Archive for category Wellness

World Spine Day is a great opportunity to shine a light on spinal disorders and encourage you to take steps to better health. This year the theme is ‘Your Back in Action’, emphasising the importance of physical activity and improving posture as part of good spinal health and injury prevention.

Millions of people worldwide suffer from spinal disorders which include low back pain, scoliosis and disc disease, to name a few. The Australian Institute of Health and Welfare reports that 1 in 6 Australians are suffering from back problems, and that these often lead to poorer quality of life, psychological distress and disability.

Improving your posture and exercising regularly can help improve and maintain spinal health. Exercises can be undertaken by Australians of all ages with a tailored program for children.

Exercises can be completed at any time of day but are most beneficial when they form part of a daily routine. It is hoped that over time, all Australians will take a few minutes every day to care for their spinal health, just as they do for their dental health.

Studies conducted overseas indicate that 90% of people who adopted the exercises as part of their daily routine reported a postural improvement. Approximately 80% reported that their backs are more comfortable and that they have better core stability after practicing the activities for several weeks.

Physiotherapists are health professionals who have a key role in helping people with long-term conditions achieve their goals, fulfil their potential and participate fully in society. They work with people to maximise movement and functional ability.

Physiotherapists can assess your functional movement and recommend stretches and exercises that correct those dysfunctions, restore proper function and help you build confidence & strength.

Ask your physiotherpist which exercise program is right for you, and your family.

Delayed onset muscle soreness (D.O.M.S) is a medical condition that is characterised by the stiffness, tenderness and pain in muscles several hours after performing a strenuous physical activity. When muscles are stressed, small microscopic tears occur in the ligaments, coupled with stiffness and inflammation, causing pain and fatigue. The soreness is felt most strongly 24 to 72 hours after the exercise.

DOMS is most notably experienced after beginning a new exercise program, rapidly altering or upping the work load or pushing the body to the extreme. For the novice, it can be an uncomfortable and off putting outcome of exercise.

DOMS certainly does lead to a decline in physical performance, including reduced muscle strength and flexibility as well as reduced joint range of motion. In addition, a deterioration in proprioception, one’s awareness of body position in space, and coordination is found in those suffering from DOMS. These changes can lead to an increased risk of injury if the athlete does not modify their training or exercise routine whilst recovering from a bout of DOMS.

DOMS Management

Cryotherapy (cold therapy) – A systematic review of 36 papers by Hohenauer and others in 2015 found that cryotherapy (cooling and cold water immersion therapy) significantly reduced the symptoms of DOMS experienced by athletes, with symptoms lasting up to 48 hours, but not having an effect at 96 hours post exhaustive exercise.

Stretching – A 2011 systematic review in the Cochrane database (Herbert, de Noronha and Kamper) examined the effect that stretching (before or after exercise) had on the development of DOMS and interestingly found evidence to suggest that muscle stretching before, after, or before & after exercise, does not produce clinically important reductions in DOMS in healthy adults.

Compression garments – A 2014 systematic review in the British Journal of Sports Medicine evaluated the effects of compression garments on recovery following intense exercise, with findings indicating compression garments are effective in enhancing recovery from muscle damage.

Myofascial Release – Myofascial release is a popular intervention used to enhance myofascial mobility. According to a 2015 study in the International Journal of Sports Physical Therapy (Cheatham and others), use of a foam roller after intense exercise appears to improve joint range of motion (in the short term) and may help maintain muscle performance and reduce DOMS.

Sports Massage – Massage may facilitate recovery from repetitive muscular contractions, so although sports massage after intense exercise may not improve muscle performance after intense exercise, massage may enhance and speed up recovery as well as reduce the effects of DOMS after intense exercise.

Tennis Elbow is a general term used to describe pain on the outside of the elbow. The most common causes are inflammation or degeneration of the tendon of the wrist extensor muscles as they insert into the elbow.

