What can an Assessment do for you?

People aren’t always sure of what a physiotherapist does or whether they have a complaint that might be helped by a physiotherapist. Personally I treat mainly musculoskeletal problems (sports/spinal/arthritis…) but physio’s are involved in a number of areas. When someone comes in with a problem that I feel would be treated by a physiotherapist with a different speciality I send them to the appropriate person (Pat in our office has a focus on Occupational Health as one sub-speciality). Specialities include neurological conditions, women’s health, occupational health and a number of other areas.  When we do an assessment we try to focus in on what a person’s problems might be and whether one of our physio’s can help or not.  The assessment can clarify if there is a serious problem or if a person might be able to just get on with things themselves using just some information for guidance.

If you would like to have something looked at or discuss a particular problem I am offering a free 15 minute assessment for anyone able to come to my office. If you are interested please follow this link http://form.jotformeu.com/form/41794272933361 to book your free assessment.

Looking forward to seeing you and hopefully giving you a hand!

Ross

 

Clinic newsletter

I have a monthly newsletter that you can look at for relevant information and up to date offers. Take a peek, let me know your thoughts and please feel free to suggest topics about rehab or injuries that you would like to see discussed. Thanks

http://eepurl.com/YpEXD

Planning for Recovery

People often say to me ”I took a month off but when I returned to playing I got injured again”!  This is frustrating for many people but it occurs partly because people make the mistake of confusing ”this no longer hurting” with their body being completely healed and back to ”normal”.  There are a couple of things to consider that might help to make planning for recovery easier:

1)  Injuries often are healed fairly quickly but the tissue that has replaced/repaired has not been subjected to normal stresses and may well be locally stiffer, more sensitive and generally weaker than it originally was.

2)  Even when strength,sensitivity and mobility have returned to normal levels you will have lost the conditioning to the affected part of your body because you haven’t been able to train properly.  Even if you healed completely you still haven’t recovered your skills/co-ordination. You can often get by without much training before returning to competition if you aren’t hurt too badly or you are only doing things at a low activity level.  You do still run a higher risk of re-injury if you don’t do some prepatory training.

3)  Ok, you now have a healed injury and your co-ordination appears to be back to normal and you are ready to go!  Well almost.  The last consideration is that with a substantial lay off you also have the chance that you have lost some of the capacity you have built up over the years from participating in whatever activity you do. This isn’t a big factor if the injury has been recent and you have gone through a conditioning program before returning to what you do.  On the other hand, if you have had a long time off ( due to injury or just inactivity) your body has lost some of it’s built up ”toughness”. This means that you might find things get sore/injured again because you have less resilience.  Part of avoiding this would be to get back on a regular graded training program  before moving on to higher levels of participation or competition.  Adults who have played a sport for years and then stopped , say to have children, and then returned a decade later find that they seem to initially get injured relatively easily to what they expected.  This is partly due to the body naturally getting weaker/stiffer when not challenged to keep up optimum strength and flexibility.

To minimize problems each of these concerns need to be reviewed.  If you need help to check things find a health care practitioner to help you go through and see that strength, range and co-ordination are back to normal and comparable from side to side.  If you aren’t sure about your conditioning then either a health care practitioner or a personal trainer might help you check your fitness (strength and conditioning) levels.

So before rushing back onto the pitch, or even back to a hard labor intensive job, consider the things listed.  With a bit of planning and training you have a good chance of recovery with minimal problems.

Ross

 

 

 

YOU can be a body mechanic!

I’m going to sound like a broken record (if you are old enough to know what that is) as I’m sure this is something you have all heard but I am going to say it again.  You need to get involved in your own self management because when people don’t do anything they rust!

Not literally, but in effect we often suffer from the little bits of stiffness/weakness and incoordination that we pick up in our daily lives. Knee patients often have a poor walking pattern due to stiffness in their hips or ankles. Forefoot pain, such as metatarsalgia or Morton’s neuroma, develop after a person starts to walk with their foot in over-pronation to again reduce strain produced by tightness higher up the limb. Wrist pain may occur when there has been an elbow injury that has healed but the person has not fully recovered their strength and mobility forcing the wrist to work at an odd angle. We often seem to be too busy to take the time to stretch out tight tissues, reduce tension and recover strength when we have had an incident that has set us back.

