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Myth 1: Patients need a referral to see a physiotherapist.
Myth 2: Physiotherapy is a one size fits all approach.
Myth 3: Physiotherapy is expensive and time consuming.
Myth 4: Physiotherapy is just for sports people or the elderly.
Myth 5: Physiotherapists only give massages and exercises.
Let me tell you a story.
Once upon a time, there was a man who really liked going for walks with his dog. They would go over the hills and around the bends, until one day he felt a bit of an ache in his back after a walk.
He shook it off, thinking it would go away, and he kept taking his dog for walks – but it didn’t go away. He could no longer go over the hills or around the bends, so he went to a Physiotherapist who made him feel a whole lot better, and he was able to take his dog out for walks again. Hills were still a little bit painful, and going around bends was tricky, but he felt a lot better overall, so he thanked his Physio, told them how much better he was feeling, and cancelled his follow-up appointments because he felt good enough.
As Physiotherapists, we don’t just treat ‘back pain,’ or ‘hip pain,’ or even knee, neck or finger pain. We treat people, and people are more complicated.
At our clinic, we use a Pain to Performance model, and we believe that relieving your pain is only one part of our job. In order for us to give you the service you deserve, we want to help you feel better than you did before your pain started.
We do this by digging a bit deeper, to the true cause of your injury, and if we can fix that, we can help you long into the future by preventing that pain from coming back, saving you time and money in the long run, and hopefully stopping those cycles of recurring injuries and nuisance pain that seems to just keep coming back.
So what is the true cause of your injury?
No matter what type of pain or injury you have, there are usually a few causes.
Are some of your muscles weak, and are other muscles doing too much work and getting tired?
Are some of your joints stiff, and are other joints moving too much to compensate?
Did you have a previous injury and never fully recover? Is that other injury making you walk, or sit, or stand slightly differently, and over time that has caused the injury somewhere else?
Did you trip or fall because you don’t have the same balance that you used to?
These are all questions that you may not have thought about, but your physio has, because they know that once you start feeling better, this is the time to start fixing the causes of your pain, otherwise you are still at risk of it happening again.
If your plumber mopped up the floor but didn’t actually fix the leaking tap, you wouldn’t think the job was done. Just because the wet floor is now dry, it doesn’t mean the problem is fixed – and just because your pain feels better, doesn’t mean you’ve completely recovered from the injury.
If you are interested in making an appointment, or would like further information please call, Proactive Physiotherapy 07 40 536 222.
References
1. Tatiane da Silva, Kathryn Mills, Benjamin T Brown, Natasha Pocovi, Tarcisio de Campos, Christopher Maher, Mark J Hancock,Recurrence of low back pain is common: a prospective inception cohort study,Journal of Physiotherapy,Volume 65, Issue 3,2019,Pages 159-165,ISSN 1836-9553,https://doi.org/10.1016/j.jphys.2019.04.010.
2. Appeadu, M.K. and Bordoni, B. (2023) Falls and fall prevention in older adults, StatPearls [Internet]. Available at: https://www.ncbi.nlm.nih.gov/books/NBK560761/#:~:text=In%20approximately%20half%20of%20the%20cases%2C%20the%20falls,other%20fractures%2C%20traumatic%20brain%20injury%2C%20or%20subdural%20hematoma. (Accessed: 08 March 2024).
3. Hopkins C, Kanny S, Headley C. The Problem of Recurrent Injuries in Collegiate Track and Field. Int J Sports Phys Ther. 2022 Jun 1;17(4):643-647. doi: 10.26603/001c.35579. PMID: 35693868; PMCID: PMC9159726.
4. Shahidi B, Padwal J, Lee E, Xu R, Northway S, Taitano L, Wu T, Raiszadeh K. Factors impacting adherence to an exercise-based physical therapy program for individuals with low back pain. PLoS One. 2022 Oct 20;17(10):e0276326. doi: 10.1371/journal.pone.0276326. PMID: 36264988; PMCID: PMC9584523.
In an Australian study measuring self-reported erectile dysfunction in 108,477 men aged 45 years or older, the overall prevalence of erectile dysfunction was 61% (25% with mild erectile dysfunction; 19% with moderate erectile dysfunction; 17% with complete erectile dysfunction).