Those engaged in strenuous sports such as tennis, climbing, swimming and those working primarily where the forearms are involved, such as waiters or musicians playing the guitar, are most vulnerable to this kind of injury. Repeating some types of activities over and over again can put too much strain on the elbow tendons.

Acute injuries occur immediately after an activity such as hitting a backhand shot in tennis with poor technique. The extensor muscles on the back of the forearm (wrist extensors) become suddenly overloaded causing micro tears of the tendon where it attaches to the elbow.

Chronic injuries on the other hand normally develop over a period of days/weeks and usually follow bouts of intense exercise/activity that the patient is unaccustomed to, such as lifting heavy boxes when moving house.

The injury can be very troublesome to treat, especially if it becomes chronic, so it is very important to obtain an accurate diagnosis as early as possible. Physiotherapy treatment for this condition is vital to hasten the healing process, ensure an optimal outcome and reduce the likelihood of injury recurrence. Treatment may include:

• Rest
• Taping
• The use of a tennis elbow brace
• Joint mobilisation
• Dry needling
• Ice or heat treatment
• Progressive exercises to improve flexibility, strength & posture
• Training and activity modification advice
• Soft tissue massage
• Technique correction
• Education
• Anti-inflammatory advice
• Devising and monitoring an appropriate return to sport or activity plan

According to the Australian Bureau of Statistics 6 out of 10 children aged between the ages of 5 and 14 participate in organised sports. Still more participate in informal recreational activities. Although sports participation provides numerous physical and social benefits, it also has a downside – the risk of sports-related injuries.

Common sporting injuries:

• Joint sprains – knee, ankle, shoulder and finger injuries
• Muscle strains – hamstring, calf, quadricep
• Tendon injuries – achilles, patella and gluteal tendon pain
• Bony overuse injuries – such as ‘shin splints’ or stress fractures
• Rehabilitation from surgery – knee, shoulder or ankle arthroscopies or reconstructions

These injuries are by far the most common cause of musculoskeletal injuries in children treated in emergency departments. They are also the single most common cause of injury-related primary care clinic visits.

Preventing and Treating Musculoskeletal Injuries

Treatment for sports-related injuries will vary by injury. If your child suffers a soft tissue injury (such as a sprain or strain) or a bone injury, the best immediate treatment is easy to remember: RICE (rest, ice, compression, elevation) and professional treatment if any injury is severe (a severe injury means having an obvious fracture or dislocation of a joint, prolonged swelling, or prolonged or severe pain).

Physiotherapists have a role in injury prevention. There are several injuries (including ankle sprains, knee injuries and hamstring strains) for which the risk can be significantly reduced where a specific injury prevention program is employed. These programs are typically not time intensive and can actually improve sporting performance as well.

Injuries can happen to any child who plays sports, but there are some things that can help prevent and treat injuries.

Prevention

• Enrol your child in organised sports through schools, community clubs, and recreation areas that are properly maintained. Any organised team activity should demonstrate a commitment to injury prevention. Coaches should be trained in first aid and cardiopulmonary resuscitation (CPR), and should have a plan for responding to emergencies. Coaches should also be well versed in the proper use of equipment, and should enforce rules on equipment use.
• Some organised sports programs have adults on staff who are certified medical professionals, including Physiotherapists. Physiotherapists are trained to prevent, recognize, and provide immediate care for athletic injuries.
• Make sure your child consistently uses proper gear for a particular sport, thereby reducing the chances of being injured.
• Make warm-ups and cool-downs part of your child’s routine before and after sports participation. Warm-up exercises make the body’s tissues warmer and more flexible. Cool-down exercises loosen muscles that have tightened during exercise.
• Learn and follow safety rules and suggestions for your child’s particular sport.

Whiplash is a non-medical term describing a range of head and neck injuries resulting from an acceleration/deceleration mechanism of energy transfer to the neck.

These forces may result in painful injuries to the muscles, ligaments and joints of the neck and other spinal areas. However, sometimes they result in no injury or pain at all.

