BEING A PHYSIO ON THE GOLD COAST
Kyle Mitchell recently featured in a STUDY GOLD COAST feature on being and becoming a physiotherapist. You can watch the video here....
GOLD COAST MARATHON
Pindara Physiotherapy has been the proud physiotherapy providers for the Gold Coast Airport Marathon for over 25 years. This year was no different with our staff providing services to over 200 people throughout the day.... the most we have recorded. It is always a great day and so good to see so many people out there pursuing their fitness goals!
The staff at Pindara recently had a great in-service from Griffith University's Sean Horan on golf injury and assessment. He provided us with the latest trends and evidence in the treatment of golfers to take our assessment and treatment to the next level.
The most common injury in golf is low back pain with the treatment requiring special consideration to the unique demands of golf.
Golf also has some great health benefits for those currently playing or looking to pick it up. See below for some of the many great benefits.....
THE BENIFITS OF A GOOD SPORTS PHYSIO..... A CLIENTS PERSPECTIVE
At the end of last season we realised that something needed to be done for my son as he was in pain after every game.
So we started with doctors that advised us to go to Physio. We chose Pindara at Benowa where my son received treatment from Sam who helps the Suns NEAFL side.
Sam advised my son to cut back his training so that he would be injury free for the season. This is now a reality. For the first time in 3 years he can train and play footy without the pain from, back, hip, knee, ankle or heels.
He also saw a podiatrist at Pindara and was advised about boots which has also been great helping with the growth plates in his heels.
He has continued the stretching routine as he sees the benefits gained from this and is so happy not to be in pain.
I believe all children in sport could benefit from what he has been taught and thank Sam and the team at Pindara so much for my sons health.
Cryotherapy at Pindara Physiotherapy again made it in the news as popularity and interest grows in the benifits of cryotherapy. This article highlights its benifits for patients with chronic pain, fibromyalgia, frozen shoulder and athletic recovery and performance.
THURSDAY NIGHT PILATES!!!
NEW CLASS COMMENCING 28TH APRIL 2016
STRENGTH / BALANCE / CONTROL / STABILITY / FLEXIBILITY
COST $15 PER CLASS (health fund rebate available)
Contact Pindara Physiotherapy on 55394484 to register your interest and reserve your spot.
Pilates class taken by an experienced physiotherapist and Pilates teacher.
Yet another Titan tries out Cryotherapy at Pindara Physiotherapy!
Whole Body Cryotherapy…helping “Put Out the Fire"
Whole Body Cryotherapy (WBC) is a system of treatment where your body is exposed to extreme dry cold at temperatures of -80 degrees or more for short periods of time (3 to 5 mins)
Cryotherapy originated in Japan where there’s a long tradition of cold therapy for assisting in the management of Rheumatoid Arthritis.
The body’s response to WBC is a decrease in inflammation and pain and an increase in endorphins….your body’s own natural painkillers which are much stronger than morphine with no side effects.
Some studies have described a reduction in creatine kinase activity (an inflammatory marker) (Wozniak 2007), increases in parasympathetic activation (Hausswirth 2013) and an increase in anti-inflammatory cytokines (proteins that serve to regulate the inflammatory response) (Lubkowska 2010; Lubkowska 2011) after WBC exposure.
Used in combination with a holistic approach to pain management with work on improving your sleep, diet, exercise and stress reduction, Whole Body Cryotherapy can assist you in reducing chronic pain. In short….it helps to “put out the fire” in terms of your inflammation.
How does it work? You simply go into a small room cooled by powerful air conditioners to -85 degrees in as little clothing as possible. You’ll be given some mittens, special shoes and a face mask to wear. You’ll be asked to move around in the chamber for 3 to 5 mins. You’ll do this twice with a break between sessions. We’d recommend you have 8 sessions over 4 weeks.
How does it feel? Surprisingly good. Whilst it is cold, it’s not as cold as you’d think. The short exposure times have you out before you start to shiver and it really is quite exhilarating. It’s not at all unpleasant or distressing. You have complete control of how long you stay in the chamber…its as easy of getting out of the shower.
What about results? As with all chronic pain issues, some people will respond extremely well, others to a lesser degree…chronic pain is a very complicated issue. We’ve had some very good responses in patients with Fibromyalgia, Arthritis in its various forms, chronic nerve pain, and long standing muscle pain.
Our biggest success stories are for those with Chronic Inflammatory problems and Joint problems being slow to settle post injury or surgery. Again, Whole Body Cryotherapy needs to be used in conjunction with focus on improvements in your sleep, diet, stress management and appropriate exercise and our normal Physiotherapy treatment to get great results.
Try it now. Call 55394484 to book an appointment.
CRYOSPORTS CHAMBER IS NOW AT PINDARA PHYSIO
GARY Ablett has shown he is willing to brave temperatures of -85C in his quest to get back on the field.
On Saturday morning, at Pindara Physiotherapy and Sports Medicine, Ablett threw on some mittens, surgical mask and an ear warmer before stepping inside a futuristically-lit room, cooled to Antarctic temperatures using powerful air-conditioners.
The Suns captain had a shoulder reconstruction in July last year, worked himself back to match fitness in time for Round 1 last month but his return lasted just two games.
Melbourne and St Kilda opponents gave the 30-year-old’s shoulder such a working over his range of movement deteriorated to the point where the decision was made to stand down from football and rehabilitate his left shoulder before any lasting damage was done.
