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Home > Archive by category "General" (Page 2)

Archive for category General

Why is correct lifting technique important?

One of the most common causes of lower back injury is incorrect lifting technique. When you lift an object with bad posture, the muscles in your back become inhibited and do not work correctly. This causes a greater load to be placed through the bones, ligaments and discs in your spine which may lead to injury.

Here are some tips to minimise the risk of injury:

  • – Get your body as close as possible to the object you are going to lift
  • – Have your feet placed shoulder-width apart
  • – Bend through your hips and your knees (not through your back!)
  • – Maintain a nice long and straight spine while you lift

Why is taking Vitamin C important?

Complex Regional Pain Syndrome (CRPS) is a serious condition which can occur after an injury or surgery. It can cause severe chronic pain, swelling, extreme sensitivity and changes in the skin. These symptoms are a result of dysregulation of the autonomic nervous system and is often a very debilitating condition.

Research has shown that the development of CRPS after surgery can be reduced by 70% by taking 500mg Vitamin C tablets for 50 days.

Prevention is the key for this condition. If you are heading into surgery it is definitely worthwhile discussing with your Pharmacist or GP about taking some Vitamin C supplements.


Did you know that 1 in 3 women who have ever had a baby experience weak bladder issues

1 in 3 women who have ever had a baby experience weak bladder issues, especially when they sneeze cough or laugh. The answer to this problem isn’t necessarily surgery, also half of women who attempt pelvic floor exercises from reading a brochure or book get it wrong!

If you would like advice, support or more information as to the options available to fix this problem there is a specialized area of physiotherapy that can help, called “women’s health”. Please contact our clinic to get more info or make an appointment. Remember you are not alone if this is a problem for you!


Do you suffer from headaches?

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.


Q&A: ‘Growing pain’ in children

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.


Can back pain be related to pelvic floor problems?

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.


Q: There are so many different types of panadol! Which one should I be taking?

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.


Q: When I get an injury should I use ice or heat?

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.


Is stretching beneficial?

Stretching is a form of physical exercise in which a specific muscle is stretched by moving it away from the body to improve the muscle’s felt elasticity and regain comfortable muscle tone. It results in improvement of muscle control, flexibility and range of motion and usually reduction in pain.

In short, static stretching does not reduce soreness or risk of injury before and after exercises!
The general routine with most people when they decide to do any form of exercise is a quick 2 minute warm up which includes a static stretch of the hamstrings and sometimes the calves and off they go. A muscle when stretched in its not warmed-up stage can lead to reduction in its performance, strength and endurance. Also, stretching can be dangerous when performed incorrectly. Research and its systematic review indicate that, on average, “Individuals will show a reduction in less than 2mm on a 100mm scale during 72 hours after exercise. The combined risk reduction of injury is only 5% which shows that in general stretching may not meaningfully reduce the risk of injuries”. (ref: Herbert RD, Gabriel M. Effects of stretching before and after exercise on muscle soreness and risk of injury: systematic review. BMJ. 2002;325:468).

Then why do we stretch? Well, there is some research out there to support stretching but it is based on the TYPE of stretch performed. There are many different techniques for stretching in general, but depending on which muscle group is being stretched, some techniques can be dangerous and cause permanent damage. Incorrect technique can cause damage to the ligaments, tendons and even joints leading to increased pain and even stiffness from the muscle going into protective spasm. Hence, it is helpful to be aware of the types and do’s and dont’s of stretching.

STATIC STRETCHING:

As the name suggests, static stretching involves holding a muscle at the stretched position for 20 -30 seconds.

  • Best done after your workouts.
  • Stretch the muscle up to a point you feel a slight discomfort but bearable stretch, hold this for a maximum of 30 sec and breathe through the stretch until you feel the muscle slowly letting go.
  • Research has shown to decrease strength and power if done immediately before weight training

ACTIVE STRETCHING:

Dynamic stretching is similar to active stretching with the main difference being, you do NOT HOLD the stretch. You are always moving or performing a dynamic or functional movement.

