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Category: pain management

Physio FusionNewspain management
By Physio Team Appointments & Fees, Exercises, falls, Home exercises, Lockdown, lockdown wellbeing, older adult, pain, pain management, rehabilitation , , , , , , , , , , , ,

MANAGING FALLS IN OLDER ADULTS

Having a fall is dangerous at any age, however, they become more frequent and may most probably result in injury in adults 55 years and over. It is also estimated that in Aotearoa, approximately a third of older adults over the age of 65 sustain a fall every year. This leads to harmful consequences for them, especially for those who live alone. Alongside, sustaining serious injuries, you may face loss of independence, mobility and confidence. But!!! The good news is that there are a number of ways that you can reduce your risk of falling.

 

So Why Do Older Adults Have Falls?

  • Poor lower limb strength
  • Cognitive and functional impairment
  • Nutritional deficiencies
  • Prior and/or ongoing history of falls
  • Vision deficits
  • Balance or gait disorders
  • Medication related- especially when using anti-depressants, sedatives, anti-arrhythmics, anti-hypertensives, diuretics, and anti-convulsants
  • Hazards around your home environment such as loose carpets, slippery surfaces, poor lighting, lack of safety equipment particularly in the bathroom/toilet
  • Medical conditions such as vertigo, dizziness, diabetes, postural hypotension, drop attacks, and fainting spells

 

The Vicious Falls Cycle

Older adults who have had a fall may limit what they do because of their loss of self-confidence and fear of falling. Whilst this may seem like the most sensible thing for them to do, it increases their risk of falls. This is because, this leads to a further reduction in muscle strength, coordination and balance. Hence, it is healthier for older adults to keep up with their activities they enjoy as safely as they can, work on improving their muscle strength, coordination and balance, and manage their blood sugar levels, blood pressure, and weight under the guidance of their doctor.

 

 

Falls prevention tips

 

Below are some measures you may take to prevent yourself from falling:

Exercise regularly: A number of benefits include better sleep, improved muscle strength, balance and flexibility, increased energy levels, stronger bones, better management of weight, blood sugars and blood pressure. Exercise programs tailored especially for muscle strength and balance have resulted in a reduction in the number of falls and injuries resulting from falls by approximately 30% and 50%. It is advised that you speak to your doctor or physiotherapist before initiating or progressing your exercise levels.

Keeping your vision in check: Vision deficits makes getting around safely a lot harder. Therefore, you should get your eyes checked yearly and wear your contact lenses or glasses with the correct prescription strength.

Being aware of the effects of your medication: As they may have certain side effects that increase your risk of falls. You should review your medications with your doctor for side effects like drowsiness or dizziness.

Reduce hazards at home: Most falls typically take place at home. So be sure to make your home safer by removing tripping hazards, having adequate lighting, and adding in handrails in hallways and bathrooms/toilets.

Other tips:

  • Taking your time to get up and when moving around- no rushing!
  • Having a personal medical alarm (please talk to your doctor about how to get one)
  • Using a night light when you get up at night
  • Wearing appropriate, supportive and well-fitted shoes
  • Not using an easily moveable object to stabilise yourself
  • Using the support of handrails in bathrooms and hallways
  • Avoiding or being very careful on wet or slippery floors
  • Appropriately using your walking aids

 

If You Have Had a Fall

If you sustain a fall, it is vital for you to stay calm.

If you think you are able to get up safely, try to bend your knees, roll to your side, and attempt to get into a 4-point kneeling position. If there is a chair near by or if you are able to crawl towards one, you can use it as support to get yourself up. Please take your time and rest as needed.

If you are unable to get up safely, attempt to crawl or roll towards a phone. You may call out to other members in your household or your neighbour. If you’re at risk of falls, please do consider the use of a personal medical alarm to call out for help when you have a fall.

After a fall, please contact your doctor as soon as you can for an assessment of potential injuries sustained, muscle strength and balance to help prevent future falls. You may be directed to community or in-home sessions to enhance your balance and strength. Please discuss this with your doctors.

By Physio Team acute pain, Appointments & Fees, chronic pain, Home exercises, Injury, Lockdown, lockdown wellbeing, online consultations, osteoarthritis, pain management, physical health, Physio, RA, rehabilitation, Rheumatoid arthritis, Rheumatoid arthritis (RA), Therapy , , , , , , , , , , , , , , , , , ,

Dealing with Rheumatoid Arthritis

Rheumatoid arthritis (RA), a chronic inflammatory condition associated with swelling, pain, fatigue, and joint deformity. Although there are no known cures for this condition at present, a combination of treatments are available to help manage your symptoms. RA is the 2nd most common form of arthritis after osteoarthritis and is known to affect 1–2% of New Zealand’s population.

 

 

Signs and Symptoms

RA may develop very quickly or gradually over time, with its signs and symptoms, as well as the severity varying from one person to another. This condition is associated with episodes of remission and flare ups, with or without apparent triggers.

