting a possible pain source that the patient may be avoiding, differentiating between calf muscle tightness or ankle joint stiffness then treating the correct deficit appropriately, teaching correct squat posture and improving postural awareness are all essential (and something we can help you with here).

Above all, we need to address that pouchy tummy and poorly activating core with cues, well-taught corrective exercise... and by not allowing our clients (or ourselves!) to continue squatting with poor form!!

For those that want more and like to watch rather than read, see this vid I did on squatting here.

Slow Cooker Chicken (or Beef) Bone Broth

This recipe for slow cooker chicken bone broth combines the nutritional benefits of mineral rich bone broth, the deliciousness of slow cooked meat and the comforting nourishment of what is, essentially, your grandmother's good old fashioned chicken soup. Although this recipe suits the cooler winter months, because it's so easy and no fuss to do, I've made this several times during spring and summer and happily eaten it to get an extra hit of nutrition.

You can also swap the chicken for beef marrow and soup bones from your local butcher to make your own super-nutritious, nutrient-rich beef bone broth. Beef broth has a slightly higher mineral content but is stronger in taste and needs more time to cook due to the larger bone size - at least 24 if not 36 hours. It’s a good option to change things up and because you can usually fairly easily and cheaply get these ‘throw away’ bones from your local butcher.

Ingredients

• 1 organic free range chicken

• 1-2 onions, skin on and quartered

• 3-5 garlic cloves

• 1 small spray-free lemon, washed and quartered

• 3 celery stalks, chopped

• 1-2 cups root veggies of choice, chopped coarsely eg. potato, turnip, swede, carrots

• Seaweed sheets, roughly torn eg. nori, dulse, wakme, kelp

• 1-2cm piece of ginger, squashed

• 3 tbs apple cider vinegar

• Sprig of thyme & 2-3 sage leaves – can used dried if fresh not available

• Pinch of Himalyan or sea salt

• Pinch of turmeric powder

• Pinch ground black pepper or 2-3 whole pepper cloves

• Coconut oil

Method

Add coconut oil to pan and allow to melt (make sure your pan is big enough to fit the chicken in!). Add onion and garlic, stirring until aromatic. Place chicken into pan and braise each side until a golden crust forms. You can add fresh thyme and sage leaves at this stage if you have it.

Place chicken, juices and spices to your slow cooker. Add root veggies and all other ingredients into cooker. Add 2-3 cups of filtered water to slow cooker – enough so it comes 2/3 way up the chicken. Set the slow cooker on for 18 - 24 hours - you can get away with a slightly shorter cooking time due to the smaller bones but 24 hours is recommended to really break down the connective tissue and bone to release as many of the amino acids, minerals, collagen and gelatin as possible.

Then go about your normal day knowing dinner is cooking away!

If you want, you can turn the chicken over midway through the cook – if you don’t, it will still come out wonderfully tender and tasty. The chicken will start to fill your house with a wonderfully delicious smell within a few hours. The chicken is done when the meat falls off the bone easily with a fork or tongs. It should also have no more pink parts.

As meal: Remove chicken meat and veggies and place into bowl with or without some of the bone broth and serve with extra veggies, a piece of crusty sourdough or as is. Season with extra salt and pepper as needed.

As bone broth: Refrigerate remaining chicken and broth overnight. Bring to boil again the next day and simmer on low heat for another 1-2 hours (I usually transfer the chicken and broth to other bowls or a smaller pot so it will fit in my fridge, then reheat it in a pot on the stove).

Strain while still warm, keeping the left over chicken meat and veggies for another meal. Pour the broth into clean glass jars and refrigerate. It will be lovely and gelatinous the next day, full of beautiful collagen, amino acids and minerals. The yellow solidified fat on the top can be skimmed off and saved for cooking or simply left and when reheated will add to the flavour of your broth.

Warm in a saucepan as a hot drink or base for soups and other meals. And please, try not to microwave it or you’ll denature all the wonderful good nutrients you spent so much time and love making!