Ablett, who recently signed with the Suns until the end of 2018, tried the therapy for the first time on Saturday before watching teammates lose their Round 6 clash with the Crows. Adelaide players also used the Cryosports Australia technology in their match recovery
Ablett spent two sessions in the cryo chamber, of three minutes and five minutes but said it was too early to tell whether there were any benefits.
The two-time Brownlow medallist expects it to take four to six sessions before he and his medical team know definitively what benefits the therapy has delivered.
Crows sports scientist Jarryd Wallace said the treatment was an alternative to ice baths for post-match recovery.
He said their full playing squad went into the deep freeze after the game and had a second session in the portable chamber at the Sofitel Broadbeach before a pool recovery session yesterday.
“We aren’t interested in it from an injury point of view, we are just looking to recover from all the lumps and bumps players get on a normal basis,” Wallace said.
“This is something we’ve done some research on and we ‘re lucky to have this available to us on the Gold Coast.”
Wallace said the chamber’s advantage over an ice bath was that it could drop to temperatures well below water’s freezing point.
“The benefit is that it reduces inflammation in a really short time,” he said.
“It’s just dry air and players are only in there for about four or five minutes.”
The cryotherapy unit is based at Pindara Physiotherapy during the week and is available for private patients.
“Adapted from “Gold Coast Bulletin” 11/05/15”
MELISSA'S HEALTH TIPS # 2
LEUKAEMIA FOUNDATION “FIT TO THRIVE” PROGRAM
Click on this link to see a video presentation by Aspire Fitness and Rehabilitation
Fit to Thrive, is an initiative of the Leukaemia Foundation of Queensland and is targeted at and is suitable for people who are:
- - Living with leukaemia,
- - Lymphomyloma
- - Myeloma,
- - Aplastic anaemia,
- - Amyloidosis,
- - Myelodysplastic syndrome (MDS),
- - Myeloproliferative neoplasms (MPN) or,
- - A related blood disorder this program may be appropriate for you.
See more at: http://aspirefitnessrehab.com.au/our-services/rehabilitation/therapeutic-exercise/fit-to-thrive/#sthash.ycseWa2x.dpuf
Pindara Physiotherapy and Sports Medicine is extremely excited to offer this fantastic initiative and for further information please review the Fit to Thrive brochure attached http://www.leukaemiaqld.org.au/wp-content/uploads/2015/03/Fit-to-thrive_brochure_Brisbane2015.pdf
melissa's health tips # 1
Catch A Wave - Surfing for your Pelvic Floor
Madeleine Newton is an ex-pro surfer who happens to also be a women's health physiotherapist working on Queensland's Gold Coast. I don't know much about surfing, except that it looks like an awful lot of fun - and potentially a great all-body low-impact exercise that might be a good pelvic floor-friendly option. Madeleine set me straight on a few things, including how and when it is and isn't pelvic floor friendly, and how your body might feel when you first try to get back to it after childbirth. There's plenty of stuff here to get you amped about surfing!
How did you get into surfing?
I have always had a love for the ocean and was always in it, from as far back as I can remember- swimming, body boarding, you couldn't get me away from the beach or out of the water! My parents signed me up for Nippers and I competed for years in that, which was great for developing surf safety skills and learning to save and help others. But one day at a Nippers competition, in between events, I was out in the water practising and just started to stand up on my Nipper board and surf. The feeling was amazing, I was instantly addicted and I just couldn't stop! My older brother bought me a lovely little old surfboard and I just never looked back! I started competing in local events and started getting really good results and had a heap of major sponsors, so that lead me to compete around Australia in the junior and school titles and on the Australian junior surfing series until I made it onto the world qualifying series (WQS) which took me to USA, South Africa, Europe, Indonesia and all around the world.
What was your best result?
I was ranked in the top 16 in the world one year and came 2nd in the Australian Junior Titles and 3rd in the world grommet titles also.
What do you love most about it?
Being in the ocean, there's something healing and magical about it! It's freedom! And the feeling of being one with the ocean diving through waves and riding them. The old saying "only a surfer knows the feeling" really is true. It's hard to describe the feeling and nothing else really compares!
How long did you have off surfing after having your baby?
Despite desperately wanting to be back in the water after having my first baby, it took about 6 months before I got back to surfing. My body was just not ready for it. The combination of extreme tiredness, low iron, recurrent bouts of mastitis, learning how on earth to feed and look after this gorgeous little human properly and having quite a difficult first birth meant I just wasn't able to get back into the water. As much as I love surfing, it just wasn't a priority for me at that stage, and I felt it had to be put on the back burner while I concentrated on the most important job in the world (and just surviving really!). Some women just ease straight into motherhood and make it look so easy, but that wasn't the case for me. My body was so heavy, sore and tired, and having a little creature to look after and care for 24/7 was a huge shock for me (especially having been quite independent previously), it was a very steep learning curve. I'm very lucky though, to have the most amazing and supportive husband in the world who continuously encouraged me to get back into the water!
What did it feel like to get back on the board for the first time after bub?
Because it had been a while, I had lost a lot of muscle tone and strength (and had put on a lot of weight too) and I was still quite sore. I remember struggling, fitness wise, to paddle out the back and getting quite frustrated, as I used to be such a high level surfer previously. I also remember doing a breast stroke kick to propel myself onto my board and my groin muscles and pelvis killing me with pain. I think I only stayed out for about 10 minutes and came in and cried to my husband! But just as I had persevered to get to an elite sports level in the past, and with some help from a personal trainer (doing a mums group training session 1-2x/week) I eventually regained the strength, found I was still able to surf just as well, lost some of the weight, and was back surfing in 6-8ft Indonesian waves again, within 1-2 years. I guess it's not the picture perfect answer you might have been expecting, but I guess my point is, that for some mums, it's a bit of a struggle after having kids, but if you keep persevering, setting and achieving small goals, you will eventually get there, just as long as you don’t give up!