Whiplash differs in severity from patient to patient, and as such, symptoms vary between cases.  Directly after impact, patients may not be aware of any neck swelling or bruising. Symptoms typically arise between 12 and 24 hours after the accident. However, pain and stiffness from whiplash is typically worse on the day following the accident and may continue to worsen with each day. While car collisions are the most common cause of whiplash, there are a number of other activities and accidents with a strong enough impact to cause whiplash:

• Contact sports (rugby, boxing, karate, football)
• A horse-back riding or cycling accident
• Any fall which causes the head to jolt backwards suddenly
• Direct impact of large or heavy object on head

A Physiotherapist will perform a head and neck examination and discuss your symptoms with you to determine the best course of whiplash treatment. The Physio will know the grade of your whiplash, the areas affected and will be able to optimise a treatment plan to relieve pain and speed the healing process.

Treatment methods for whiplash may include:

• Deep Tissue Massage The physio uses direct pressure and friction to try to release the tension in your soft tissues (ligaments, tendons, muscles)
• Heat Therapy By using heat, the physio seeks to get more blood to the target area because an increased blood flow brings more oxygen and nutrients to that area – blood is also needed to remove waste byproducts created by muscle spasms, and it also helps healing
• Ultrasound By increasing blood circulation, an ultrasound helps reduce muscle spasms, cramping, swelling, stiffness, and pain – it does this by sending sound waves deep into your muscle tissues, creating a gentle heat that enhances circulation and healing
• Exercise to encourage flexibility, strength and good posture
  • ROM exercises, low load isometric, postural endurance and strengthening exercises
  • Fine neck muscle and proprioception retraining programs
• Acupuncture or dry needling for pain relief
• Education on the injury
  • The importance of continuing your normal daily regime
  • Advice for ergonomic and lifestyle changes – if needed, you will learn how to correct your posture and incorporate ergonomic principles into your daily activities (even after you recover from whiplash, this posture work should help you because you’ll be able to prevent other forms of neck pain that develop from daily living)
• Joint mobilisation or manipulation to loosen stiff joints
• Vestibular rehabilitation if dizziness is one of your symptoms
• Kinesio taping may assist in reducing pain

There are many myths and misconceptions about core stability, particularly since the term in recent years has become a popular concept in both the rehabilitation and fitness industries. Everywhere you look, social media, TV, online, emails and even women’s magazines; “experts” are imploring you to ‘train your core’.

Physiotherapists are seeing an increasing number of people who have fallen victim to an often misguided approach, and undertaken exercise regimes that have led to back pain and/or related hip and leg problems, often linked to improperly ‘training their core’. Also, very few people have good true core control and dynamic stability of the spine, which sometimes leads to spinal injuries.

Overworking the abdominal muscles can create too much tightness around the centre of the body which can adversely affect important aspects (eg altered spinal posture and difficulty effectively controlling movements of the trunk) and can lead to:

• Increasing incidence of low back pain and allied disorders
• Unhelpful and unsupportive breathing patterns
• Neck and shoulder tension and pain
• Stress urinary incontinence
• Sacroiliac joint pain and dysfunction
• Hip pain
• Gluteal pain
• Chronic hamstring strains
• Pregnancy pain
• Post-partum pelvic and low back pain
• Lower abdominal bulging
• Sports injuries
• Lower limb injuries
• Piriformis pain syndrome

The core muscles not only consist of the abdominal musculature, but also consists of the trunk muscles, pelvic muscles and quite importantly the muscles of the hips and shoulders.

There is no single muscle or single exercise for low back problems and motor control/core stability. Physiotherapists are aware of key concepts in motor control and exercise and follow an evidence-based approach to exercise prescription.

Improved control of the ‘core’ enables the pelvis and base of the spine to better support posture and movements of the whole spinal column. Core control is also fundamental in being able to develop functional strength as well as the ability to stretch more effectively and safely without reinforcing unhealthy stresses on the spine.

