Pilates in Macau

Thanks to Su-Lin's information, finally my friend in Macau can try out Pilates. I am quite surprised to know it is so affordable to learn Pilates in Macau, it's either MOP$/HK$80 per class, or MOP$/HK$500 for a month of 8 classes.

This Pilate place has no website. So you have to call/ email the owner for more information. Here are the contacts:

Address: Carmo Swimming Pool in Taipa - Studio B,

Rua da Restauração, behind the Taipa Houses Museum

Mobile: 66646783 / Fax: 28841521 / Email: fitforlife_macao@yahoo.com

Terymun is Limping - SIJ Dysfunction

I have stopped almost all physical activity, including walking, in the first 3 months of my pregnancy, mainly because of morning sickness (I wonder who on earth created this name, the sickness definitely last beyond morning!). Another major reason was that I was limping. I suspected that I was suffering from Sacroiliac Joint Symdrome.

The sacroiliac, or "SI", joints (there is one on each side of the body) are the link between the spinal column and pelvis. They help absorb damaging shock forces, and they also help stabilize the body and transmit weight to the lower limbs. You can see these joints from the outside as two small dimples on each side of the lower back at the belt line.

The SI joint is one of the larger joints in the body. Very little motion occurs in the SI joint. The motion that does occur is a combination of sliding, tilting and rotation. The most the joint moves in sliding is probably only a couple of millimeters, and may tilt and rotate two or three degrees. It appears that the primary function of the joint is to be a shock absorber and to provide just enough motion and flexibility to lessen the stress on the pelvis and spine.

If the motion in the pelvis is asymmetric, then dysfunction can occur. Some conditions that cause asymmetric motion include leg-length inequalities, a unilaterally weak lower limb (eg, polio), tight myofascial structures (eg, iliopsoas), and scoliosis. Hip osteoarthritis can lead to leg-length shortening and SIJ pain.

Women may be at increased risk for SIJ problems because their broader pelvises, greater femoral neck anteversion, and shorter limb lengths lead to different, possibly predisposing, biomechanics. In addition, pregnancy often leads to stretching of the pelvis (because the pelvis must stretch to accommodate childbirth), specifically targeting the sacroiliac ligaments and possibly leading to dysfunction, hypermobility syndromes, and chronic pain.

Rest and anti-inflammation medication (topical or oral) might help in the initial stage. But physical therapy is effective too, because pain in the SI joint is often related to either too much motion or not enough motion in the joint. Range-of-motion and stretching exercises can help maintain joint flexibility, and strengthening exercises to give your muscles additional stability.

SIJ symdrome is hard to diagnose, but few assessment may help to identify it:

Leg length difference measurements - both straight leg and bent leg assessments.

Ilia rotation- this assesses whether the ilia is rotated on one side creating imbalance.

The Stork test - to assesss whether the sacroiliac joint is moving correctly.

Stork Test

1. With the patient standing and the examiner sitting behind, the examiner's left thumb is placed over the most posterior portion of the left posterior superior iliac spine (PSIS) and the right thumb overlying the midline of the sacrum at the same level.
2. Examiner asks the patient to flex the left hip and knee to a minimum of 90 degrees of the hip flexion. Imagine making an "L" with the leg and thigh.
3. A negative test finds the left thumb on the posterior superior iliac spine (PSIS) moving caudad (towards the tail) in relation to the right thumb on the sacrum.
4. A positive finding occurs when the thumb on the PSIS moves cranially (towards the head) in relation to the thumb on the sacrum.
5. The findings of this test are correlated with those of the standing flexion test. The Stork test is more specific for SI joint Restriction.

Since the pain started near my right sacrum, I have cut down movements that required loading my body weight on my right leg, such as taking the stairs, lunges and other related Pilates exercise; and I made sure I have good support when I got in and out of the car. Now the pain has subsided so I have started some stabilising work (but in a very cautious range of motion). Hope the pain will not come back again.

*For instructors, you may find more useful information here.