Some cultures, such as in India or China, developed methods of dealing with this sort of problem and came up with yoga and tai chi. In the west we had a history of physical culture exercises and callisthenics that were once performed by a variety of people to keep themselves relatively fit and flexible. These days many of those practices have fallen out of favour although yoga, tai ch and more recently pilates have been taken up as attempts to keep ourselves going.

Whatever the method that suits you, I think it would be a good investment. Physically anything that keeps you moving and tries to maintain normal strength and flexibility will help to limit how easily you get injured from just being inactive. Financially you will save yourself all sorts of money being less likely to need treatment from any type of therapist or physician. Your body is no less in need of regular maintenance than your car and deserves , at the very least, regular attention to make sure it is functioning normally. I am sure there are lots of methods others could suggest and I would be happy to hear them. The most important thing is to start now and don’t wait until something breaks down and you end up needing treatment. One oil company has an advertising slogan that amounts to you can pay a little bit now (be active) or you can pay a lot later (to whatever type of practitioner). Not a bad concept to keep in mind.

Regards, Ross

Walking stick blues..

One of the things that make me a bit crazy are walking sticks. I see people using them incorrectly all the time and have to resist the temptation to run across the street and teach them how to do it properly. You wouldn’t have thought that something as simple as using a stick could be so complicated.

The first thing that I notice is that people never seem to have their sticks cut to the proper length. Some have them so short that they are leaning forward and bent over. The stick is supposed to take some of the effort out of walking and this won’t happen when you are in a semi-unbalanced state all of the time. Other people have the stick so high that their arm is held bent and they can’t actually take any amount of weight through the stick. You should be able to put some weight through the stick with a straight elbow while the stick is at your side, not too far forward or to far to the side.  You will find that having the stick tip around 5-10 centimetres (2-4 inches) in front and to the side will be about right.  The actual distances will vary somewhat depending on your own size and shape.  You need to be able to fully straighten your elbow when using the stick so that your arm muscles can work efficiently.

Measuring a walking stick.

(For a complete description of how to measure a walking stick go to stick measurement . This shop has a full description of how to measure a walking stick and a variety of different and interesting types of sticks that will show you just what is available.)

The stick also needs to be used correctly. You should not overload the stick and certainly not lean on top of it. It is commonly used to take weight off of one side of your body and should be held in the opposite hand. Using the stick in the opposite hand helps to lessen the load by allowing weight to be distributed between the two sides of the body or by lessening the work needed by the muscles on the affected side to hold you up. A good example is when a person has a sensitive hip the muscles in the hip area will compress the joint and make the joint more sensitive. If the stick is pushing your weight up from the other side the muscles don’t have to work so hard and there is less compression in the joint. If you have a sore knee or ankle the stick can be used to lessen the amount of weight that is being applied by shifting it to the opposite arm and leg.

When cutting or adjusting a stick you need to take into consideration whether there will be a rubber or metal ferrule (the rubber tip or possibly metal studs for using the stick on ice) that will be added on afterwards as this will make the stick longer again and this can also cause you to push inefficiently with your arm.

For some a stick will be a temporary assist to allow injuries to settle down, heal and get a rehabilitation program started. For others, a stick may be a necessity to allow a person to continue to function because of age, illness or permanent injury.

Remember that a stick is to assist and not to take all of your weight. If you lean too heavily you risk falling either because the stick breaks or because the tip might slip if it is not placed down flat.

What ever your reason for having a stick, it’s best to have it measured correctly and to use it properly.  I will be back soon with some information on ways to walk with a stick or crutches to help you get moving as quickly and safely as possible.

Ross

 

 

An easy treatment for arthritic pain in base of your thumb.

Many people get soreness at the base of their thumbs.  Sometimes it can hurt up the outside of your forearm or perhaps up the thumb itself.  It may start out as an ache that never quite goes away.  You might wake in the morning with some stiffness in the thumb that eases after a few minutes or up to an hour later.  As the day goes on it may behave and you might just get occasional twinges. In the evening the ache may be back again constantly.  Over time your thumb start to ache all of the time and the pain may not go away.  Eventually you may find the pain eases as your thumb becomes progressively stiffer…

This is a very truncated description of how wear and tear arthritis may behave.  In the beginning the joint has had a sprain due to being a bit worn and may swell up.  As the swelling goes away the joint is left a bit stiff. This leaves you susceptible to a re-injury and over time, if you do nothing, you can arrive at the result I just described.