Was your experience any different following the birth of your second baby?
Yes totally different. My second baby was a breeze in comparison. I was surfing on a rubber mat right up to the day my second baby was born. I was a lot stronger and fitter, I seemed to handle the pregnancy better (no back or pelvis pain this time), labour better and I knew what to do with the baby the second time round. I was back surfing at around 6 weeks. Being a physiotherapist with a special interest in women's health, I knew the dangers of going back too early and the risks of injury due to joint laxity (and also mastitis from lying on or hitting those enormous boobs) and I was very cautious to only go out in small safe conditions. My main worry was slipping on the board and stretching already lax ligaments, but that never happened and I found surfing helped me get stronger, fitter, healthier and much happier!!! I was a better mum for it too.
Do you think surfing helped you bounce back after having a baby?
Definitely! I felt human again. It gave me "me" time (alone or with friends) in the surf. The feeling was amazing. I felt refreshed and started regaining my strength and energy. It's just an awesome sport for lots of reasons..
Do you ever think about your pelvic floor muscles when surfing?
I don't really think about them, but since having children I am much more aware of my pelvic floor muscles and a correct contraction, and I do notice when they are contracting. For example during paddling, along with some of the other back (multifidus & erector spinae) and core muscles (transversus abdominus), I sometimes feel the pelvic floor muscles co-contracting as well. And sometimes I am aware of them 'bracing' prior to and during certain manoeuvres and turning the board and so on. Surfing definitely helps strengthen all muscles including the pelvic floor. And SUPing (stand up paddle boarding) has been great for small days too. SUPing is great for the core, arms and legs.. Well, the whole body really! Lots of reasons.
As a physiotherapist, a surf coach, surfer and mum, what advice would you give to mums trying out surfing for the first time?
Just have fun with it. It's your time away from the kids to enjoy. Expect (& embrace) a bit of a workout, and allow yourself some time to learn. It usually takes a few sessions to get up and standing. It's also worth getting a qualified surfing instructor to give you some tips to start off with, even the tiniest tips, can help you stand up and ride that wave right through to the shore. Keep persevering, because once you get that feeling, you won't want to stop! Oh and also, the learn to surf boards can be heavy so make sure you buddy up with someone to help carry your board down to the water to protect your pelvic floor and back, especially if your women's health physiotherapist has advised you not to lift! Just be aware also not to strain to get the surfboard into position, you can ask your instructor for easy ways to manage your surfboard without having to lift or strain to position it (things like pulling the board around from the leg rope on top of the water rather than trying to lift the board against the water current etc). Even just laying down and paddling in some safe, flat water is a great low risk way to get used to the board, get a bit of fitness in and get out in the water with your friends!
And great bonus news, mums...you can see Madeleine as your women's health physiotherapist at Pindara Physiotherapy and Sports Medicine on the Gold Coast. But whatever you do, make an appointment and don't just drop in - it's the ultimate surfing no-no!
POWERSTEP - A NEW FRONTIER OF ANTERIOR CRUCIATE LIGAMENT REHABILITATION
Anterior cruciate ligament (ACL) injuries are a debilitating musculoskeletal injury to the knee. Injuries to the ACL are relatively common in sport, especially in AFL, basketball, netball, touch football, soccer, and alpine skiing. Historically, ACL ruptures have prematurely halted sporting careers.
Currently, surgical repair of the ACL is the primary management strategy. ACL rehabilitation can be a long and arduous period often extending to 12 months to restore function to the affected knee to be able to return to sport.
Acute (0-2 weeks) and intermediate (3-12 weeks) rehabilitation of ACL reconstructions is relatively simple with many guidelines and milestones. However, end stage rehabilitation right through to a “release to full activity” is poorly managed with minimal guidelines. This period of 3 to 12 months post surgery is extremely pivotal and it is essential for your Physiotherapist to recognise the potential gap between the athlete’s perceived versus actual sports readiness.
At Pindara Physiotherapy & Sports Medicine we have worked closely with Dr Christopher Vertullo at OSSM and the Gold Coast Titans to develop and implement an extensive late stage ACL rehabilitation program that takes the client from 3 months post surgery to return to sport. The PowerStep program is a staged rehabilitation program to take you back to full fitness and return you to your favoured sport at the elite level.
The key to the PowerStep program is incorporating a battery of sports-specific assessment tools including force plate assessment of your strength and power.
If you or someone you know have had an ACL reconstruction and want to return to sport safely and in optimum condition the PowerStep program is for you. By booking an appointment with your Physiotherapist at Pindara Physiotherapy, you can have access to the best practice assessment and management.
Please call (07) 5539 4484 now to make an appointment with one of our experienced physiotherapists to get you on the right track to return you to the optimal level of sport.
Below is a teaser of the PowerStep program.
SHOCKWAVE THERAPY ANNIVERSARY
I am pleased to announce our third year anniversary of Shockwave therapy on the Gold Coast.
