Latest Resources

Friday, July 13, 2012 - 16:15

After suffering from any injury, inflammation (which causes swelling) immediately goes to the damaged area to start the repair process. Whilst this swelling is important in tissue healing it is often excessive and cause increased pain and decreased function. Therefore, for the first 24-72 hours after an injury it is important to try and limit the amount of inflammation by the R.I.C.E. protocol – Rest, Ice, Compression and Elevation. All these steps slow blood flow to the area and therefore decrease swelling. By applying heat or massage to the area in the first 24-72 hours can increase blood flow and cause more inflammation! Ice should be applied for 20 minutes at a time with a cloth between the ice and your skin and repeat every 2 hours.   

 

Heat is useful in relaxing tight muscles, particularly around the neck and lower back. Many people often feel better after a hot shower in the morning as the heat helps to release tight muscles and trigger points. Using heat in these areas helps soothes muscle pain and tension. Massage works very similar to heat so if you can get to a massage therapist or physiotherapist you will get even better relief. Heat should be applied for 25-30 minutes via a heat pack or hot water bottle.

 

If you experience pain or swelling from an old injury after exercising ice is still the better option in this situation even though you don’t have a new injury. This is because swelling or pain after exercise often indicates inflammation and aggravation of the tissues.

Friday, July 13, 2012 - 16:09

Firstly, it is important to remember that if you are going to be taking any kind of medication it is important to talk to your GP or Pharmacist about it first. The information below has been developed from looking at research on the different types of Panadol.

 

Panadol – The GlaxoSmithKline brand name for 500g of Paracetamol . This 500g of Paracetamol is common among all of the panadol range and acts as an analgesic (pain relief) and anti-pyretic (decreases temperature). It contains no anti-inflammatory substances. The usual adult dose is 1000mg, which equates to 2 tablets per every 4 hours. The active ingredient paracetamol is absorbed within the gastrointestinal tract with the highest concentration of paracetamol usually occurring 30-60 minutes after administration. Because a reasonable amount of paracetamol remains in the system for 24 hours there is a maximum daily dosage of 4000mg (4 x 2 tablet doses).

 

Panadeine – Contains the same 500mg of Paracetamol that is in panadol but with an additional 8mg of codeine phosphate. Codeine is from the opiate/narcotic family, with the strength of approximately 17% of morphine. In fact, a small amount of codeine actually converts into morphine when metabolised within the body. The codeine acts centrally, blocking not only the sensation of pain but also the emotional response to pain within the central nervous system. It does have a mild sedative effect with some people experiencing dizziness and drowsiness  and prolonged high doses of codeine can result in addictive behaviours.

 

Panadeine Extra – Basically is the stronger version of Panadeine. It still has the same 500mg of paracetamol but also has 15mg of codeine added to each tablet. It is an S3 medication which means that although it can be purchased without a prescription it will only be found behind the counter and the pharmacy assistant needs to get clearance from the pharmacist before selling it to you.

 

Codeine side-note: Opiates such as codeine and morphine have long been known for not only their pain relieving effects but also their smooth muscle relaxation effects. Historically they were often used to treat diarrhoea as they slow the peristaltic movement of faeces through the intestine, increasing the water re-absorption time and thereby resulting in firmer stools. However this also means that in a person with normal bowel motions, the taking of a pain reliever such as Panadeine or Panadeine Extra can result in constipation.

 

Panadol Extra – Contains 500mg of Paracetamol per caplet with an added 65mg of Caffeine. The Caffeine is absorbed easily in the body after oral administration. It has been shown to reach its highest concentration levels within 1 hour. The standard dose of two caplets results in a total consumption of 1000mg of Paracetamol and 130mg of caffeine, which has been suggested to be equivalent to approximately 2 cups of instant coffee.

Every 1 Panadol Extra caplet provides the equivalent caffeine of 1 cup of coffee. The usual dose of two tablets is therefore equivalent to approximately 2 cups of coffee.

Caffeine has long been known to be a pain reliever. The question is whether it provides additional benefit to paracetamol alone. Some of the concerns with caffeine is that even in small doses of 50mg caffeine can cause tachycardia (increased pulse rate) and anxiety in some people. Pregnant women are also advised not to consume more than 200mg of caffeine per day.

Unlike Panadeine Extra, Panadol Extra is an S2 medication. This means that whilst it is sold in a pharmacy it does not require input from a pharmacist and can be found of a standard shelf not behind the counter. A person can pick it up and take it to the cashier at the register without anyone questioning or advising what is in it.