Luckily, if you catch things early there is a chance you can minimise or even prevent this condition from becoming a problem. The basic exercise program is as follows:

  • 1. Use an elastic band or something similar to provide a slight resistance to the movements that need to be performed.
  • 2. Start out by just performing movements in simple planes and be gentle. The exercises are meant to be painless and should be carried out painlessly.
  • 3. The resistance needs to be below the two obvious joints , above the wrist but below the knuckle level.
  • 4. Use the elastic to provide a little resistance, do not try to stop your thumb moving. This is not supposed to be a battle.
  • 5. The thumb can move up and down vertically or in and out horizontally. You need to resist both directions. Repeat each movement 6-10 times, 2-4 times a day.
  • 6. Don’t forget to try not to overload the thumb while it is sensitive/stiff. If necessary you can wear a temporary support or use strapping to limit the movement of the joint so it does not take any weight in a position where it is sensitive.

I have used these exercises myself after spraining my thumb a number of times in sport and I have also given them to elderly patients who have had no difficulty performing them as instructed. Give it a try but be sure that you allow yourself a week or two before you decide if the exercises are helping or not. Your body often has had a long time to develop a problem even if you only recently noticed it. You need to give it time to recover if you want it to work more comfortably.

Ross

What to do when you have an acute attack of neck pain.

1.Some people find cold packs can reduce how sensitive the area is and allow the muscle to relax. Alternatively, you may use some heat on the neck and shoulder muscles to help them relax eg hot water bottle, hot pack or shower. Often it is easiest to apply something for 10 minutes every hour but you can leave things on your neck for 20-30 minutes as long as you let the neck return to normal temperature before repeating the treatment again. Be careful if you have sensitive skin not to get a either a heat or cold burn.

2.Lie down flat and REST as much as possible for the first 24-48 hours while the pain and stiffness is very bad. This too will allow the muscles to relax and so ease the pain.

3.A temporary collar may be needed for a short period of time. Usually for the first 24-48hours. This again will rest the neck muscles and allow them to relax.

If your neck isn’t feeling too sore you can try to regularly remove the collar and gently move your neck to try to prevent things stiffening up too much.

Here is an easy way to make a temporary collar.:

Take a pillow case, fold it in half length wise
Next fold that three times so you end up with a pillow case that is
one sixth normal width.
Wrap this folded pillowcase around your neck and then tape in place.
You can wear this while up or sleep with it on.

4.The type and number of pillows you use can have quite an effect on the amount of pain you will have. Usually it’s best to sleep with a lower pillow but you may need to start with a couple and work your way down to a thin pillow over a day or two Some pillows, particularly foam ones, will compress and flatten while you are sleeping. . If you end up with your head tilted all night it can really irritate things. Which ever type of pillow you have, you can modify the pillow to make sleeping easier:

Take a towel and fold it to make a 2-4 cm pad.

Stick this in your pillow case under the pillow and it will stop your head from tilting over into a painful position while you sleep.

You can also take a small towel and roll it up and put this in the leading edge of the pillowcase to support the curve of your neck.

5.If you can’t tolerate something around your neck then an alternative it to use a sandbag. You can put a sandbag (or equivalent) beside your head when you are lying on your back so that you can’t turn your head in the most painful direction.

6.When you lie down the weight of your legs will pull on your spine whether on your back or on your side. You can sleep with 1-2 pillows between/under your knees to stop your spine being pulled sideways while you sleep.

7.All of these measures can be useful during the initial attack of neck pain and may get you to the point where you can progress further with self treatment or to the point where you can tolerate being treated by a professional. After numerous years of contact sports (including wrestling/rugby/judo) as well as numerous car accidents (I was driven into 5 times in the first 5 years here in the UK!) I can tell you from personal experience that these methods can be effective.  I know that there are many approaches to dealing with neck pain and I am sure that some of what I have said will be a bit controversial.  Tell me your thoughts or suggestions. I am always happy to hear of ways to improve what I have to offer my patients.

I hope this information is helpful for you.

Regards,

Ross