After first bringing Shockwave therapy to the Gold Coast after extensive consultation with the Queensland Sports Medicine Centre, we found it an exteremely useful adjunct with treatment of chronic tendinopathies, plantar fasciitis and various other recalcitrant conditions.
However, its success is only part of a multi-disciplinary/multi-modal treatment approach as our experienced Sports Physiotherapists are able to modify your exercise load accordingly, as the right exercises at the right time are still the keystone to improving many of these degenerative tendon conditions.
Our team of Specialist Sport and Titled Sports Physiotherapists have the extended scope in this area to manage these difficult conditions.
Such treatments we often employ with elite athletes to manage their return to sport and competition, such as nine time kickboxing World Champion Nathan "Carnage" Corbett seen here being treated by one of our experienced Physiotherapists Simon Carlton.
CONCUSSION: ASSESSMENT AND MANAGEMENT
Concussion is an innate risk and unfortunate aspect of contact sports. Although relatively uncommon, Australian research figures suggest one in seven athletes in Australia that participate in all major football codes have suffered one or more concussions.
By definition a concussion results in impaired brain function, including the ability to both acquire and process information, that represents damage to the neural tissue. Unlike structural brain damage the severity of functional brain damage caused by concussion unfortunately cannot be assessed with MRI and CT imaging. When making a diagnosis a great importance is placed on symptom and behaviour recognition especially when only 10% of all concussions an athlete loses consciousness or is knocked out.
This is why the Sports Concussion program has developed a series of Pre-concussion assessments, assessment products and applications that aim to assist the early diagnosis and treatment of concussion. This testing method is currently used by elite sports teams including the Gold Coast Titans, Gold Coast Suns and Gold Coast Breakers.
Pindara Physiotherapy and Sports Medicine are proud to announce the introduction of an in-depth Concussion Screening Assessment, a first for amateur and school athletes of the Gold Coast. Using the Axon Sports Concussion testing and screening tools we are able to obtain pre-injury baseline data, which can be used to compare data taken after an athlete has suffered a concussion. This comparison of data under the guidance of a sports physician, we can effectively tailor a treatment program to ensure the safest return to school, training and game.
Delayed assessment and poor management of a concussion can have dangerous complications for athletes, including increasing the risk of further functional brain damage. Therefore we would highly recommend you, as a parent or an athlete to take this opportunity to protect and minimise the risk of the potentially serious implications of concussion.
It is important to take precautions when an athlete's health and safety are concerned especially that of mental health and brain functioning. By booking a quick, simple and inexpensive 30 minute appointment at Pindara Physiotherapy, you can have access to the best practice assessment and management should your child experience a concussion.
Please call 07 5539 4484 now to make an appointment with one of our experienced physiotherapists.
Heel pain in young athletes is one of the most common conditions presenting to our clinic. Read on to find out what it is and what can be done...
(Also known as Calcaneal Apophysitis)
What is Sever’s syndrome?
The muscle group at the back of your lower leg is called the calf. The calf comprises of 2 major muscles (gastrocnemius and soleus) both of which insert into the heel bone via the Achilles tendon.
In children who have not reached skeletal maturity, a growth plate exists where the Achilles tendon inserts into the heel bone. (See Figure 1.)This growth plate is primarily comprised of cartilage. Every time the calf contracts, it pulls on the Achilles tendon which in turn pulls on this growth plate. When this tension is too forceful or very repetitive, irritation to the growth plate may occur resulting in pain and sometimes an increased bony prominence at the back of the heel. This condition is called Severs Syndrome. (Named after JW Sever who first described it in 1912)
Severs syndrome is typically seen in children ages 7 to 15, with the majority of patients presenting between 10 and 14 years of age, quite often during periods of rapid growth.
Figure 1. X-Ray of the heel showing the Growth Plate *Note the Growth Plate at the Heel
Signs and symptoms of Sever’s Syndrome.
Children with Severs Syndrome typically experience pain that develops gradually in the back of the heel or Achilles region during and after activity. We typically find this occurs in very active children whose sports and activities require strong or repetitive contraction of the calf muscles such as running and jumping.
As the condition progresses, patients may experience symptoms that increase during activity and affect performance. (Limping and obvious discomfort)
Treatment for Severs Syndrome.
Sever’s Syndrome is a self-limiting condition that gradually resolves as the patient moves towards skeletal maturity. This usually takes between 6 to 12 months but may persist for as long as 2 years. Children with Severs Syndrome typically improve gradually over time and full recovery is normal and expected with correct management.
The cornerstone of correct management primarily comprises of activity modification (a reduction in the volume and intensity of sport and activity) so the child gradually becomes pain free pain-free.
Whether a child should continue playing sport is dependent on symptoms. Patients with mild symptoms may be able to continue to play some sport with a reduced training load and elimination of unnecessary activities (i.e. lunchtimes at school, free time at home). Those with more severe symptoms will require time off all sport until pain free on normal, non-sporting activities such as walking. A very gradual return to sport can occur after this time with careful monitoring of symptoms and activity levels.
Contributing factors to the development of Severs Syndrome.
