Better Sleep, Better You

Karin Hilfiker, Physiotherapist at Fix London Fields, on why sleep is so important and how to get some good shut eye.

Who doesn’t love sleep?  What doesn’t feel more glorious than climbing into bed after a long day?  

That said,  many of us don’t get the amount of sleep we need.  Did you know that  more and better sleep can not only increase concentration, enhance motor performance and mood, it can also help prevent or reduce persistent pain? (1).  There are several possible mechanisms of how this might happen including changes in dopamine and opioid levels in the brains as well as reduced inflammation and changes in neuroendocrine levels.

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If you’re an athlete, sleep is even MORE important as it can enhance performance, promote tissue recovery and reduce risk of injury, as shown by numerous recent studies (2).  Lebron James, Usain Bolt, and  Roger Federer famously sleep 10-12 hours per night! (3)

Getting enough sleep is both about the quantity of sleep as well as the quality of your sleep.  Below are are some tips to for a great night’s sleep:

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1. Getting enough sleep: the average person needs between 7-9 hours of sleep per night, athletes in training likely need a bit more.  If you are getting much less than the recommended amount, start small and just try turning off the lights a half hour earlier each night.

2. Going to bed and waking at the same time each day helps normalize your circadian rhythm and can help you fall asleep faster when you get in bed.

3. Establish a night time routine:  dim the lights,  drink a cup of caffeine-free tea, take a warm shower or listen to soft music. Meditation or a gentle yoga practice can help relax your body and your mid.  

4. Create your Cave: your sleeping area should be quiet, cool and dark.  Optimal room temperature is 16-18 degrees centigrade.  Use blackout blinds, eye mask, or ear plugs if you need to.  Ideally avoid using your bedroom to work, watch television or eat before sleeping.

5. If you cannot sleep within 15 minutes, get out of bed and try performing a mundane task.  Don’t work or watch TV as this might be too stimulatory.  Similarly, if you regularly wake during the night and have a hard time falling back to sleep, go to another room and read or do other quiet activities until you feel sleepy.

6. Avoid coffee, alcohol and nicotine in the hours before bed.  Some people are very sensitive to caffeine and should avoid caffeine after 12pm.

7. Napping has been shown to have benefits on cognition and motor performance! (4) If you have trouble sleeping, however, you may want to avoid daytime naps or because it can interfere with sleepiness at night


1. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-52. 
2. Bird, Stephen P. PhD, CSCS Sleep, Recovery, and Athletic Performance: A Brief Review and Recommendations.1,2
3. https://www.forbes.com/sites/brucelee/2017/06/09/this-is-how-many-hours-of-sleep-lebron-james-gets-a-day/#5d4e781279b2

4. Lovato, N, Lack, L. The effects of napping on cognitive functioning. In: Gerard A.Kerkhof and Hans P.A. van Dongen, editors: Human Sleep and Cognition, Vol 185, Oxford: Elsevier Science; 2010, p. 155-166.

Hay fever - How Acupuncture can help

Cristina Betto, Acupuncturist at Fix London Fields, talks about the ways Traditional Chinese Medicine can help hay fever sufferers this season

Have you had enough of the tablets and nasal sprays and you want something more natural as a treatment ?

 Despite its name, hay fever is seldom caused by hay and this medical condition does not lead to an elevation in body temperature. The term “hay fever” was originated in England in the early 1800s when doctors noticed that some rural residents experienced sneezing, itchy eyes and coughing after being exposed to cut hay or grass.

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Hay fever, also known as seasonal rhinitis, is an allergic reaction to pollen and therefore is common in spring and summer. Typical symptoms include itchy eyes, blocked or runny nose, sneezing, watery, red eyes, blocked sinuses and tiredness. However, while grass pollen is the most common (May to July), there are pollens specific to trees (February to June) and weeds (June to September) which can also cause the allergic reaction.

While this disease is not life-threatening, it is definitely life-altering and, if left uncontrolled, allergic rhinitis can seriously impair a person’s quality of life.

According to Allergy UK, allergic rhinitis is the most common form of non-infectious rhinitis affecting between 10% and 30% of all adults and as many as 40% of children (https://www.allergyuk.org/information-and-advice/statistics).

Most suffers rely on anti-histamines and intranasal steroid sprays to manage its symptoms. But in the long term hay fever can lead to more complicated health conditions such as nasal polyps, chronic sinusitis, and significantly increases the probability to develop asthma (https://www.asthma.org.uk/advice/triggers/pollen/)

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In looking at alternative remedies, studies suggest that acupuncture can help with symptoms of hay fever (https://www.ncbi.nlm.nih.gov/pubmed/23420231).