Nourishing Notes:

• It’s essential to use organic, hormone free & if possible, pastured, meat/bones, as toxicants and chemicals that are given to conventionally farmed animals will be stored in their fat and bones and transferred to your food which is not what you want

• Onions & garlic: provide sulphur, a mineral essential for healthy connective tissue and flexibility; also anti-bacterial and a great prebiotic

• Lemons & ACV: provide acid needed to dissolve bone and protein chains in the chicken to obtain all the goodness out of the carcass

• Celery: provides chloride (essential for stomach acid production needed for good digestion, pH and fluid balance, endocrine function), potassium (regulates blood pressure, needed for cellular waste removal ie. Reduces oedema) and sodium (essential for cell hydration, good muscle contraction and regulating blood pressure)

• Seaweed/nori sheets: high in iodine, needed for healthy thyroid function and to stop your hair falling out

• Root veggies: enhance the flavour and texture of the broth

• Turmeric + pepper: turmeric contains curcumin which is a potent anti-inflammatory while black pepper helps increase curcumin's absorption in the body

Note: If the list if ingredients seems overwhelming, be reassured that you can get away with the meat/bones and liquid, plus whatever veggies you want to add - or none at all! The goodness is in the meat and broth, but I like to get the most bang for my buck when cooking so adding all the extras makes it an even more nutritious meal!

4 (Inexpensive) Ways to Support Bushfire Crisis & Our Earth

I don't there's anyone who hasn't heard of, seen or been touched by the fires that have been burning through our country (Happy new year right? For so many of us, sadly not really)

(Heads up: This is fairly long email about a topic I'm super passionate about, especially when thinking about our children and the next generations to come. So while I would love you to take the time to read this if you can - promise it'll be worth it -  I'm also okay if this isn't for you as I know we're all at different places and headspaces in our life and that's totally cool too! Love x)  

As someone who never watches TV or mainstream news, even I got the gist of how devastatingly the bushfires have hit our country (social media has become the new news medium but that's a whole other article).

At the same time I also felt a bit overwhelmed by all the calls to donate, requests for help, charity fundraisers - as well as unsure and stuck about how I could best contribute. As much as I'm heartened by the way this tragedy has brought out so much of what is positive about the human race, I also believe there's a greater, bigger picture to this situation that not enough people are doing enough about.

Whether the issue is climate change or not, no one can disagree that the way we're living currently is taxing our poor Mother Earth, is not sustainable long-term and will very likely leave behind a not-so-beautiful country for our children. Wanting the best for them should extend further than making sure they eat good quality food or what school they'll go to as none of that will matter if the world they live in is polluted and sick.

If you're also struggling to know where to donate, are maybe hesitant to donate because you don't know how much of the funds will actually get to those who need it or don't have a lot to give, then these easy and (nearly) free tips will help our country regenerate and also address a longer-term, bigger picture issue that's affecting our world today.

Four easy ways we can (inadvertently) support the bushfire crisis and start to change our Australia and the world for the better:

 1. Reduce your waste especially food waste. The Government estimates 5 million tonnes (!!) costing 20 billion a year goes to landfill EACH YEAR. Think about what means not only for the planet but for your wallet. Don't waste food - buy what you need and if you have leftovers, cook into another dish, freeze or at very least compost. Avoid the single use bags at the supermarket; your apples will be totally fine sitting naked in your basket, I promise. Use those mesh produce bags or do what I used to do for small things like manderines - use the paper mushrooms bags instead. When you eat sushi, say no to the plastic container and the soy sauce fish - get it in a paper bag or direct in your hand and use sauce out of the bottle instead. And seriously, if you're still buying water in plastic bottles or getting coffee on a regular basis in takeaway cups - invest in yourself and get a reusable water bottle or cup. Kmart & Target do cheap but trendy looking versions of all the expensive brands.
Bonus: I'll happily gift anyone who doesn't yet have one, a stainless water bottle! Just send me an email and I'll put one in the post for you (in a compostable satchel too :))

2. If you're not doing so already, learn how to recycle. It's not just paper, bottles and cans but even soft plastics and packaging can now be recycled at nearly all Woolworths and Coles through REDcycle - the key is anything you can scrunch. For a list of surprising things you can recycle see here. I was super happy and totally surprised that you can even REDcycle those baby food pouches! Last year the QLD government also brought in the container refund scheme for cans and glass bottles, which you can get paid as vouchers for supermarket shopping or straight into your Paypal account. 