Other symptoms may include

 

  • Swollen, tender joints- (often accompanied by warmth and redness)
  • Joint pain
  • Joint stiffness which worsens in the mornings and after a period of inactivity
  • Fever, loss of appetite weakness, and fatigue
  • Muscle pain
  • Changes to the skin and nails

In the early stages of RA, you may notice its impact on your smaller joints- especially in your toes and fingers. And as this condition develops, your symptoms typically branch out to the bigger joints- your shoulders, ankles, knees, wrists, hips and elbows. Symptoms are likely to affect your joints bilaterally. Over time, RA also causes joints to deform and shift out of place.

Because RA is a systemic condition, it is estimated that approximately 40% of the RA population may experience symptoms and signs other body systems than the joints. These may include:

  • Kidneys, lungs, heart
  • Skin, eyes, mouth
  • Bone marrow
  • Nerves and blood vessels

 

 

Causes and Risk Factors

Your immune system is designed to help protect your body from infection and disease. However, in RA, changes occur in your immune system that (for poorly understood reasons), causes it to mistakenly attack the healthy soft-tissues of joints resulting in pain, swelling and inflammation. Because of this ongoing process, over time damages to the lining of your joints and other soft-tissues may lead to bone erosion and joint deformity. It can also have an impact on your heart, lungs, nerves, eyes and skin.

One can get RA at any age, although it is more probable to develop in those in the age bracket of 25-50 years old. Though rare, under 16s may also develop Juvenile RA or Still’s disease.

Risk factors for the development of RA include:

  • Family history of RA
  • Age bracket of 25-50 years old
  • Smoking
  • Women are more likely to develop RA than men
  • Obesity

 

 

 

Diagnosis

 

At present there is no single test to confirm a clinical RA diagnosis. It is often difficult to differentiate this condition in its initial stages from other forms of connective tissue inflammation (fibromyalgia, lupus, gout etc.).

Your doctor will get your full medical history (as well as any familial history of RA), discuss your signs and symptoms, undertake a physical assessment- particularly of your joints, and refer you on for imaging and blood tests. X-rays may help evaluate RA progression in your joints over time, whilst MRI and ultrasound imaging may help evaluate the severity of RA in your body. The blood test will evaluate your level of anti-bodies and proteins (including the rheumatoid factor protein that is present in approximately eighty percent of the RA population), and markers of inflammation.

 

 

Management

At present, though there is no cure for RA, a range of treatments are available which may help slow its’ progression and reduce pain and inflammation, minimise and/or prevent joint damage and maximise joint movement.

A combination of prescribed medication as advised by your doctor and other treatment options as noted below are recommended:

  • Cease smoking if you are smoker
  • Physiotherapy will help improve and maintain your joint range of motion, increase your muscle strength, and decrease your pain. Additionally, your physiotherapist or occupational therapist will be able to teach you ways of using your body efficiently to reduce stress on your joints
  • Finding a balance between rest and activity
  • Use of heat and cold packs to help ease pain and inflammation
  • The use of splints or braces for joint support as needed
  • Hydrotherapy- exercising in water reduces the pressure on your joints, whilst the warmth of the water will relax your muscles and help lessen your pain.
  • Seeking regular medical advice and check-ups to monitor your RA symptoms and the progression of the condition
  • Adopting a healthy and active lifestyle
By Physio Team hand and wrist pain, Home exercises, Injury, online consultations, pain, pain management, physical health, Physio, rehabilitation, Sprain, tendon, Therapy , , , , , , , , , , , ,

Dealing with De Quervain’s

De Quervain’s tenosynovitis is categorised as an overuse disorder which affects the tendons in your wrist that you use to straighten your thumb. It is associated with swelling in the two tendons around the base of your thumb, which then causes the sheaths encompassing these tendons to become inflamed. This results in increased pressure on surrounding nerves as well, resulting in symptoms such as numbness, tenderness and pain. You are likely to have these symptoms when making a fist, gripping or grasping something, pinching, twisting your wrist, and/or laterally bending your thumb.

Symptoms

The key distinguishing symptom of De Quervain’s tenosynovitis is tenderness and/or pain at the base of your thumb. You can experience pain referring up or down your forearm. You may notice the pain gradually develop or appear suddenly, and worsen when using your wrist, thumb and hand. Painful movements include making a fist, gripping or grasping something, twisting your wrist, pinching, and/or laterally bending your thumb.

Other key symptoms include:

  • Swelling at the base of your thumb
  • Experience numbness along the back of your index finger and thumb
  • ‘Snapping’ or ‘catching’ sensation experienced when you move your thumb

Causes

De Quervain’s tenosynovitis is typically associated with the chronic overuse of your thumb, hand and wrist. When undertaking movements like gripping, grasping, clenching, pinching, or wringing items in your hand, the two tendons in your lower thumb and wrist usually glide in a smooth manner via the small tunnel which attaches them to the base of your thumb. However, when you repeat a certain movement day in day out, it irritates the sheath around these two tendons, resulting in swelling and thickening which restrict their movements.