There are several factors that may increase the likelihood of developing this condition. These need to be assessed and corrected with direction from a physiotherapist to ensure an optimal outcome. Some of these factors include:
- inappropriate training loads
- inappropriate footwear
- calf tightness
- calf weakness
- joint stiffness
- poor lower limb biomechanics
- poor foot posture
Physiotherapy and Podiatry for Sever’s Syndrome
Physiotherapy treatment is vital for children with this condition to reduce pain, allow for increased activity levels and ensure an optimal outcome. Treatment may include:
- activity modification advice and education (absolutely vital)
- biomechanical correction
- exercises addressing any flexibility, strength or balance issues
- soft tissue massage
- footwear advice
- a gradual return to activity program
- comprehensive home program (this condition can be easily managed at home with minimal treatment required. Our aim is to give you the advice and tools for this and provide back up assistance when needed)
A consultation with a Podiatrist may be indicated to correct abnormal foot biomechanics, which can impact on this condition. Your treating Physiotherapist can advise if this is required. Conversely, a skilled podiatrist can also advise in most of the areas outlined above.
Q: Is all heel pain Sever’s Syndrome?
A: Certainly in the age groups we’ve outlined it by far the most common, but not the only potential problem. That’s why accurate diagnosis by your Physiotherapist /Podiatrist is so vital.
Q: Is this simply “Growing Pains”?
A: No. There is no such thing as “growing pains” Certainly it affects the growth plate at the heel, but this is a growth plate injury…. not a normal consequence of growing.
Q: Can my son/daughter just “run through it”?
A: No. This is a sure fire way to make things worse and may increase symptoms to a degree that a long and total rest from all sport will be required.
RUN LIKE THE GREATS!
On Saturday Jan 22nd Hardy and I attended The Pose Tech Running Course lead by the famous Dr. Nicholas Romanov.
In the 70′s Dr. Romanov, a Russian scientist, University teacher & University Track Team Coach developed a method of teaching sport specific techniques, especially running. He called it the Pose Method.
Dr. Romanov suggests that running is something most of us can do so its not traditionally perceived as something that needs to be taught…that is… its not perceived as a skill based activity. Why is it then that some runners look great, free flowing, and natural, while others look like “plodders” who struggle along. Clearly there is a difference and Dr. R has tried to quantify this and then teach it…to turn Plodders into Gazelles!
Hardy and I went along at the invitation of Debbie Savage, a level 4 Pose Method Coach and great runner in her own right. (Thanks Deb) We felt it may have some benefits in looking after our injured runners…and statistics show that 85% of runners sustain a running related injury!
There wouldn’t be too many serious runners or running coaches who haven’t heard of the Pose Method.
Now we have to realize that this Pose Method is Dr. Romanov’s “life work”. As such he has a real passion, which really showed in his presentation. The Day went from 9 to 5:30 and he was just as enthusiastic at the start as he was at the end. And it was a hot, long day in a tin shed in Southport…so not easy conditions. Was he a good presenter…no. In fact because English is not his native language he struggled and he tended to ramble a bit. So did this mean the day was a waste…emphatically no. By the end of the day I found him to be a charming and endearing man. His passion shone through and the reasoning process he went through was very, very sound, something we emphasize to our Physiotherapy Students all the time.
I enjoyed the way he looked at some of the worlds best runners…Usain Bolt, Haile Gebrselassie and showed the common patterns of running that these guys used naturally. He then broke this down into three simple elements and taught it to us.
So what is it?
Describing it here won’t really do it justice so check out his website…which rambles a bit like him www.posetech.com
Now is Pose Method for everyone. It’s hard to argue when you look at the great runners and see that they do run with the elements Dr. R suggests…and they do this naturally. Pose has its detractors, and I’d bet a few of these don’t have a great understanding of what it is. Is it easy to learn?…yes and no. Some people will pick it up quickly and some won’t but like all things worthwhile…it takes time, patience and dedication. Can you run quickly without it…well yes you can. With anything I learn, I’ll take the elements I like and try to put my own slant on things. Hardy and I will spend a bit more time practicing and getting some feedback from Deb Savage and we’ll let you know how it goes. Stay tuned.
Reading Helps lose weight!
It’s hard not to be affected by the things we read.
Something I just noticed recently, after buying yet another book on healthy lifestyle (Mark Sisson’s “Primal Blueprint”, which I think is pretty good…I’ll review this later and post it here).
So my advice is if you really want to improve some aspect, or number of aspects of your health…. get reading. By immersing yourself in the authors messages of healthy eating, exercise, stress management, good quality sleep, its almost impossible not to have a little bit rub off. And not just one book…try a whole bunch on the same subject (if you’d like some recommendations, feel free to ask.)
A few old “clichés” come to mind here too. “Don’t believe everything you read” is one, and yes you do need to sort out some of the rubbish from the good stuff. This isn’t always easy and I’m not sure if I have a good answer to this one. One thing I try to do is question firstly….is this author trying to sell me something or are they trying to provide me with information. If it’s the selling angle, I’m immediately put off.
The other “cliché” is “Knowledge is Power”….this is something books can provide…so if you want to do something as basic as loosing some weight to take some pressure of some sore joints and improve your overall health…start reading. My latest book cost a measley $10 at Amazon and so far its money well spent!
EFFECTS OF GOOD QUALITY EXERCISE ON CHRONIC PAIN
There are two types of exercise that we can talk about when we talk about chronic pain. General and Problem Focused.
Problem Focused exercise is just what it says…focused on your pain problem specifically. It is the type of exercise typically given to you by a Physiotherapist like me to reduce your pain. These exercises are usually aimed at improving the flexibility of the painful part or its surrounding structures and/or improving the function of the surrounding muscles. Now don’t get me wrong…focused exercise is important for many people, but for those with chronic pain it may not be the best place to start. Focussing exercise on the problem area may also highly focus the brains attention to the problem area and in turn ramp up the pain response in some people. The other problem is that those with chronic pain are often easy to “stir up”, so the Physiotherapist has to be highly skilled (and even then it’s not easy ).