Interestingly, more than 20% of healthy men aged 60–65 years with no risk factors had moderate or complete erectile dysfunction. Therefore,erectile dysfunction is fairly common although not many openly talk about it or seek help.
A growing body of literature has identified erectile dysfunction as being associated with diseases of heart and blood vessels which is often overlooked.In cases of poor blood supply to the penis, it is difficult to get and maintain an erection.Thus ,erectile dysfunction maybe the first tell-tale sign of heart disease and therefore it is very important to seek help from your doctor.
What are the causes?
As the causes of erectile dysfunction are widely varied, a holistic approach is required to effectively manage it .The team includes you and your partner, doctor/urologist, sexologist ,psychologist and physiotherapist.
Pelvic floor rehabilitation has been found to be helpful in managing erectile dysfunction.This is because the muscles of the pelvic floor ,which are in close proximity to the penis ,help in shunting blood to the penis.In some cases , your pelvic floor muscles could be tight and weak contributing to the erectile dysfunction.Therefore you would benefit from an assessment of your pelvic floor.This can be done by thorough history taking and using real time ultrasound or by rectal examination to determine the state of your pelvic floor muscles.
If you are suffering from erectile dysfunction, do not shy away. Help is a phone call away. Book in for a comprehensive assessment and start your journey towards a happy , healthy sex life.
If you or someone you know is experiencing headache or migraine, it is likely the question ‘what triggers your headache (or migraine)?’ has been asked. This is because the medical model of headache recommends that if triggers can be identified, then avoidance will prevent episodes.1,2
On the face of it, this advice makes sense; if all triggers could be avoided, then no headaches should occur. However, clinicians and those with headache or migraine recognise that avoiding triggers is ‘easier said than done’. Firstly, it is not always easy to identify triggers, and rarely does an identifiable trigger always provoke headache.3 Secondly, some have many, wide-ranging triggers, and thirdly some simply cannot be avoided (e.g. menstruation); trying to avoid all triggers can in-itself be stressful and lead to a restricted lifestyle.1
Furthermore, there is no scientific research to support that avoiding triggers leads to successful management.4,5 Avoiding triggers is not necessary. Why? Triggers do not ‘cause’ headache or migraine – there is a difference between a ‘trigger’ and a ‘cause’. A trigger starts something that is primed to happen, it acts on a pre-existing state (cause) – were it not for the pre-existing state, the trigger would not result in migraine or headache.
Migraine, by definition, is a unilateral headache.6 Stress, weather changes, lack of sleep, hormonal changes, dietary factors, dehydration, do not choose to affect one side of the head… they cannot be the cause of migraine. If these factors were the cause, why a one-sided headache?
Tension-type headache (TTH) is defined as headache on both sides,6 and is more likely to affect the whole head. Therefore, theoretically, and some might consider the triggers mentioned above as potential causes of TTH. However, the same triggers lead to migraine and TTH (and other forms of headache) suggesting they are acting on a common (with migraine) disorder which is most likely at the Brainstem level.7
Research has shown the underlying disorder in migraine8-16 and TTH17,18 is a sensitised Brainstem. The Brainstem is responsible for regulating and balancing incoming responses from the structures and systems inside the head, including blood vessels, visual (sensitivity to light), olfactory (smell – reaction to odours) and auditory (hearing – sensitivity to sound) systems.19 Under normal circumstances the Brainstem is able to balance this information, but when sensitised, normal incoming information from blood vessels for example, and systems is exaggerated and perceived as being much greater than normal (i.e. exaggeration of blood vessel expansion, sensitivity to light, odours, sound).19,20 The body’s response to this artificially magnified information (now interpreted to be abnormal) is to create (head) pain. Another way of interpreting this situation is to consider the Brainstem as an audio speaker… a sensitised brainstem is now an audio speaker in which the volume control is stuck on maximum!
Furthermore, neck symptoms (pain, discomfort, stiffness) precede and accompany migraine and TTH in 70-80% of patients.21-23 and disorders of the upper neck can sensitise the Brainstem.24-28 Incriminating the neck further is the finding that neck pain and sitting at a computer for long periods are amongst the most common triggers for headache and migraine.29
The headache team at Proactive Physiotherapy, have undertaken comprehensive post graduate courses in assessment and management of the upper cervical spine in headache conditions (Watson Headache® Approach – which has been shown to desensitise the Brainstem in those with migraine24), and are able to assist you with ruling in or out cervical disorders in sensitisation of the Brainstem. By disarming (or de sensitising) the Brainstem, triggers of headache and migraine do not need to be avoided.