Factors which may increase your risk of developing this condition are:

  • Being in the age bracket of 30 to 50 years old
  • Pregnancy
  • Found more commonly in women.
  • Baby care: Lifting, carrying and/or holding your child repetitively with using your thumbs as leverage.
  • Hobbies or occupations which involve repetitive wrist and hand movements

Diagnosis

Your doctor or physiotherapist will discuss your medical and occupational history, and carry out a physical assessment of your wrist and hand.

The physical examination will include palpation for pain when pressure is applied to the thumb side of the wrist, as well as clinical test called the Finkelstein test. This test requires you to bend your thumb across the palm of your hand and bend your fingers down over your thumb. You will then bend your wrist towards your little finger. If this causes pain on the thumb side of your wrist, you are likely to have this condition.

Whilst X-rays are usually not needed for the diagnosis, however, you may be referred on for ultrasound imaging.

Management

The aim of the management for this condition is to reduce pain caused by the irritation and inflammation of the tendons, preserve movement in the wrist and thumb, and prevent its reoccurrence. If treatment is commenced early, the symptoms should subside in 4-6 weeks. If your symptoms arise during pregnancy, they may settle around the end of the pregnancy or post the breast-feeding stage.

  • Splints may be utilised to immobilise and rest your wrist and thumb
  • Ice application to the affected area
  • Your doctor may recommend the use of anti-inflammatory medication to ease swelling and decrease pain
  • Avoiding pinching with your thumb when moving your wrist from side to side
  • Avoidance of aggravating repetitive movements and activities
  • Administration of corticosteroid injection into the tendon sheath can ease pain and decrease swelling if recommended by your GP
  • Physiotherapy: Your physiotherapist will examine how you use your wrist and provide suggestions on how to make technique modifications to relieve stress on your wrists. They will teach you strengthening exercises for your wrist, hand and arm to help decrease pain and limit tendon irritation
  • Surgery may be recommended by your specialist in more severe cases and if conservative management fails
By Physio Team Appointments & Fees, body parts, chronic pain, Exercises, good posture, Home exercises, Injury, Lockdown, muscles, OA, online consultations, osteoarthritis, pain, pain management, physical health, Physio, rehabilitation , , , , , , , , , , ,

Managing Your Osteoarthritis

Osteoarthritis impacts millions of people worldwide and is typically known as the most common form of arthritis. It is associated with the wear and tear of the protective cartilage which cushions the ends of your bones in your joints over time. Though this condition may cause damage to any joint in the body, osteoarthritis primarily impacts the joints in your spine, hands, hips, and knees.

 

Causes and Risk factors

Over time, the gradual deterioration of the cartilage which cushions the ends of your bones in your joints causes arthritis. Cartilage is a solid slippery tissue which allows almost frictionless joint movement. As the cartilage wears down, bone will eventually rub on bone.

This condition is typically characterized as a wear and tear degenerative disorder. However, in addition to the breakdown of the cartilage, it also impacts the joint as a whole. Osteoarthritis triggers alterations in the bone and damages connective tissue which holds the joint together and attaches your muscles to your bones. Inflammation of the lining of the joint is also triggered.

Factors which may put you at higher risk of developing osteoarthritis include but are not limited to:

  • Your age- the risk increases with getting older
  • Gender- though unclear why, but women are more perceptible to developing osteoarthritis
  • Bony deformities- those with abnormal joints or defective cartilage
  • Sustaining bony or joint injuries like those which take place during sport or from an accident.
  • The risk increases with obesity- the more you weigh, the greater your risk, as it adds more stress to your weight-bearing joints (particularly hips and knees)
  • Your occupation or a sport that you play which puts repetitive and excessive stress/loading on the joints, can eventually lead to the development of osteoarthritis.
  • Certain co-morbidities such as diabetes

 

Common symptoms

Below are some common examples of symptoms you may experience with arthritis. These may develop and worsen gradually over time

  • Pain: Your joints may hurt before and/or after undertaking an activity
  • Loss of joint range of motion– loss of overall joint flexibility and movement
  • Tenderness felt on applying light pressure to the joint
  • Joint stiffness that is most noticeable on waking up first thing in the morning or after a prolonged period of inactivity
  • Noticeable changes in joint pain with changes in the weather- particularly colder weathers
  • Sensations of grating and grinding// sounds of clicking and popping (crepitus) when you use the joint
  • You may notice swelling and redness around the joint, which may be triggered by soft tissue inflammation
  • Bony spurs that feel like hard bumps may develop around the impacted joint

 

How will I be diagnosed?