From a Chinese Medicine perspective hay fever is seen as an inability to produce enough energy for a healthy immune response to wind and allergens. When the immune system is depleted through poor diet, worry, stress and lack of exercise, it cannot produce enough protective energy (wei qi) which is important to defend against outside wind and pollen. Without healthy wei qi,  wind penetrates the body to produce hay fever symptoms such as sneezing, itchy eyes, coughing, running nose etc.

Acupuncture works to balance the body, helping it stay strong and resilient. By inserting fine needles just below the surface of the skin, a reaction is triggered to promote homeostasis. In addition to promoting a calmer nervous system, acupuncture points are chosen to address symptoms as they present, so, in peak allergy season we work on unblocking noses and clearing out lungs. Better yet, prior to allergy season we try to create a stronger healthier respiratory function so when the pollen count gets high, the body can handle it better.

With hay fever season just around the corner it is important to get in front of it and start making the changes now. Perhaps, instead of deciding which cocktail of medicines will be taken this year, a course of acupuncture should also be something to consider.

Fix has acupuncturists at both our London Fields and East Village clinics. Click here to book in with them.

The importance of Change

Nick Warner, Physiotherapist, talks about the importance of progressive loading for injury recovery, strength and a well-functioning body.

Change, it’s a word many of us are wary of, whether that be everyday tasks or our training and exercise habits. Without change, our bodies will plateau, leaving us continually fighting against those niggling aches and pains. Too much change to quickly? Well we all know what that can lead to…

This brings us on to the topic of progressive overload, the science of getting change right.

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Overload is a training principle used in exercise in order to allow for adaptations in our muscles. We can see these adaptations as increases in strength, power and endurance, for example. When we perform a certain exercise above or beyond what we have has done before, our body will undergo physiological changes to enable us to complete that exercise with greater ease and efficiency. If we continue to work at the same intensity of that exercise, we will soon reach a plateau, where that movement or exercise no longer stresses the body and further improvements will stop! By making our exercise harder, or increasing the workload on the muscles, we can then again induce these adaptations, which then allows for further progression.

Post injury, we can often find ourselves lacking strength in certain muscles groups. This can be due to lack of mobility and altered mechanics due to pain, decreased training loads due to injury and pain inhibition of certain muscles. Therefore, on the road to recovery, overload can be used to safely return to movement and is critical to return these muscles to optimum function, with decreases in pain and lower risk of re-injury.

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Overload can occur in a number of different ways. The five simplest ways of achieving overload are listed below:

  1. Increase the resistance or weight lifted

  2. Increase the total volume of work (sets and/or repetitions)

  3. Change the exercise

  4. Modify the order of the exercises performed

  5. Modify the rest period between exercises


In order to safely achieve progressive overload, without overtraining or running the risk of increasing the risk of injury, it is important not to rush. You don’t need to try and do more every time you exercise! Unfortunately there is no magic number on how much or when to overload. Small increments can be made weekly if manageable without any increases in pain or soreness. When increases are made, it’s fundamental that you are able to complete that exercise with the same technique.

Give yourself time, stay consistent and happy loading!

Postnatal Yoga @ Fix Studio

We have a new ‘Postnatal Yoga’ class joining the Fix Studio timetable on Tuesdays, 11am at London Fields.  This is a new addition to Fix’s specialist team of physios, massage therapists and movement teachers here to support women every step of the way through pregnancy and into motherhood. 

Q&A with Nuria - The Fix 28 Day Full Body Reset

Nuria Rodriguez, Nutritional Therapist at Fix East Village introduces the online 28-day nutrition & movement programme

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Nuria, tell us, what is the '28-day Full Body Reset' programme?  

It is a 28-day programme that allows people to have a total body reset over a 4-week period.  It’s a fully supported nutrition that gives participants the chance to access unlimited yoga and Pilates classes for four weeks.

All the evidence shows that regular exercise and good nutrition are key to improving your long-term health outcomes, and also that they boost day to day happiness.  We wanted to create a structure where people can get a lot of daily support as they make positive changes to their lifestyles. February can feel like a long month at the end of winter, and we wanted to give people something really positive to help them enter the Spring feeling really great.    I’m really excited!

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What can you achieve in the 28-day programme?