So for some people a more general, non pain focussed program is a better place to start. For example, if you have an upper body problem, some lower body exercises such as walking or bike riding will help. For those with pains all over, a little experimentation may be in order. In this case I might start someone with 30 seconds on an exercise bike (I have done this before).It’s important that this first session is successful and you understand why we are doing this. The next session might be the same if we have no flare ups. Then slowly but surely, week by week, month by month we’ll increase the time until the fitness benefits below start to kick in!!!
General Exercise Helps Pain By…
*Increases endorphin release…endorphins 50 times stronger than morphine. Happy chemicals.
*Tells your mind that it’s OK to move so function is improved.
*Improves your strength
*Improves your flexibility
*Improves your fitness/helps you lose weight
*Improves your bone strength
*Improves your Blood pressure (reduces)
*Improves your Heart efficiency
*Improves your Lung efficiency
*Reduces your stress levels.
* Improves your sleep quality
*So... counteracts most of the stress response.
Now you tell me... do you think you would feel better, healthier and more able to cope with pain if you made improvements in these areas? Of course you would. In many cases pain perception itself is also reduced…something we all want. Is it easy to start? Not if you haven’t exercised before. Get some advice…start ridiculously easily and slowly. This has been proven time and time again to work extremely well. Give it a go. (In fact you have no choice…you cannot be sucessful in pain management without it.)
Success in pain management
“Success in Pain Management is built on making fewer errors in a number of key areas – errors in pacing, nutrition, stretching, fitness, sleep, relaxation, depression management, activity selection – the entire package. The further a person strays from an extremely dedicated process – the more space he or she allows for pain to take over. ”
I think it was Jim Rohn who said that “some things are just well said”. I adapted this definition from a paragraph on how elite athletes need to approach their training. I’ve always been interested in the parallels between sport and life and I think this is a beauty….I hope you like it.
Hardy and richard full of "holes" for the benifit of our patients
Following Jaclyn’s recommendation after having done this course earlier in the year, Hardy and I completed the Musculoskeletal Segmental and Dry Needling Course (put on by Leigh and Trevor of Combined Health) on the weekend of 24/25 July at Griffith University.
This course taught us how to use Accupuncture needles to treat a variety of very common conditions that present to us daily. I must have had over 100 accupuncture needles inserted in various bits from tip to toe over the weekend…but worth every bit if it allows us to get you better faster!
It was a real “eye opener” just how quickly some common conditions can be improved with this technique. Whats great about it is that the evidence behind it (that is… well conducted research that shows that it actually works!) is quite good on a number of fronts.
My own personal experience is from Jaclyn treating my crook left heel (plantar fascia pain) over the last 2 months with good results…and I must say I was a little skeptical at first…but not now….my foot was better after one treatment and continues to improve. Seeing the improvements in range of movement, strength and pain in some of our fellow course attendee’s (and yes Hardy was the biggest crock there!), as well as Leigh and Trevor’s relating of their clinical experiences shows that this is a very effective and legitimate treatment option for alot of people.
We may offer you this as an adjunct treatment to our normal methods starting from now.
So if you think your pain problem or condition could be helped by needling, ask your Physiotherapist for more information.
Special Report: Fight Age with Muscle
This is a long post... but a very worthwhile read
The latest research is changing how doctors look at muscle mass. No longer seen simply in terms of performance or vanity, muscle mass serves as the body’s armour against several age-related diseases as well as heart problems, diabetes, and even cancer.
By John Brandt, Best Life
Just as most men believe they possess a keen sense of humour, most men assume they are reasonably strong. Their muscle mass — the aggregate of muscle tissue they have built over a lifetime, enabling them to support their bones, fill the legs of their jeans, and lift the heavy end of a sofa — is at least adequate, relative to other men their age. Before my meeting with Gianni Maddalozzo, PhD, an exercise physiologist at Oregon State University, I was one of those men. After our meeting, I still think I have a pretty good sense of humour.
The latest research is changing how doctors look at muscle mass. No longer seen simply in terms of performance or vanity, muscle mass serves as the body’s armour against several age-related diseases as well as heart problems, diabetes, and even cancer…
Maddalozzo’s research focuses on the study of osteoporosis and muscle strength in adults ages 40 to 80. Most of his subjects suffer from advanced sarcopenia, the loss of muscle mass that occurs naturally -and inevitably – with age. Compared with sarcopenia, other sneaky scourges of the middle years, such as arterial plaque buildup and prostate enlargement, announce their presence with a fanfare of symptoms. But sarcopenia creeps by in imperceptible increments, stealing a fifth of a pound of muscle a year, (0.1 of a kg per year) from ages 25 to 50, and then it picks up a dreadful, yet still mostly silent, velocity. The condition subsequently bleeds a man of up to a pound (just under 0.5 of a kg) of muscle a year, a loss he is unlikely to notice until it’s too late. “You haven’t gotten any thinner, because the pounds of muscle are typically replaced by pounds of fat,” explains Maddalozzo.
“But sarcopenia is progressing all the time. One day you trip and fall and suffer a fracture of your hip. Then, when you try to rehab after hip-replacement surgery, you discover that you have virtually no muscle mass to build on.”