Osteoarthritis is typically diagnosed based on your medical and occupation history and a physical examination undertaken by your doctor. During the physical examination, your doctor will assess your affected joint(s) for swelling, tenderness, redness, and stiffness. X-rays may be recommended to reveal cartilage loss (the narrowing of the space between the bones of your joints), changes in bone, and bony spurs around the joint. Blood tests may be used to rule out other causes of joint pains like rheumatoid arthritis. Joint fluid analyses may also be used to test for inflammation to ascertain if the pain is triggered by an infection or gout instead of osteoarthritis.

 

Management

Though there isn’t a cure for osteoarthritis, various treatments which can help relieve symptoms of pain and disability are available.

Lifestyle modifications: Changes to your daily life may protect your joints and slow the progression of osteoarthritis.  Minimising activities which exacerbate your symptoms such as climbing stairs, squatting. Swapping high-impact activities like running and jogging to lower-impact activities such as cycling or hydrotherapy will decrease the stress on your joints. Weight-loss reduces the stress and loading on your joints, which then results in less pain with increased function.

Assistive aids: Using assistive aids like a stick/cane, wearing proper shoes w orthotics and supportive braces/sleeves may improve your stability and support your functional capabilities.

Physiotherapy: Targeted exercises may help improve your flexibility as well as build strength in your muscles. Your physiotherapist will develop a personalised active rehabilitation program which is safe and will meet your requirements and lifestyles.

Medications: Various kinds of medication (such as paracetamol and NSAIDs) maybe helpful in treating and controlling the symptoms of osteoarthritis. As everyone responds differently to medications, your doctor will prescribe medicines (type and dosage), which is safe and will work best for you.

Cortisones: Strong anti-inflammatory agents which is injected into the affected joint to give pain relieve and decrease inflammation for a short period of time. Due to potential side-effects, it may be recommended to restrict the number of injections to 2-3 per year.

Other: Heat and ice applications, self-massaging with pain-relieving creams/ointments and/or wearing elastic supports may provide some relief from your pain and give you support.

Surgery: Surgery may be recommended if there is considerable degeneration in your joints and/or if your osteoarthritic pain causes disability that is not relieved with conservative management. Your doctor or specialist will discuss your options with you.

By Physio Team acute pain, body parts, bones, chronic pain, ergonomics, Exercises, good posture, hand and wrist pain, Injury, ligaments, muscles, pain, pain management, physical health, Physio, post-op, rehabilitation, repetitive stress injury, Sprain, surgery, tendon , , , , , , , , , , , ,

Carpal Tunnel Syndrome – What is it?

Have you been experiencing pain, pins and needles or numbness in your wrist and hands, especially after using the keyboard, chopping up a few veges, reading a book, using your mobile phone or with driving?

If you answered yes – then you are most likely to have Carpal tunnel syndrome.

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is the most common condition in the arm. It is caused by compression of one of the three major nerves in the forearm – the median nerve, which travels through the wrist into the hand and fingers. Entrapment of the median nerve usually due to inflammation, occurs in the wrist commonly resulting in tingling of the wrist and hand (in some cases forearm), numbness, pain and weakness of the hand.

Signs and Symptoms

Often unrelated to a specific incident or an injury, symptoms of carpal tunnel syndrome usually develop gradually overtime. Symptoms may be worse in the morning and night. Many people find that the frequency and duration of symptoms increase as the conditions worsen.

Signs and symptoms may include:

  • Tingling, numbness or burning sensation of the thumb, index, middle and ¾ of ring fingers of the hand
  • Electric shock like radiating pain through the hand into thumb, index, middle and ¾ of ring finger
  • Weakened grip, loss of dexterity and fine movements such as picking up a hair pin, buttoning clothes.
  • Hypersensitivity or in other cases lessened sensation of hand to pressure, heat or cold temperatures
  • Swollen wrist

Let’s take a closer look at the anatomy!

As its name suggests – a group of small bones aka carpal bones form a tunnel like passageway in the wrist (palmar view). This unique architectural design allows for the tendons of the forearm muscles and the all-important median nerve to pass through the narrow tunnel through the wrist and into the hand and fingers, supplying sensation and motor function.

Causes

Common causes and risk factors that increase the likelihood of carpal tunnel syndrome include:

  • Repetitive wrist & hands movements – during work related tasks or leisure activities may irritate the tendons in the wrist, resulting in inflammation that irritates the nerve.
  • Wrist or hand injury – recurring sprains, swelling and reduced wrist movements reduces the space in the carpal tunnel
  • Pregnancy and menopause – hormonal changes can increase fluid retention in body increasing pressure in the carpal tunnel compressing the median nerve
  • Genetic history – petite
  • Medical conditions (rheumatoid arthritis, diabetes, hyperthyroidism)

Interesting facts about carpal tunnel syndrome

  • Women are 3 times more susceptible to develop carpal tunnel syndrome than men. This can be due to hormonal changes during pregnancy or menopause and also because women tend to have smaller carpal tunnels.
  • Not all fingers are affected. Median nerve supplies movement and sensation in the thumb, all fingers except the little finger.
  • Computers/keyboard are not the only reasons to blame – repetitive nature of any work related or leisure word increases risk of developing carpal tunnel syndrome

Diagnosis

Carpal tunnel syndrome is fairly easily diagnosed by your physiotherapy, doctor or a hand therapist.