Everybody's biochemistry and physiology is different.  So the end results won't be the same for all the participants.  However the programme has been designed with the following goals in mind.  To:

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  • Establish healthy lifestyle habits

  • Restore energy levels

  • Reset your metabolism for a fat-burning boost

  • Improve body composition

  • Boost your immune system

  • Support your exercise and fitness goals






And Nuria, why create a programme that combines good nutrition and movement?

I am very excited to be able to deliver this programme in collaboration with teachers at Fix as I am passionate about the great results you can get with with a combination of good nutrition and movement.

It is also an opportunity for you to try many the different styles of yoga and Pilates taught at Fix. Regular yoga and Pilates has been shown to offer a range of health benefits including reducing blood pressure, increasing upper body strength and endurance, flexibility, and creating improvements in perceived levels stress and health perception. However the improvements differ for the type of yoga.(1) This is a unique opportunity to try all types and discover what is the best one for you.

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In addition, if you want to lose those extra kilos, this programme is the right one for you. Research says that the best way of managing weight is not getting on a diet or doing exercise but combining both.  Carefully planned nutrition and exercise together will really help people see and feel significant gains in a relatively short space of time.(2)

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What can people expect to receive during the programme?

By signing up to this programme you will receive a resource pack including a flexible meal plan with simple recipes and a shopping list. You will be part of a private facebook group/online community and I will give you the support to go throughout the programme and implement changes to achieve your health goals. On the first and last days of the programme I will measure your body composition so you can track the physical changes in your body. For this I will meet you at Fix East Village, but don’t worry if you cannot make it, the body composition analysis is optional.

So I hope you will join me and take the chance to Reset your metabolism and Reboot your body in 2019!

  1. Cowen VS, Adams TB. Physical and perceptual benefits of yoga asana practice: results of a pilot study. Journal of Bodywork and Movement Therapies. 2005 Jul 1;9(3):211-9.

  2. Mayo Clinic (2017) Weight Loss. Accessed: https://www.mayoclinic.org/healthy-lifestyle/weight-loss/expert-answers/weight-loss/faq-20058292, 15th January 2019

The Fix 28 Day Full Body Reset runs from Sunday 3rd Feb until Sunday 3rd March and costs £89. For more info and to book please contact us.

Strength and Conditioning for Triathletes

Alice thomas, team GB TRIATHLETE AND Fix Strength and Conditioning Coach, talks about the importance of strength and conditioning for boosting performance and injury prevention.

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OVERLOOK STRENGTH AND CONDITIONING AT YOUR PERIL

Let’s be honest, Strength and Conditioning (S&C) is all too often the training session that first gets dropped or overlooked by many sports people, not least triathletes. However, the evidence is pretty overwhelming that regular S&C forms vital part of any successful training programme. The musculoskeletal system provides form, support, stability, and movement to the body. Strengthening this system as a triathlete is key. S&C will improve your performance and lessen your chance of injury.

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SO WHAT IS STRENGTH & CONDITIONING, AND WHY IS IT SO IMPORTANT FOR ATHLETES?

The two elements of S&C work hand in hand to maxmise your potential. Strength training boosts the power and endurance of muscle groups to boost your performance. Whilst the conditioning element might be said to focus a little more on the mobility to key joints, on the fluidity and timing of movements to improve efficiency, and to minimise muscular imbalances and weaknesses to help avoid injury.

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Swimming, cycling and running use repetitive movements over long periods of time creating load on muscles, tendons, ligaments and joints. If there are weaknesses or imbalances in your body this can cause other more dominant muscles to become over worked, often leading to injury.  Often the site of pain may not be the root cause of the problem, which is why at times its essential to work with a team to fully understand the context of your pain.

Good quality S&C has exercises and movements that are specific to the movements in your sport and tailored to your training level and goals. This type of focussed conditioning work is sometimes called functional training.  I'd recommend any athlete to have a good quality, coach-led S&C weekly session all year round. It's about focussing on flexibility, mobility, plyometrics (practising explosiveness movements of the muscles), balance and more. It's also important to remember that a S&C plan needs to be specific to the individual and that having someone lead the session can really help you understand key areas for you to focus on.

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Some reasons why S&C should be incorporated into your weekly training plan.

  • Improve triathlon performance - efficiency in all 3 disciplines.

  • Injury prevention - S&C can help to avoid overuse of muscles by minimising imbalances in the body, and smoothing out imbalances in muscle activation.

  • Improve muscle recruitment for when you need it during races.

  • Creating a strong but dynamic inner support system (or ‘core’) will stabilise the body and maintain a good posture, on the bike in the water as well as running.