 

Panadol Osteo – Contains 665mg of Paracetamol and is a unique bi-layer tablet incorporating an immediate release and a sustained release dose of paracetamol. The paracetamol in Panadol Osteo is released in 2 stages, with 31% being released immediately, for rapid onset of action, and 69% of the paracetamol being released slowly over the day or night, to provide prolonged pain relief.

 

Monday, April 30, 2012 - 12:48

We know now that as part of persistent back pain and pelvic pain, muscles can tend to want to switch off that helps us to stabilise and support this area. Some times these muscles can be tricky to get working again especially as they can be quite subtle and abstract feeling to engage. We also know that if these muscles are getting switched off a lot, they may be weak, or inefficiently overactive. If your core muscles have been eluding you or you have been trying to activate your pelvic floor muscles but not sure if you have the technique, or worse, are getting internal or tail bone pain when trying to switch these muscles on then it may be helpful for you to have a one-on-one session to address these concerns.

 

Monday, April 30, 2012 - 12:40

Question: My son has been complaing of knee pain for the last 2 months, which is worse when he plays soccer. I think it is just growing pains but it doesn't seem to be going away. Is there anything I can do to help?

A: With the winter sports season well under way, we tend to see a big increase in young patients with 'growing pains' that are beginning to interfere with their sporting activity.  Two areas of pain that children often complain about are in the front of the knee, and in the heel.  These are often known as Osgood-Schlatters Syndrome, and Sever’s Syndrome respectively.

Osgood-Schlatters is characterised by pain in the upper part of the shin bone, where the ligament from the kneecap (patella) attaches to the top of your leg bone (tibia).  It is often associated with an obvious lump, redness and some swelling.

It is most common in children between the age of 9 and 15 and often occurs following a growth spurt.  It is far more prevalent in active children, particularly those involved in running and jumping sports such as basketball, netball, volleyball, soccer and gymnastics and is more common in boys than girls.

Symptoms include redness and a lump over the top of the shin bone, pain with running, jumping and/or stairs and in severe cases even walking.  It can occur on only one leg, or both legs simultaneously.

Treatment firstly consists of ice and relative rest from the aggravating activity.  It may also be appropriate to talk to your Doctor regarding a course of anti-inflammatories to help settle the initial inflammation down.  This should be followed by an appropriate stretching and strengthening programme that focuses on decreasing use of the front thigh muscles (quadriceps) and increasing the use of the other muscles around the hip.  Often analysis and education of correct running and jumping techniques will help decrease loading on the knees, and not only help in a quicker return to activity, but also prevent the problem from reoccurring as well.

 

Sever’s is a relation to Osgood Schlatters however it affects the heel rather than the knee.  It is characterised by localised tenderness over the heel, occasionally with an obvious lump, and difficulty with any activity that uses the calf muscles such as walking, running or jumping.

Treatment again consists of ice and rest, followed by an appropriate stretching and strengthening programme.  Use of a heel raise will often help decrease stress on the heel in the short term while the pain settles, and enable an earlier return to activity.

 

Both conditions often settle within a few months with appropriate rest and treatment however severe cases have been known to continue for 1 – 2 years.

Monday, April 30, 2012 - 12:28

Headaches are one of the most common conditions seen by physiotherapists today. 90% of people have experienced a headache at some point in their lives. The most common type of headache is a tension-type headache followed by cervicogenic headache (arising from the neck) and migraines. Your jaw is also another region that can contribute to a headache. For example, in people who chronically clench their teeth or tooth grind. Studies have shown that 80% of young adults grind their teeth during the deeper stages of their sleep.  People with jaw related headaches may also present with pain in the teeth and jaw region and have a fullness feeling in the ear.

A cervicogenic headache starts at the base of the skull to up and around the eye, either on one or both sides of the head.  Whereas a tension type headache presents on both sides along with a tight/ pressure feeling around the head. Migraines tend to initiate in the forehead and have a pulsating quality.

The good news is physiotherapy can play an integral role in the treatment and management of all of the above. It is up to the therapist to assess and identify the type of headache and the extent the musculo-skeletal system is contributing to it. Along with some hands-on therapy, a specific exercise program will assist the rehabilitation process and also prevent reoccurrence of headaches.  Tips and advise will also be provided regarding aspects such as posture, ergonomics and involvement of other medical professions such as a dentist where applicable.