Your health practitioner will gather information on your general health, history and nature of your symptoms. They will then carefully conduct a thorough clinical assessment to assess the movements of your hand and wrist, strength and use a collection of tests in effort diagnose your symptoms. In some cases, your therapist may examine your neck, shoulders and arms to rule out other potential causes.

You may often hear the physiotherapist or hand therapist mention that they want to conduct a functional assessment – A functional assessment is activity specific, where the therapist will watch you perform the activity that aggravates your symptoms the fastest. For example, if using a keyboard is generally when you feel your symptoms start – the therapist may observe you performing the very task to examine your overall posture.

Referral to scans or nerve conduction tests may be arranged by your doctor or therapist depending on the severity or complexity of your symptoms.

Scans

Referral to scans or nerve conduction tests may be arranged by your doctor or therapist depending on the severity or complexity of your symptoms.

  • Xray – provides key information on bone health, when dealing with a potential injury, or arthritis
  • Ultrasound – can examine potential soft tissue injury or inflammation compressing the median nerve
  • MRI – this advanced imaging provides in depth review of your wrist and hand. Usually arranged by your doctor or a specialist
  • Nerve conduction study – studies the electrical activity of the median nerve. This test will help you doctor examine the severity of your problem.

Treatment

In most cases, carpal tunnel syndrome will progressively worsen overtime. So, the key is early intervention!

Conservative management

Mild symptoms can be easily managed with a conservative approach.

  • Wearing splints or braces – keeps your wrist straight to prevent repetitive use of hands, thus reducing pressure or inflammation in the carpal tunnel.
  • Non-steroidal anti-inflammatory medications – such as celecoxib and ibuprofen as prescribed by your doctor may decompress the median nerve by reducing the inflammation in your body and wrist.
  • Activity modification: your physiotherapist will play an important role in providing you with advice around to modifying your activities to reduce your symptoms. They will also prescribe you with effective stretches and exercises to help manage your symptoms while safely aiding your recovery.
  • Steroid injections: your physiotherapist or doctor may recommend a ‘cortisone’, also known as a ‘corticosteroid’ injection to control your symptoms. It contains an anti-inflammatory substance that is injected into your carpal tunnel. The effects of the steroid injection may be temporary and can vary person to person depending on many factors (cause of symptoms, stage of your condition).

In mild to moderate cases, the effects of injection may last between 3-6months.

Surgical intervention

If non-surgical approaches have failed to relieve your symptoms, surgery may be required.

By this stage you would have consulted an orthopaedic surgeon. Your surgeon will thoroughly examine your overall health, symptoms, results from the scans and the nerve conduction study to help you decide on the best treatment approach.

If you decide to undergo surgery – the surgical procedure your surgeon will perform is called ‘carpal tunnel release’.

Recovery and outcomes

  • After your surgery you may be given a splint or a brace for a period of time specified by your surgeon. While in the splint or brace you will be encouraged to move your fingers to prevent stiffness and swelling.
  • Expect to experience minor pain, stiffness and swelling for a couple of weeks to months after your surgery. Pain medications provided by your surgeon must be taken as prescribed.
  • You may be encouraged to see your physiotherapist, who will work closely with your surgeon to help meet post-operative outcomes.
  • You will have regular 6-8 weekly follow ups with your surgeon as required to assess your healing and discuss gradual return to light activities and return to work.
  • If you have underlying medical conditions such as arthritis, except that your recovery may be slower than otherwise expected. It is important that you follow post-operative protocols your surgeon, doctor and physiotherapist recommend.
By Physio Team acute pain, Appointments & Fees, chronic pain, Exercises, Home exercises, Injury, online consultations, pain, pain management, Physio, rehabilitation, Sporting, Sprain, Studies, Therapy , , , , , , , , , , , , ,

We Want You To Understand Your Pain

What is pain?

Pain is the brain giving out a message to protect you . It is part of our bodies natural defense system.

When an event occurs that we need protecting from, our brains response is to increase our pain. Living things detect and respond to stimulus. | Characteristics of living things, Natural hairstyles for kids, Characteristics

Example: Putting a hand on a hot pan. You feel pain, which is the brain giving you a warning signal to move your hand away.

Pain is all about protection, never about measuring the condition of the tissues in the body.

In this instance we experience a high level of pain to prevent a bigger injury eg. causing a burn.

This is our bodies way of protecting us

So what is happening in our brain?

  • We as human beings are amazingly adaptable. The longer we have pain, the longer our brains learn to produce pain.

  • It hurts in the tissues (back, knee, hand), but the problem is in the nervous system. There is an adaptation within our nervous system.