  • Having weaknesses & imbalances in your body can lead to a decreased power production in the legs, overuse of injury, poor posture and muscular imbalances.

  • A subtle balance of both core strength AND flexibility is important to hold a good aero position on the bike

  • Improving joint range of motion, and power through range, allows you to maximise you muscles when you need them.

In my view, it’s not about lifting and smashing out generic super-heavy KGs but rather focus on building a well conditioned body that will allow you to pursue your sport with more efficiency, power, strength, and avoid injury, improve musculoskeletal imbalances and strengthen weaknesses

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MOBILITY & ACTIVATION

Mobility and activation exercises activate specific muscles being used in your training, firing up your neuromuscular system and increase range of motion. Ultimately prepping your body for the exercise it's about to do. It offers huge benefits to your workout, and it's something often disregarded. A few examples include:  

  • Glute activation exercises before cycling prepares the muscles before ride (clams, bodyweight squats, lunges and jumps)

  • Resistance band work before rides activate the muscles eccentric and concentric ranges

  • Foam rolling before rides and runs can help with soft tissue restrictions and boost blood flow.

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EXAMPLES OF STRENGTH AND CONDITIONING EXERCISES

There are many exercises and this list isn't exhaustive. Check out this article on S&C I wrote for Liv Cycling and Bike Radar for some fuller examples. 

  • Lat Pulldown - great for swimmers, working those latissimus dorsi muscles. This is my staple weekly shoulder, arm and back exercises. Important to focus on good technique to avoid shoulder injury

  • Single Leg Squat - fantastic for building strength and neuromuscular control

  • Squat - Ideal to work on those glutes. Often cyclists have relatively weaker glutes, and bias their hamstrings and quads. This exercise helps to protect the back and knee joints by building strong glutes.

  • Lunges - forward and back to work acceleration and decceleration / eccentric and concentric

  • Core stabilisation exercises such as Dead Bugs and Planks to help access the body’s deep musculature

  • Box Jumps - works on explosive power through the legs and core - great for giving you that kick when you need it.

  • Kettlebell exercises, these dynamic loaded compound movements are fantastic (when coached correctly and safely) for working large numbers of muscle groups.

I’m really thrilled to have joined the team at Fix and to be able to offer focussed sport-specific S&C in their new Studio in London Fields. Come and give it a go!

Yoga for MS, Parkinson's and other Neurological Disorders

by Dr Bryony Hughes, yoga teacher at Fix Studio

Earlier this year, I was invited to teach yoga to a small group of students with Parkinson's Disease.  With my background in medicine and a passion for making yoga accessible to everyone, I jumped at this opportunity.  It was been wonderful sharing the practice of yoga with this group.  Each week, I learn something new about how the condition impacts on my students' lives, and together we explore how different practices can help them manage their symptoms.  Since moving the class to Fix Studio, I am now looking to expand the class to include students with multiple sclerosis and other progressive neurological conditions.

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What are the benefits of yoga?

Practising yoga and mindfulness can give people a sense of control over their body and mind.  In Parkinson’s Disease (PD), the uncertainty over how symptoms will change over time can be challenging.  Changing how the body feels through breathing and movement practices can give back a sense of self-efficacy.

Postural instability is a hallmark of PD.  Yoga improves balance through standing poses (as well as the more advanced arm balances and inversions). Balance poses are modified to the individual with support from a wall or a chair as needed.  Practising balance within the safe and supported class environment can help address a fear of falls. Yoga postures help to develop strength, specifically in the lower body, spinal extensors and the core muscles.  This is beneficial for postural stability and functional mobility. 

Those with PD may face difficulty initiating and controlling voluntary movement such as standing up, walking and sitting down.  Yoga involves bringing awareness and attention to movements that automatic in everyday life.  It is thought this form of ‘attention retraining’ may help improve functional movement.  

Studies have shown a regular yoga practice can improve flexibility and range of motion in the shoulders, hips and spine.  This supports people with PD achieving a more upright posture and addressing rigidity. 

Yoga can be beneficial for mood and sleep.  The practice triggers the ‘relaxation response’, increasing vagal tone and enhancing output from the parasympathetic nervous system.  This can alleviate anxiety as well as equipping people to manage stressful situations in everyday life.  Improving mood can also be beneficial for motor symptoms.  Research has shown that mindfulness can also alleviate low mood and help to manage stress.  For those with PD, learning to be present can help with acceptance of a diagnosis as well as living with the daily challenges of the disease. 