If you are interested in making an appointment, or would like further information please call, Proactive Physiotherapy 40536222.
Do you have knee osteoarthritis (OA)?
Interesting facts about OA:
Symptoms of knee OA:
Treatment for knee OA:
There is evidence to indicate that physiotherapy interventions can reduce knee pain and improve function in those with knee OA. Physiotherapy treatments aim to dissipate knee joint load, alter lower limb alignment, improve range of motion, and restore normal neuromuscular function.
No single physiotherapy intervention has shown to provide superior results over the other and it is likely that a combination of treatments is most effective. There is some evidence that physiotherapy in combination with other management strategies, such as weight loss and attention to psychological factors may provide more significant outcomes than any one of these in isolation. An individual approach to patient management is needed to determine which treatments are most appropriate for each patient.
If you want to try, and delay getting a knee replacement, seek guidance from your physiotherapist, call 07 4053 6222.
I often jokingly tell my patients “If everybody had perfect posture, I would be out of a job!”
Why is this?
Posture is the single most important basis of correct body functioning. It is so important, that I decided to dedicate all my blogs for 2024 towards making our readers more aware of this:
When, why and how should we think of our posture?
What is the correct postural alignment?
How can I improve my posture?
Why is it so important?
What came first: the illness/disease or poor posture?
What are the benefits of good posture?
What part does my core play?
What is posture?
Simply put, posture is the alignment of our bodies.
If there is a midline through our bodies where the centre of gravity would go, it should look ideally like this when standing:
But how / what do I do to get this posture?
There are 2 ways that I teach my patients good postural alignment (and making it so, that it is easy to remember) :
1) The cha-cha-sha technique:
“Where’s my chin? Where’s my chest? Where’s my shoulders?”
So, “ch -ch- sh…”
“Chin in, Chest up, shoulders back down and relaxed.”
You can repeat this during the day a few times – this also works for sitting postural alignment.
2) The Bee – sting technique:
Think of: “A bee stung me in the middle of my back!” and straightening yourself up from there – this puts you whole spine and head in a good alignment.
And this also works for sitting posture.
When we correct our postures, using these above -mentioned ways, it can feel exaggerated and tiring. This is because our postural muscles are weak and we are kinetically not used to having the correct posture. A few pointers:
– Try to correct it as much as possible during the day
– Set a timer on your phone or computer to remind you to correct your posture
– Stick with it, even if it feels uncomfortable…
– If there are no underlying pathology, it should feel better within 3 weeks and more normal
Always think of your alignment when you are sitting standing or lying down / sleeping.
If you have an underlying issue, any pain or stiffness, it can help to alleviate these symptoms. If there is no underlying pathology the correct alignment will prevent a condition from developing.
No one gets younger… If we do not improve and work on our postures NOW, the chances are that it will only get worse as we get older!
Correct posture in different static positions:
Thanks and have fun developing good postures!
Cycling is not only a popular outdoor activity, but also a fantastic low-impact exercise that offers numerous health benefits. However, improper cycling biomechanics can lead to various musculoskeletal problems and decrease performance. In this blog, we will explore the fundamental principles of cycling biomechanics and provide tips to improve efficiency and prevent injuries.
1. Bike Fit: The first step towards optimising your cycling biomechanics is ensuring a proper bike fit. Seek professional guidance or follow a bike fitting guide to adjust the bike’s components such as saddle height, handlebar position, and pedal alignment. Correct bike fit promotes optimal power transfer, improves comfort, and reduces the risk of overuse injuries.
2. Pedalling Technique: To maximise efficiency and reduce strain on your muscles and joints, the pedalling technique plays a vital role. Focus on the following key aspects: a) Pedal Cadence: Aim for a cadence of 80–100 revolutions per minute (RPM) to maintain a smooth and efficient pedal stroke. b) Pedal Stroke: Maintain a circular pedalling motion, engaging both the quads and hamstrings throughout the entire rotation. c) Foot Position: Keep your feet parallel to the ground and centred on the pedals. Avoid excessive pronation (inward rolling) or supination (outward rolling) of the feet.