Long term pain or Chronic pain

Chronic pain is defined as persistent or recurrent pain lasting longer than 3 months

If you have had pain for more than 3 months, your system is now overprotective. Your nervous system and immune systems have learnt.

 

Movement is medicine: why exercise therapy reduces chronic pain - Hinge Health

 

  • With chronic pain the buffer size is increased- therefore pain comes on quicker than before.

  • You get pain when you are not anywhere near being in danger.

Management of chronic pain:

  • Identify why your brain is protecting you – fear, anxiety, quality of movement, posture, injury

  • Reduce the size of your buffer – desensitization, reassurance, progressive load management

  • Understand your pain- know that it may not go completely, but can become more manageable

Medication:

  • Depending on the type of pain you are experiencing, painkillers/NSAID’s may be beneficial in the short term – speak to your GP/pharmacist

  • Note: the research does not show good outcomes for the long-term use of medication to treat chronic pain.

Occupational Therapy:

  • If you have been off work because of your pain – try to return to work asap. An OT can discuss and plan a gradual return to work plan for you

  • They can also assist by providing aids to helps with daily tasks such as getting out of bed, or putting on shoes.

Physiotherapy:

  • There is no quick fix for persistent pain. We can help guide you along your journey to recovery

  • With persistence and hard work you can learn to adapt and cope with your pain

  • Movement is king – it is critical for retraining the system

  • Movement gradually suppresses the pain system.

  • Finding any form of exercise or movement that you enjoy and gradually increasing the volume over time

  • Moving regularly- on your good days and your bad days

Self Help:

  • Meditation or mindfulness – Apps such as Headspace or Calm are easy to use and will guide you through the process

  • The Pain ToolKit

By Physio Team acute pain, Appointments & Fees, back pain, bones, chronic pain, ergonomics, Exercises, good posture, Home exercises, Injury, Lockdown, muscles, neck pain, online consultations, pain, pain management, Physio, posture, rehabilitation, sitting posture, Sprain, Studies, Therapy, WFH, Working from home , , , , , , , , , , , , , , , ,

Do You Have a Healthy Work Station Set Up?

An ergonomically correct workstation has all the best practices to help maintain a healthy posture and improve your health and productivity.

Here are a few helpful tips;

1. Set up your screen

Adjust the monitor height so that the top of the screen is at—or slightly below—eye level. Your eyes should look slightly downward when viewing the middle of the screen. Position the monitor at least 20 inches (51 cm) from your eyes—about an arm’s length distance. If you have a larger screen, add more viewing distance.

2. Set up your chair

  • Height – You should be able to sit with your feet flat on the floor and your thighs roughly parallel to the floor. If you require a taller chair in order to reach the floor you can use a foot rest to ensure you achieve the right angle.

  • Backrest Recline and Tilt – Research has shown that a reclined seat (at least 135 degrees back)  significantly reduces the pressure on your back, and is particularity beneficial for people with back

  • Lumbar support – the shape of the backrest should have a natural curve to support your lower back.

  • Arm rests – Look for armrests that are not just height adjustable and support the entire length of the forearms.

3. Adjust your Desk Height

  • Your legs should fit comfortably under the desk if you are sitting with your feet flat on the floor: you should have enough space to cross your legs.

  • The angle between your forearm and upper arm should be between 90 degrees and 110 degrees while your arms are at rest on the desk.

  • Make your desk organized using storage accessories i.e. Document holders

  • Use an ergonomic mouse pad; to keep your wrists supported.

4. Organizing your Desk space

Organize all the items on the workstation according to their priorities and assign them to the proper ergonomic reach zones.

  • Primary Zone: High use items, easiest access

  • Secondary Zone :Medium use items, comfortable reach

  • Third Zone: Low use items, reduction in efficiency

:sparkles: MOVEMENT IS KEY :sparkles:

Its a simple action step, but mighty! Get up out of your chair and take frequent posture breaks!

When we sit in one position for hours without moving, our performance slowly starts to deteriorate, our body slows down, static loading takes over our muscles and we actually get fatigued even when we aren’t putting in any physical effort. However, when you consciously integrate these microbreaks into your day, you’re giving your body a much-needed refresher and an opportunity to wake up your muscles and replenish blood flow. Research has shown that movement can also help with creativity, or get you ‘unstuck’ so you can approach your work with a different or fresh perspective and energy.

If you think your desk set up could be better, or want us to have a quick look we can do this via a video call. Book in for an appointment www.physiofusion.co.nz or give us a call on (09) 626 6186

By Physio Team acute pain, Appointments & Fees, chronic pain, Exercises, good posture, Home exercises, Injury, Lockdown, muscles, neck pain, online consultations, pain, pain management, Physio, posture, rehabilitation, Studies, Therapy , , , , , , , , , , , ,

Do you experience Cervicogenic Headaches?

What on Earth is a cervicogenic headache??