Despite (or perhaps because of) its universal, inexorable nature, sarcopenia, until recently, did not get much respect. Indeed, until 1988, the condition lacked its own scientific name. “Historically, the scientific community has taken muscle for granted,” concedes William Kraemer, PhD, a professor of kinesiology at the University of Connecticut. Perhaps more tellingly, sarcopenia’s proven antidote – resistance training – will never make a dime for a pharmaceutical company. Scientists such as Kraemer, Maddalozzo, and a cadre of others are at the forefront of a movement that is redefining the importance of muscle mass in terms of overall health, not simply performance or vanity.
Recent research shows that diminished muscle strength and mass are empirically linked to declines in the immune system and the onset of heart disease and diabetes, not to mention weaker bones, stiffer joints, and slumping postures. Muscle mass has also been shown to play a central role in protein metabolism, which is particularly important in the response to stress, and decreased muscle mass correlates with a decline in overall metabolic rate (muscle mass burns more calories at rest than fat does). Further research is expected to show measureable links between diminished muscle mass and cancer mortality. The thinking about muscles and resistance training, in short, is reaching critical mass, and a major shift in the American fitness paradigm is under way. Along with this increasing emphasis on resistance training, there is an increasing awareness about the nutritional factors that can complement muscle growth, namely increasing daily intake of protein.
“In the last 20 years, we have come full circle,” says Wojtek Chodzko-Zajko, PhD, a professor of kinesiology and community health at the University of Illinois and a fellow of the American College of Sports Medicine. “We used to discourage older adults from lifting heavy weights. Now we’re telling them they can’t maintain overall health without it. After age 50, you can’t get by just doing aerobic exercise.” Although it’s not explicit yet in the government’s overall health guidelines, agencies such as the Centers for Disease Control and Prevention now recommend a couple of rounds of resistance training a week. “Muscle function can improve – sometimes robustly – with resistance training, even after the onset of sarcopenia,” says Robert Wolfe, PhD, a professor of geriatrics at the University of Arkansas. “But it is far more effective to begin resistance training before the process gains momentum. Intervention in the middle years is necessary.”
The muscles of most men reach maximum size (or, strictly speaking, attain the maximum number of fibers per muscle) at age 25. From that lamentably early peak, a long, gradual decline ensues. Over the next 25 years, the muscles lose approximately 10 percent of their fibers. Then, starting around age 50, things go to hell. The body’s production of testosterone, human growth hormone, and DHEA ebbs, and the motor cells of your nervous system, which spider out from the spinal cord to control the contraction of muscle fibers during physical activity, deteriorate rapidly. As the motor cells die, so do the fibers to which they’re attached, especially type II or “fast-twitch” fibers, the ones employed for short bursts of anaerobic power. For instance, if your biceps consist of 90 fibers when you’re 50 years old, by age 80, that number will be closer to 50 fibers, most of them feeble type “slow-twitch” fibers.
It’s through the study of sarcopenia that a greater appreciation of muscle mass is evolving. Two seminal works, “Starvation in Man,” an article published in the New England Journal of Medicine in 1970, and Hunger Disease: Studies by the Jewish Physicians in the Warsaw Ghetto, a book published in 1979, show that the depletion of muscle mass is the cause of death in human starvation. This is because essential organs and tissues such as the brain, heart, and liver rely on a steady supply of amino acids to synthesize new proteins and maintain function. Normally, dietary protein supplies these amino acids. Under duress, however, these organs maintain homeostasis by drawing protein from the muscles. Our skeletal muscle mass, besides powering all of our movements, also serves as a reservoir for our vital organs. And like all reservoirs, this one can run low – or, in the case of starvation, run dry.
In 2005, results from the Mediterranean Intensive Oxidant Study, which examined the causes of osteoporosis in men, found that bone density and mineral content had a direct correlation to skeletal muscle mass. “The stronger and thicker your muscle tissue, the more force that tissue exerts on the bone,” explains Maddalozzo. “And increased force, both during exercise and normal daily functioning, results in the bones growing stronger and denser. That significantly retards osteoporosis and, as a man ages, the rate of hip fractures.”
A man with a full reservoir of muscle mass enjoys dual protection: stronger bones combined with enhanced strength and Muscle mass has also proved to play a key role in more common, but no less deadly, conditions such as cardiovascular disease and diabetes. A study of scientific literature published in Circulation in 2006 cites articles showing that sarcopenia has been linked to insulin resistance (the main factor in adult-onset, or type 2, diabetes), elevated lipid levels in the blood, and increased body fat, especially “visceral adipose tissue,” which gathers around the heart and other vital organs and is a primary risk factor of heart disease. In fact, researchers concluded that long-term adaptation to resistance training lowers cortical response to acute stress; increases total energy expenditure; relieves anxiety, depression, and insomnia; and demonstrates beneficial effects on bone density, arthritis, hypertension, lipid profiles, and exercise tolerance in coronary artery disease. “As the dates on these studies indicate, we are just seeing the tip of the research iceberg,” says Wolfe. “In the years ahead, we are likely to see the proof of even closer relationships between muscle mass and disease states.”
The case against overreliance on cardiovascular fitness – a case striking close to my heart – was made best in a study conducted at East Tennessee State University more than a decade ago. Researchers studied 43 healthy individuals who were 55 or older. Twenty-three of the subjects worked out three times a week for 30 minutes per session, confining their exercise to the treadmill, stair machine, and stationary bike. The other 20 subjects performed 15 minutes of aerobic exercise and devoted the rest of their sessions to training their major muscle groups on weight machines. After four months, bone density and lean muscle mass increased significantly in the group combining aerobic and strength training, but it did not improve for the group confined to aerobic activity.