3. Be mindful of water and electricity usage - given the recent crisis, I think we've all realised that our water supply shouldn't be taken for granted. We're on rainwater tanks so are motivated to take heed of our usage but so many of us still leave the tap running while brushing our teeth, wash produce under a running tap or don't use the single flush function on our toilets. All these tiny little things count! Electricity is another resource that we've come to take for granted growing up in a developed nation. Switch to LED lights (up to 80% more efficient than fluorescent or incandescent lights), think about installing solar or just switch off appliances at the wall (yes, they drain electricity even if not in use). The thing about being less wasteful is that you'll also usually save money, and who doesn't want to do that!

4. Share respect and care of our planet with your children - This is one of the easiest and most effective ways to take care of our earth and make sure it's well looked after in future. Kids are naturally curious learners and love being in nature, plus they do what they see so being a pro-active, non-polluting nature-loving parent/aunty/uncle/friend will make a significant difference to the way they see the world. I think one of the reasons why so many of us don't implement earth-friendlier methods is not because we're wasteful, materialistic people - but because we lack awareness of the impact we're having and an appreciation of the natural world we live in. We can only value what we love and respect, and that starts with spending more mindful time outside, going for walks, playing on the grass or at the beach, collecting leaves and simply enjoying what Australia is known for best. (I have to admit I'm just a little bit proud when my two-year old sees rubbish on the street during our walks and straight away says 'bin' so we have to pick it up and throw it away properly!)

I think what will make the recent bushfires an even greater tragedy is if nothing changes in how we treat, interact and live in this beautiful land we call home. 

While doing these things aren't going to change the state of the world overnight, they're small ways that we can start to make a positive move against future threats of climate change. Depending on large scale companies and businesses to initiate the change can be frustrating and passive - but as consumers and customers, we can push them in the right direction while doing our bit by starting with small actions at home that we do have control over. 

Sissy

P.S. I've included plenty of links with useful information that can help you even more. Sharing or forwarding this with your friends and family is also another small step that you can make!

P.P.S. If you're still looking for a place to donate where you know your money will go to where it's needed, Against the Grain Health are running a GoFund me Campaign to support the Wildlife Rescue & Rehabilitation Fund in Victoria (unfortunately the bulk of public monies raised so far are going to NSW only). These Sunshine Coast-based guys make amazing, natural eco- and baby-friendly products and I know them personally and love what they're trying to do to help our earth. They have no idea I'm sharing this so it's purely because I trust them and know they have the very best of intentions - plus I also love spreading the word about great products that other people would like!

Nutty Protein Balls

Who doesn't like protein balls? These nutty balls are so named because their protein comes mainly from the nut butter used rather than from the addition of protein powder. Whilst I don't have anything against a good quality, no filler whey or vegan protein as a supplement to a good diet (especially post training), I don't often add them to snacks that I make for my partner because he's lactose-intolerant. It also makes these balls pretty much as unprocessed as you can get!

Ingredients

• 1 cup dates, roughly chopped

• 1/2 cup organic nut butter (nuts only with no added nasties)

• 1/3 cup mixed seeds (sunflower, pumpkin or flax)

• 1 tbs raw cocoa powder

• Pinch cinnamon

• Pinch Himalyan salt

• Desiccated coconut for rolling

Method

Put chopped dates in a blender or food processor and blend until moderately smooth. Add seeds, blend further (they can stay a little chunky). Add nut butter, cinnamon & salt and blend until the mixture comes together. You may need to add a little bit of water to get the mixture smooth.

Spoon out tablespoons of mixture, roll into balls and press into coconut.

These are awesomely stick-to-the-roof-of-your-mouth-delicious and naturally sweet from the dates. They are great as an alternative to chocolate or perfect as a high energy snack after training or for breastfeeding mums. I would recommend keeping them in the fridge but they won't last for long!