  • Dynamic stretching is not the best for improving flexibility. It mainly helps in improving function
  • Research has supported that this type of stretching increases acute muscle power much more than the other types
  • It is good way to warm up for your sport and has shown to improve performance

DYNAMIC STRETCHING:

Dynamic stretching is similar to active stretching with the main difference being, you do NOT HOLD the stretch. You are always moving or performing a dynamic or functional movement.

  • Dynamic stretching is not the best for improving flexibility. It mainly helps in improving function
  • Research has supported that this type of stretching increases acute muscle power much more than the other types
  • It is good way to warm up for your sport and has shown to improve performance

FUNCTIONAL STRETCHING:

Functional Stretching is the most updated type according to research. Most of the strength coaches and trainers use functional stretching to improve flexibility in their clients/athletes.

  • The theory of specificity says that strength, coordination, speed, & balance are highly specific to that movement. Functional stretching is based on the same theory. If you want to transfer the newly achieved range of movement into your functions/tasks, the stretching should be specific to that function.
  • eg: For ground based movements or tasks, like lifting, you perform the task a few times as a stretch.

SUMMARY AND TIPS FOR STRETCHING:

  • Do not stretch 1st thing in the morning when you get out of bed. Move around and do your morning chores for 30 mins and then stretch if you need to.
  • Pain whilst stretching should be a “stretch” pain and not “pain” pain.
  • Do not hold your breath while stretching.
  • Stretching is good before and/or after your physio exercises if tightness is restricting you from switching muscles on or actually performing the exercises.
  • Use static stretching after your activity/end of the day, if the muscle is really tight. Better to avoid static stretching before your workouts (gym/walk/sport). Instead perform Dynamic or Functional stretching, for example before starting any physical activities at work/school/sport.
  • Your physiotherapist can help you with what type of stretches are best for you at your next appointment.

Q: Why are so many athletes in the Olympics wearing coloured tape?

The tape you are referring to is known as Kinesiology Tape (or Kinesio Tape) and has become very popular amongst athletes and practitioners. It was developed by a chiropractor, Dr Kenso Kase, in the 1970s but became an overnight sensation in 2008 during the Beijing Olympics when the tape was donated to 58 countries for use during the games. Since then it has been used widely to prevent and relieve sporting injuries and a variety of other conditions.

The theory behind kinesiotape is that it:

  • stimulates sensory pathways in the nervous system, increasing feedback to the brain
  • lifts the skin and reduces pressure on pain receptors
  • increases blood circulation to the taped area which may increase range of motion
  • reduces fear of movement, which is associated with increased pain levels, thus increasing range of motion
  • facilitates small immediate increases in muscle strength by pulling on the tissue of the muscle which may increase muscle contraction
  • gives proprioceptive information to the brain if a joint is being stretched beyond normal limits
  • may increase muscle activity

As Kinesio tape has only become popular in the last 5 years the research on its use and effectiveness is limited, mainly due to poor study designs. There has been some research (meta anaylsis by Williams et al. 2012) on the benefits of using kinesiotape in the following conditions:

  • decreased pain in acute whiplash disorders (Gonzalez-Iglesias et al. 2009)
  • improved range of motion in patients with a rotator cuff impingement (Thelen et al. 2008)
  • improved biomechanics in baseball players with rotator cuff impingement (Hsu et al. 2009)
  • in healthy individuals (with no injuries!) it has been shown to increase trunk flexion, extension and side flexion (Yoshida et al. 2007)
  • increase in strength of lower trapezius muscle (an important shoulder stabilizer) and decreased activation of upper trapezius muscle (a muscle overactive in shoulder conditions) (Hsu et al. 2009)
  • increased hand grip strength when tape is applied to wrist flexors (Lee et al. 2010)
  • increased quadriceps peak torque (strength) (Vithoulka et al. 2010)
  • increased VMO activation in patients with patellofemoral pain (Slupik et al. 2007)

Use of Kinesio Tape at Take Control

At Take Control Active Rehab we use kinesiotape for many conditions and particularly like using it around the neck, shoulder, lower back and hips. In saying that, we use it as an adjunct to our treatment to try and maintain the benefits gained from manual therapy. It is never used purely by itself to treat a condition.

We find that the tape is a lot more hypoallergenic compared to other types of tape that we have in the practice. Ask your physio if you would like more information on Kinesio Tape.


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