Studies have shown that the practice of ‘yoga nidra’ is associated with a short-term increase in dopamine levels (Kjaer TW et al, 2002).  This suggests that it may be beneficial for those with Parkinson’s Disease where dopamine levels are low.

Attendees during one Bryony’s classes. The use of chairs and props, plus careful programming help make the sessions accessible and safe to all levels.

Attendees during one Bryony’s classes. The use of chairs and props, plus careful programming help make the sessions accessible and safe to all levels.

What to expect from the class?

This is a class specifically for those living with Multiple Sclerosis, Parkinson’s disease and other progressive neurological conditions.  It is accessible for different mobilities - Some students use the floor to practice, but the class can also be practised entirely from a chair.   Through breath work, physical postures and deep relaxation, the class aims to give inner calm and stillness as well as to help manage symptoms and side effects of medications.  It is a safe and supported space to practice yoga and explore what it can do for you.

In the class, you can expect: 

To be treated as an individual.  Recognising that conditions affect each person differently, the yoga practice will be adapted to your needs on that day. 

To feel part of a community.  By attending a class, you can meet other people who share some similar challenges and get support from being part of a group.  During the class, we practice in silence, but there is an opportunity for discussion at the end.

To begin with relaxation.  This may involve a guided body scan meditation, breathing exercises or visualisation.  Relaxing can help reduce motor symptoms and allow you to get more from the physical practice.

To learn physical poses (or asana).  Yoga postures help develop strength, flexibility and balance.  Every pose is modified to the ability of the individual with the use of the wall, chairs and/or blocks for support.

To link movement with the breath.  Simple movements are practised with the breath, moving in and out of postures as you breath.  It can be easier to control movement in flow rather than longer holds.

To practice mindfulness.  Throughout the class, you will be guided on being aware of body sensations and keeping your attention on the present moment.  The practice of yoga encourages acceptance, non-judgement and compassion for yourself.    

To end with guided relaxation or yoga nidra.  Yoga nidra is a deep relaxation practice.  This meditative state has been shown to have many benefits for brain function.

Happy Yogis! With class teacher Dr Bryony Hughes.

Happy Yogis! With class teacher Dr Bryony Hughes.

Yoga for MS, Parkinson's Disease and other Neurological Conditions is on Fridays 11am-12pm at Fix Studio, London Fields.  For more information, please do get in touch by email (hughes.bryony@gmail.com),  I am always happy to answer any questions about the class before you attend. 

You can book online here, or check out Bryony’s bio for more details.

MOVE MORE... FIX STUDIO OPENS IN LONDON FIELDS OCTOBER 2018

FIX STUDIO is now open for group classes, workshops, teacher trainings and 1:1 movement sessions.

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Nestled just next to our London Fields clinic, FIX STUDIO will offer a safe and accessible space for the highest quality, clinically informed yoga, Pilates and movement therapies.

We’ve put together some thoroughly tempting opening offers to whet your appetite this Autumn. These will only stick around until the end of the year, so…

  • Any first yoga class £5

  • Unlimited two weeks £25

  • 10-Class Pass £80

  • Drop in (45min/60min/75min/90min) £8/£10/£11/£12

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We’re really excited about bringing you workshops, teacher trainings and courses in the coming weeks and months.

Hope to see you there soon….

The Osteopath's approach to sports injuries

The Osteopath's approach to sports injuries.

Many patients often ask what the difference between an Osteopath and Physiotherapist is. Many are surprised to find that, when it comes to sports injury treatment, both professions in private practice offer a similar experience. 

Back up and running-Steve Hobbs on recovery from ankle injury

Back up and running-Steve Hobbs on recovery from ankle injury.

Way back in November 2017 (or as I prefer to think of it - a few weeks ago) I ran the Florence Marathon. It rained, constantly, was freezing cold and was hard, as marathons tend to be, and I ran slightly slower than I planned to, finishing in 2h38. But I was delighted. Why?

Avoiding injury with Prehab - a conversation with Luke Selby

Avoiding injury with Prehab - a conversation with Luke Selby.

We've been seeing more and more talk about 'prehab' in movement circles lately so we decided to have a chat with Osteopath Luke Selby about what that actually means and the different ways that we can incorporate it into our physical activities and lives.

Yoga for Cyclists

Yoga for Cyclists.

I love cycling! Whether it is getting around London as my mode of transport, doing a day ride out of the city or a long tour across Europe, my bike will get me there. What an amazing sense of freedom you can have from two wheels and a little leg power.  It is an incredible sport, at whichever level you choose to engage with it at.