A strong core can lead to the improvement of everyday life, injury prevention, chronic back pain reduction, and enhanced sports performance.

If you are suffering from any upper and lower limb injury as well as pain in the spine, one of our physiotherapists can assess your functional core stability needs and prescribe an appropriate rehabilitation program.

The health of golf benefits have been widely reported in recent years with an 18 hole round amounting to 6-8 km of walking, requiring over 8,000-12,000 steps and a calorie burn of 1,500. A reported 60 million people of all ages play golf across the world, sometimes into their 80’s and 90’s.

However, golf can be very demanding; requiring strength, endurance, explosive power, flexibility and athletic ability to perform a movement that produces some of the fastest club head and ball speeds of any sport.

The effect of these repeated large forces on the body on golfers can lead to many different types of injuries, which are often specific to certain areas and sides of the body, depending on their lead side.

Much research has been done on the types and likelihood of injuries experienced by golfers with the main areas of the body prone to injury being;

• lower back,
• neck, shoulder, elbow, wrist
• hips

Lower back

injuries account for roughly 30% of all golfing injuries, with poor technique and lack of flexibility in the mid spine and hips possible causes. Often it presents as an ache and/or discomfort on moving into certain positions and doing certain activities. However, the soreness and stiffness that people often present with is called ‘non specific’ as it is not usually clear which structure is causing the problem/pain.

Golf requires much more athletic ability than many imagine and the consequences of this mean many people suffer injuries through poor general conditioning, lack of warm up, poor technique and practice and playing habits.

Neck, shoulder, arms and the hips

Usually they are the last point of reference in a golf swing, often because these parts are forced to compensate for what the rest of the body is not doing properly.

Treatment for golfing injuries may include:

• Soft tissue release/massage
• Specific joint mobilisation and manipulation
• Electronic muscle stimulation
• Exercise to work on strengthening:
  • Upper limbs
  • Core Muscle stability
  • Thoracic and Lumbar spine
  • Hip Joints
  • Lower back
  • Gluteal and pelvic floor
• Rehabilitation exercises that are individualised to the golfer’s body type, swing mechanics and likes and dislikes

With regular conditioning, improvement in technique, warm ups and structured practice, the improvements in a golfer’s performance and reduction in injuries can be significant. Your physiotherapist can help you with this as well as provide you with effective treatment should you suffer with any injuries.

Exercise releases feel-good endorphins and it’s a hard feeling to beat. Twenty minutes of exercise a day or three to four hours per week is what you should be aiming for at the very least. If you’re in an exercise slump, consider ways to change your routine around. Find a fit buddy to motivate you to make those early morning classes, or go for a run or a brisk walk at lunchtime. You’ll get some time out of the office and work up a sweat. Winning!

The body feels the repercussions from Sports at any level. You don’t have to be an elite athlete to need Sports Physiotherapy although athletes and individuals who play sports regularly are more prone to develop sports injuries.

Some of the common sports injuries are tennis elbow, ankle sprain, strain, fractures, herniated disc, knee injuries, Achilles tendonitis, dislocation, and tarsal tunnel syndrome. These injuries emerge from various sports such as golf, football, basketball, athletics, and tennis.

Sports injuries can also occur as a result of overuse and over training (eg runner’s knee or tennis elbow) as well as under training or poor training practices (not stretching or  warming up).

Professional sports injuries management, rehabilitation, and advice can be sought from the expertise of physiotherapists, enabling you to return to your sporting activity as soon as possible following injury.