Headaches happen for lots of reason and can be cause by several sources- both primary and secondary. Once major “red flags” are ruled out, understanding the type of headache is important in order to have it properly addressed.

A cervicogenic headache is a secondary headache arising from a musculoskeletal dysfunction within the cervical spine, and is a disorder that many physiotherapists treat. The main players that are typically involved in generating the pain are the joints, discs, ligaments, nerves and/or muscles found in the upper portion of the neck.

Characteristics of a Cervicogenic Headache:

:sparkles: Pain usually one sided or one side dominant

:sparkles: Pain originates from the back of the neck and radiates along the forehead, orbits around the eye, temple area and ear.

:sparkles: Steady ache or dull, diffuse pain that travels into shoulder region

:sparkles: Limited neck movement especially when turning head

:sparkles: Tenderness to touch at the muscles at the base of the head.

Here are some exercises that would help alleviate your pain:

  1. Cervical side flexion with chin tuck

  • Sit upright in a chair.
    With your shoulders relaxed, relax one arm to your side.
    Drop your opposite ear to your shoulder until a stretch is felt.
    Using your fingers, tuck your chin in, as to resemble a double chin.
    Gently release pressure with your fingers and hold this position.
    Relax and repeat

2. Levator stretch Neck stretch – levator scapula

  • Start in a seated position.
    Place the hand of the side you want to stretch down by your side.
    Tilt your head forwards and to the opposite side at an angle, as if you are trying to
    look at your armpit.
    Keeping your back straight and upright, continue to tilt your head down until you
    feel a stretch from the base of your skull down into your shoulder blade.

3. Neck stretching (Upper trapezius)

 

  • Stand up straight.
    Take the hand on the symptomatic side and place it behind your back.
    Take your other hand and place it on your head.
    Tilt your ear directly down towards your shoulder and hold this position.
    You should feel a stretch down the side of your neck.

If you believe you experience Cervicogenic Headaches get in touch with us https://physiofusion.co.nz/ for an in-depth assessment and lets knock out those headaches and decrease you dependence on pain meds

By Physio Team Appointments & Fees, bones, Exercises, good posture, Home exercises, Injury, Lockdown, online consultations, pain, pain management, Physio, Pilates & Exercise Classes, posture, rehabilitation, rotator cuff, shoulder, shoulder pain, Sprain, Therapy , , , , , , , , , , , , , , , , , ,

What is your Rotator Cuff and What does it do?

 

You may have seen videos or posts online about people talking about a specific area of your shoulder known commonly as the “Rotator Cuff” and wondered what they were on about. Your shoulders do a lot of important things you might take for granted! They help you get something off a high shelf, comb your hair, or play a game of cricket.

It’s a complicated process that your body makes look easy. And your rotator cuff is a big part of that. It protects and stabilizes your shoulder joint and lets you move your arms over your head. It’s importance is widely used in sports like swimming, tennis and netball.

In New Zealand healthcare, shoulder injuries have one of the highest prevalence when it comes to ACC claims and overall cost. Within this, rotator cuff injuries are among the most common pathologies affecting New Zealanders. Other pathologies include acromioclavicular injuries, dislocations, osteoarthritis and frozen shoulder.

 

So, what exactly is the cuff and how does it influence the shoulder?

  • The rotator cuff (RC) is a combination of four muscles that run through and attach onto specific areas of the humeral head (top of the arm bone).

  • Supraspinatus, Infraspinatus, Teres minor and Subscapularis are the four muscles comprising the RC and each one plays an important role however they all contribute to shoulder stability:

Supraspinatus

Infraspinatus

Teres Minor

Subscapularis

A thin triangular muscle that helps perform abduction

A thicker, triangular muscle that performs external rotation.

The smallest muscle of the cuff, helps with rotation as well

The largest muscle of the cuff performs internal rotation (arm behind your back!)

 

 

Many people suffer from shoulder pain, so here are the most common injuries that can happen at the rotator cuff:

Rotator Cuff Tear:

A rotator cuff tear is often the result of high levels of load over a short amount of time or a high impact force stressing one or more of the tendons/muscles. Fortunately, majority of tears are partial. Tears are more common in people with jobs that involve heavy loading or lifting or in high impact sports like rugby. It also can happen suddenly if you fall on your arm or try to lift something heavy. Common and easily treatable with conservative management by a physiotherapist, a rotator cuff tear can come right.

Rotator Cuff Tendinopathy:

A rotator cuff tendinopathy is the most common shoulder pain complaint/injury resulting in inflammation and irritation of one or more of the cuff tendons. This pathology is more common in individuals who have an occupation where repetitive use of the shoulder, particularly in an overhead position such as carpenters or painters, or individuals that play highly repetitive, throwing sports like tennis, baseball or volleyball. Once again, this injury is treatable by a physiotherapist, conservative management can be very effective in treating these injuries with a thorough, well planned exercise program to help get patients back to doing what they love.