According to Wolfe, Kraemer, Chodzko-Zajko, and other experts, resistance training must be conducted at a high intensity, at 70 percent or more of the maximum perceived effort, in order to produce the cellular and metabolic changes that yield stronger, thicker muscles and the resultant health benefits. “A little bit of training – swinging a five-pound dumbbell around – just won’t cut it,” says Kraemer. “That’s not enough to catalyze growth and engage the systems.”
That’s why scientists such as Maddalozzo also emphasize a muscle-friendly diet that will complement – and, to a certain degree, compensate for – the bare-bones, let’s-get-through-this strength-training programs that most people are likely to follow. “Unless you eat the right diet, you won’t get the best benefit from strength training,” says Fred Hahn, a trainer in New York City. “You absolutely must have an adequate intake of protein for your body to adapt to the stress.” In Wolfe’s 2006 study in the American Journal of Clinical Nutrition, “The Underappreciated Role of Muscle in Health and Disease,” he argues that the present recommended daily allowance of protein, 0.36 grams per pound of body weight, was established using obsolete data and is woefully inadequate for an individual doing resistance training. He, along with many others, recommends an amount between 0.8 and 1 gram per pound of body weight.
Maddalozzo’s strength-training program, which he teaches others and practices himself, is one of these new programs: It is two 30-minute sessions a week, comprising one set of eight full-body, multijoint exercises. Each exercise consists of eight to 15 reps, at 60 to 80 percent of “maximum perceived effort,” with the final rep performed to the point of voluntary failure. “I work 60 hours a week, and I have two kids at home,” says Maddalozzo. “I don’t have the time or interest to spend hours in a gym.”
“We’ll start with the squat,” he says, leading me across the floor to a bare barbell. “That’s the fundamental lower-body exercise. You need basic leg strength for your running and also for general functioning, for movements such as getting in and out of a chair.”
Getting in and out of a chair? “How much weight?” I ask coolly.
Maddalozzo hesitates. “Before we talk about weight,” he says, “let’s see a squat with no resistance.” I reach for the barbell, but he stops me. “We don’t even need that for now. Let’s just see you do a squat.”
I squat, or at least I give my version of a squat. I begin by pushing out my knees, and then I bend from the waist with my shoulders curled forward. “Not like that,” says Maddalozzo. “You need to keep your back flat and your shoulders square, and drop your buttocks.” He demonstrates the proper form with striking ease and fluidity.
I try to copy the motion, but I am dealing with decades of scar tissue from a torn ACL, compensating behavior, avoidance, and, I admit, increasingly active sarcopenia. My shanks have undeniably shrunk.
I try a third time, imagining myself as a baseball catcher crouching behind a batter. Maddalozzo brightens. “Good,” he says. “That’s perfect.” It hardly feels perfect. Bands of pain shoot through the decimated muscle fibers of my tight, weak hamstrings. I force myself to squat lower, and in so doing, I briefly lose my balance. I touch the mat to right myself. My quads begin to tremble. A cool breeze combs the room, but I start to sweat. With some gruesome noises from my knee joint, and another bolt of pain, I stand, a lean and sneakered pantaloon, summoning as much dignity as possible.
“I guess I should begin with a pretty modest weight.” Maddalozzo gives an encouraging smile. “Just by repeating the proper motion a couple of times, you’re starting to redirect your neural pathways,” he says. “You’re on your way. Let’s go try some lunges.”
By John Brandt, Best Life
Richard’s comments on this article:
If you are over 50 this is pretty scary stuff. The good news is this “sarcopenia” (even the name sounds bad) can be slowed, halted and even reversed with weight training, resistance training. Your choice to weight train with MedX is therefore very wise.
You’ll notice, in this article, that the system Mr. Maddalozzo recommends is the same as us….
“It is two 30-minute sessions a week, comprising one set of eight full-body, multijoint exercises. Each exercise consists of eight to 15 reps, at 60 to 80 percent of “maximum perceived effort,” with the final rep performed to the point of voluntary failure. “I work 60 hours a week, and I have two kids at home,” says Maddalozzo. “I don’t have the time or interest to spend hours in a gym.”
So keep up the training…read this article again and be pretty happy about all the benefits you are currently achieving through your MedX training.
STRENGTH-STABILITY-FLEXIBILITY-ENDURANCE:Four elements essential for your spinal health
Low Back Pain is the most common problem that presents to our clinic and indeed pain clinics worldwide. As such we have a strong desire to provide you with the absolute latest treatment and rehabilitation methods available. We don’t feel prescribing to one particular method is necessarily the best, but rather take the best features of a range of different approaches and apply them to each person individually is the best approach. By doing this we feel patients obtain superior results both in treatment of current episodes of pain and prevention of further episodes.
In general terms you should seek to reduce “Pressure” or “Shearing/Strain Forces” on the problem area. This is usually why any body part gets sore in the first place- too much load being placed on it during your desired activity.
Most often your back will get sore because it’s being asked to do too much work (for some just the normal activities of daily living).
Here at Pindara Physiotherapy we focus on your Back strength and back muscle endurance, your flexibility, particularly through the hips and pelvis and ensuring you have good body techniques.
In summary, with good flexibility, good muscle function and good technique, you will be well on the way to reducing your back pain and having a great exercise programme that maintains this long term.