3. Posture and Body Alignment: Maintaining an optimal riding posture and body alignment is essential to prevent unnecessary strain on your muscles and joints. Follow these guidelines:
a) Spine Alignment: Keep your spine straight, with a slight forward tilt from the hips. Avoid excessive rounding or arching of the back. b) Head Position: Look forward, keeping your head aligned with the spine. Avoid dropping your head or hyperextending your neck.
c) Arm and Shoulder Position: Relax your shoulders and slightly bend your elbows. Avoid locking your arms or gripping the handlebars too tightly. d) Knee Alignment: Ensure that your knees track in a straight line with your toes during the pedal stroke to prevent excessive stress on the knee joint.
4. Core Stability and Strength: A strong core is crucial for maintaining proper cycling biomechanics. Strengthening your core muscles (abdominal, lower back, and glutes) enhances stability and power transfer. Incorporate exercises like planks, bridges, and Russian twists into your training routine to improve core strength.
5. Flexibility and Range of Motion: Having adequate flexibility and range of motion in your lower back, hips, and lower extremities is vital for efficient cycling. Perform regular stretching exercises for these areas to improve flexibility and prevent muscle imbalances.
6. Gradual Progression and Recovery: Avoid sudden increases in training volume or intensity, as it may increase the risk of overuse injuries. Gradually progress your cycling workouts, allowing your body to adapt. Give yourself ample time for rest and recovery between rides to prevent overtraining and promote muscle repair.
Understanding and implementing proper cycling biomechanics can make a significant difference in your performance and long-term cycling enjoyment. By focusing on bike fit, pedalling technique, posture, core strength, flexibility, and gradual progression, you can enhance efficiency, prevent injuries, and enjoy the benefits of cycling to the fullest. Remember to listen to your body, seek guidance from a physiotherapist if needed, and make any necessary adjustments to ensure a comfortable and injury-free ride. Happy pedalling!
If you would like to get some more information for cycling/bike adjustment for your body, please contact us 07 4053 6222 to make an appointment with our physiotherapist.
What is Nocturia?
This is when you wake up MORE then once a night to go the bathroom. According to the Urology Care Foundation (2023), 1 in 3 adults over the age of 30 experience nocturia. This number increases to 70% in persons over the age of 70 years old.
Why is this a concern?
Nocturia causes sleep disruption which may affect you the following ways:
What is a bladder diary, and why is it important?
Your physiotherapist or GP may give you a handout to complete called a Bladder Diary which will give the practitioner lots of information about the type of nocturia it is and how best to address it
What are the types of Nocturia?
There are two different types of nocturia:
Medical and Behavioural.
Medical causes due to underlying medical conditions (such as heart problems, UTIs, diabetes, kidney problems) may show the following outcomes on a bladder diary:
Behaviour causes:
What can a physiotherapist do to help?
If you start experiencing nocturia that is not behavioural in nature it is important to see your GP and get investigations to make sure there is no underlying medical cause
If you want more information or assistance with this concern please contact Proactive Physiotherapy on 4053 6222 to book your appointment with our pelvic health physiotherapists.
Urology Care Foundation, Amercia. (2023). What is Nocturia? https://www.urologyhealth.org/urology-a-z/n/nocturia
Urinary incontinence and Female Urology. (2023). Frequent Urinartion At Night (or Nocturia). https://www.urineincontinence.com.au/other/frequent-urination-night-or-nocturia
Are you at an increased risk of injury? Complete a Functional Assessment Screen to find out now.
Today’s individuals are all working harder to become stronger and healthier, by working to improve their flexibility, strength, endurance, and power. Many people, however, do not realise they have inefficiencies with some movement patterns which have potential to lead to injuries or long-term problems.
Completing a functional movement screen (FMS) will allow people to address concerns or issues that may lead to injury before they
happen. It gives people the opportunity to stay healthy and continue doing the things they want to do.
What is a functional movement screen?
What is involved in the FMS
Book in now to stay in control with your body and prevent
injuries from happening! Please call 07 4053 6222 to book functional movement screen.
Studies have shown that both men and women can suffer from similar pelvic floor conditions. However, not many men do seek help for these conditions. There is help available and support systems for all.
Do you experience any of these?
If you experience any of the following, you may need to book yourself in for a pelvic floor assessment.
Please call 07 4053 6222 to book your appointment with our pelvic health physiotherapist.