Majority of people experience pain around the shoulder joint, with some movements being highly provocative. Tenderness on touch at the affected site is also common – this helps your physiotherapist hone in on potentially which tendon is causing those problems!

 

Medical management vs Physio management

 

Medical management will be advised by your local GP if you decide to see them first. They might prescribe NSAIDs (anti-inflammatory medications such as ibuprofen) to help with the pain you’re experiencing and recommend you see a physiotherapist. Depending on your injury as well as your ability to function, surgery may be an option if conservative medical and physio treatments don’t help. Most people get by without the need of surgery but some tears can be too large to heal without the use of surgical intervention.

Physiotherapy management is designed around reducing pain and disability, restoring range of motion and helping people return to work or sports to perform how they were prior to the injury. In the early stages of these injuries, rest and ice and/or heat are recommended to allow the inflammation to settle – then your physiotherapist will begin to introduce a detailed exercise program, this may include:

  • Isometric (static hold) exercises
  • Resisted movements using bands
  • Range of motion exercises to restore lost movement
  • Functional loading – task specific or sport specific

If this is successful, the last step is to build back up the strength that was lost over time – this is done by concentrically (against gravity) loading the affected tendons/muscles in a way that they adapt and lay down more tissue, grow and becoming stronger in hopes that you get to return to what you enjoy!

 

 

By Physio Team Appointments & Fees, back pain, body parts, ergonomics, Exercises, good posture, Home exercises, Injury, lifting, Lockdown, muscles, online consultations, pain, pain management, physical health, Physio, posture, rehabilitation, Sprain , , , , , , , , , , , , , , , , , , , , , ,

Lifting Mechanics

IS IT DANGEROUS TO LIFT WITH A BENT BACK?

One common belief about lifting is that rounding your back when lifting an object is considered dangerous while lifting with a straight back is considered safe…

 

 

However, there is a lot of misinformation circulating around lifting mechanics and what is deemed “good technique” versus “bad technique.”

Here are some key myths and misinformation that you may have heard:

 

A ROUNDED BACK WHILE LIFTING OVER STRESSES THE BACK MUSCLES AND LIGAMENTS

  • Research has shown that regardless of lifting position, whether you’re stooped, squatting or weightlifting, your back has to produce the same amount of force. Statistically speaking, it’s not significantly different.

 

 

FLEXING THE SPINE WHILE LIFTING INCREASES THE LOAD ON THE LUMBAR DISCS

  • Under heavy loads, discs are unlikely to fail unless >95% flexion is achieved (which is near impossible)

  • With low loads, the disc is unlikely to fail unless you do thousands of repetitions continuously

  • Your body is an amazing adapter, this includes discs! Your discs can adapt and become more and more able to handle loads when stressed appropriately

 

THESE COMPOUND TO CAUSE INJURIES AND PAIN TO THE BACK MUSCLES AND DISCS

  • Resistance training has demonstrated through countless studies the ability to increase bone mineral density (BMD) of the lumbar spine. BMD is actually positively associated with the strength of the spinal discs and ligaments at that level. With appropriate loading and training, disc, ligament, bone and muscles are going to adapt favourably

 

A NEUTRAL SPINE IS SAFER, STRONGER, MORE EFFICIENT AND BETTER TO LIFT WITH

  • There is no significant difference between activities that encourage more spinal flexion and one’s that do not in the long term

  • Lifting with lumbar flexion is not a risk factor for low back pain

  • Research has shown lifting with a bent back is more metabolically and neuromuscularly efficient

  • When the spine is in extension during bent over activities, the hip is actually flexed to a greater degree – decreasing the ability for the glutes and hamstrings to create as much internal torque. Flexing the spine reduces this effect and reduces the moment arm for the hip extensors

 

STOP BACK PAIN & INJURIES BY LIFTING WITH A NEUTRAL SPINE

  • Your lumbar spine flexes every time your hip flexes! It is impossible to isolate one versus the other. It is also impossible to not flex while doing common movements

  • Extreme flexion however (>/=100%), may pose an increased risk under heavy loads, but not at light loads

 

You may still be wondering why you have back pain (stay tuned for our next blog!). Your pain may not be directly related to your lifting strategy.

 

 

Could you have pain with forward bending? Absolutely.

Is bending at the lumbar spine an increased risk for pain or injury? In the vast majority of situations, no.

If I have pain with forward bending, is it bad to temporarily limit doing so? Not at all.

Should I fear bending at the spine with or without pain or injury? No. Being fearful of flexing/moving your spine is actually a stronger predictor of disability and back pain.

 

Work on moving through your spine, after all it’s what it is designed to do! Choose comfortable movements and gain confidence over time, then build up your strength gradually with resistance training – try and not to push too fast, we want nice, healthy adaptation! Give your body time to adapt, back pain is not quick fix sometimes but you are resilient and with healthy, normal movements and some patience, you will be okay.