Treatment for a sports injury will depend on factors such as how severe the injury is and the part of your body affected. Treatment goals include:

• Relieving your pain quicker
• Reducing your scar tissue formation
• Getting you back to sport or work quicker
• Improving your performance

 Physiotherapy treatment techniques may include:

• Electrotherapeutic agents such as interferential, ultrasound, laser, shock wave therapy (ESWT)
• Ice and/or heat therapy
• Joint mobilisation and manipulation techniques to increase the length and strength of muscles
• Soft tissue massages to relax tight muscles, decrease swelling, reduce tissue adhesions, or pain relief
• Exercise prescription to enhance balance and co-ordination
  • Stretching – muscles can become tight during periods of inactivity following an injury and stretching can help loosen these tight muscles and improve range of motion (ROM)
  • ROM exercises – to improve or maintain joint range of motion
    By performing ROM exercise whenever possible, you can prevent your joints and muscle from becoming stiff
    Range of motion exercises may also be combined with strengthening exercises once you have improved strength
  • Strengthening – being inactive for a long time can make your muscles weak
    Strengthening exercises are important to achieve independence in movement and will also help maintain strength of uninjured muscles
• Patient education to learn self-care – this may be in the form of exercises, strapping/bracing, learning how to modify your activity to reduce overstressing your injured part and learning self-treatment strategies

Your physiotherapist will guide you safely back to the level of sport at which you wish to participate. 

This gentle stretch can help alleviate the aches associated with tight muscles around the neck and upper back. This can be done first thing in the morning, as well as during breaks at work to help minimise tightness and decrease the potential of tension related headaches.

Gently bend your head forward with one hand, whilst guiding your chin towards your chest with the other, until you start to feel a stretch at the back of the neck.  Hold this position for 30 seconds and repeat twice.

The diagnosis of cervical headache is frequently under-recognised. Many symptoms of cervical headache are similar to other classifications of headache such as tension headache, migraine, hormonal headache and even cluster headache. There may also be clear dietary, environmental or hormonal triggers for the onset of a patient’s headache, however these triggers are only active when there is an increased sensitivity in the structures of the upper cervical spine.

Cervical headaches are usually described as a constant, steady, dull ache. They can be to one side or both sides and can often feel like a pulling or gripping feeling (sometimes described as a tight band around the head). These headaches are usually felt at the base of the skull and can be referred to the front of the head, to the temple area or over and behind the eyes. The headaches usually come on over a period of time, gradually getting worse, and may be present for days, weeks or even months. Sometimes there may be a history of an acute trauma such as whip-lash injury or repetitive trauma associated with work or a sporting activity.

Our Physiotherapists can thoroughly assess your neck and headaches. They will ask specific questions to rule out other causes of headaches and will then feel and assess the structures of your neck to decide what may be causing your headache. If the neck structures are involved, the physiotherapist may find;

• Tight and painful structures in your neck (joint and muscle)
• Pressure on specific structures of your neck which may reproduce your head pain
• A forward head posture and stiff mid back
• Reduced motion in the upper joints of the neck
• Reduced endurance in the deep muscles of the neck

After correctly diagnosing the neck as the cause of headache, treatment may be quite straightforward and include; 

Postural Assessment and Advice

Education on optimal trunk posture and postural retraining (without postural correction, cervical headaches can linger for extended periods)

Mobilisation

Mobilisation of stiff joints in the neck to restore range of movement – stiffness in the jaw joints can also be problematic and should be mobilised if needed

Stretching

Stretching of the neck and shoulder muscles to help alleviate headaches

Strengthening

Cervical muscle retraining to restore the normal muscle balance

Stress and tension management

Identification and reduction of the sources of stress and tension to reduce tightness in the upper back and neck muscles

Soft tissue work and massage

Different massage and soft tissue techniques for the muscles in your neck and upper back

Dry needling 

Dry needling (the placement of very thin needles into specific locations or trigger points in the body)

Workplace and ergonomic assessment

A poor chair, a desk at the wrong height or a badly placed computer may result in poor posture contributing to strain on the neck

Neural stretching

Assessing abnormal neural tension & providing stretches as needed

If you are experiencing ongoing headaches, call our practice on 9838 3030 to arrange an immediate assessment.

Laughter is indeed the best medicine. It can relieve stress, boost your immune function, ease pain, burn calories, and improve your mood. To bring more laughter in your life, indulge in funny activities such as watching funny movies, being with funny people, and spend time with kids!