If you or someone you know is experiencing headache or migraine it is likely the question ‘what triggers your headache (or migraine)?’ has been asked. This is because the medical model of headache recommends that if triggers can be identified, then avoidance will prevent episodes.
On the face of it, this advice makes sense; if all triggers could be avoided then no headaches should occur. However, clinicians and those with headache or migraine recognise that avoiding triggers is ‘easier said than done’. Firstly, it is not always easy to identify triggers, and rarely does an identifiable trigger always provoke headache. Secondly, some have many, wide-ranging triggers, and thirdly some simply cannot be avoided (e.g. menstruation); trying to avoid all triggers can in-itself be stressful and lead to a restricted lifestyle.
Furthermore, there is no scientific research to support that avoiding triggers leads to successful management. Avoiding triggers is not necessary. Why? Triggers do not ‘cause’ headache or migraine – there is a difference between a ‘trigger’ and a ‘cause’. A trigger starts something that is primed to happen, it acts on a pre existing state (cause) – were it not for the pre existing state, the trigger would not result in migraine or headache.
Migraine, by definition, is a unilateral headache. Stress, weather changes, lack of sleep, hormonal changes, dietary factors, dehydration, do not choose to affect one side of the head… they cannot be the cause of migraine. If these factors were the cause, why a one-sided headache?
Tension-type headache (TTH) is defined as headache on both sides, and is more likely to affect the whole head. Therefore, theoretically, and some might consider the triggers mentioned above as potential causes of TTH. However, the same triggers lead to migraine and TTH (and other forms of headache) suggesting they are acting on a common (with migraine) disorder which is most likely at the Brainstem level.7
Research has shown the underlying disorder in migraine and TTH is a sensitised Brainstem. The Brainstem is responsible for regulating and balancing incoming responses from the structures and systems inside the head, including blood vessels, visual (sensitivity to light), olfactory (smell – reaction to odours) and auditory (hearing – sensitivity to sound) systems.Under normal circumstances the Brainstem is able to balance this information, but when sensitised, normal incoming information from blood vessels for example, and systems is exaggerated and perceived as being much greater than normal (i.e. exaggeration of blood vessel expansion, sensitivity to light, odours, sound) The body’s response to this artificially magnified information (now interpreted to be abnormal) is to create (head) pain. Another way of interpreting this situation is to consider the Brainstem as an audio speaker… a sensitised brainstem is now an audio speaker in which the volume control is stuck on maximum!
Furthermore, neck symptoms (pain, discomfort, stiffness) precede and accompany migraine and TTH in 70-80% of patients and disorders of the upper neck can sensitise the Brainstem. Incriminating the neck further is the finding that neck pain and sitting at a computer for long periods are amongst the most common triggers for headache and migraine.
The Physios at Proactive Physiotherapy have undertaken a comprehensive, post graduate course in assessment and management of the upper cervical spine in headache conditions (Watson Headache® Approach – which has been shown to de-sensitise the Brainstem in those with migraine), and are now able to assist you with ruling in or out cervical disorders in sensitisation of the Brainstem. By disarming (or de sensitising) the Brainstem, triggers of headache and migraine do not need to be avoided.
“Is it painful?” Is a question I ask multiple times daily to various patients. “No, it hurts.” Or “Yes, it is sore”, is an answer I get a lot.
To try understanding a patients’ pain, we make use of scales and questions.
A few interesting facts about pain:
Why do we experience pain?
We need the sensation of pain to let us know when our bodies need extra care. It’s an important signal. When we sense pain, we pay attention to our bodies and can take steps to fix what hurts. Pain also may prevent us from injuring a body part even more.
This is what happens in our body when we feel something painful:
There are many ways
that we, as physios, try to understand someone’s physical pain:
1)
VAS or
Visual Analogue Pain scale:
This is the most common pain scale that we use.
Positives:
Negatives:
This is a simple, although subjective measuring tool to quantify a person’s pain intensity/severity.
When you are asked to complete the VAS, please keep the following in mind:
Mild pain may be annoying and noticeable, but it doesn’t keep you from performing normal activity:
Moderate pain begins to get in the way of your daily life:
You may be able to push level 4 pain aside for periods while involved in a task, but it is still very distracting.
Severe pain can render you unable to perform normal activity:
If you are in pain, please contact your physio to understand your pain better, change it, resolve, and relieve it. Maybe together we can even transform your pain into performance.