fbpx
Your first step to recovery
Visit Our Clinic
New Windsor
Give us a call
09 626 6186 (New Windsor)
Send us a message
admin@physiofusion.co.nz
Opening Hours
Weekdays
8AM Until Late
Weekend
By Appointments

Tag: rehabilitation

Physio FusionNewsrehabilitation
By Physio Team Appointments & Fees, body parts, ergonomics, Exercises, good posture, Home exercises, Injury, Lockdown, lockdown wellbeing, mental health, muscles, online consultations, pain, physical health, Physio, posture, rehabilitation, Therapy, wellbeing, WFH, Working from home , , , , , , , , , ,

How to stay Healthy and Sane during Lockdown

 

The restrictions and change brought by the outbreak of COVID-19 has resulted in a great deal of control being taken from our hands; this has been anxiety provoking for many of us. Nevertheless, it’s important to re-evaluate, acknowledge and place focus upon the matters that we DO have control over so that we can gain our personal power back!

 

Lockdown Productivity Tips

 

 

Check in with yourself: how is your body and mind feeling. Embrace your emotions and give yourself permission to feel the way toy do.

:large_blue_diamond: Stay connected: Social connection is inevitably limited at the moment but catching up with people via text or facetime will help prevent feelings of isolation.

:large_blue_diamond: Maintain some form of routine: Maintaining a routine helps provide some structure do days which often all seem to merge into one.

:large_blue_diamond: Get fresh air where possible: Daily fresh air can provide an easy change of scenery when we are stuck at home most of the day.

:large_blue_diamond: Gentle exercise is a MUST!

:large_blue_diamond: Stay Hydrated: Drinking enough water is important to keep your body hydrated and makes sure your body functions properly.

:large_blue_diamond: Eat well- You’d be surprised how your diet can affect how you feel. Gut health in particular is linked to mental health.

:large_blue_diamond: Get to that “thing” you’ve been delaying for months

:large_blue_diamond: Pick up a good book

:large_blue_diamond: Learn new habits or rediscover old ones

:sparkles: These may seem like simple strategies but sometimes it’s the simple things that are most effective :sparkles:

“One day this will all be over and we will be grateful for life in ways we never felt possible”

The gratitude we will have for the things we once took for granted will be unmeasurable- getting on a plane, an impromptu visit to the cinema, a shopping spree, going to the gym, even meeting a friend for lunch at a café. Keep going, nothing lasts forever and we have so much to look forward to. In the mean time take each day as it comes, be kind, support those who are struggling and keep going! You are stronger and more resilient than you know!

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.

By Physio Team acute pain, Appointments & Fees, body parts, chronic pain, Exercises, feet, heel pain, Home exercises, Injury, Lockdown, lockdown wellbeing, muscles, online consultations, orthotics, pain, pain management, physical health, Physio, rehabilitation, Sporting, Sprain, tendon, Therapy , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

Disorders of the Achilles Tendon

Basic Anatomy

The Achilles tendon is the largest tendon in the human-body. It is a band of tissue that connects your calf muscles to your heel bone (calcaneus). This tendon primarily facilitates general mobility such as walking, running, climbing stairs, jumping, and standing on your tip toes, by helping to raise the heel off the ground.

 

 

Common Achilles Pathology

Achilles tendinitis and tendinosis are two common disorders and are typically classified as overuse injuries.

Achilles tendonitis involves inflammation of the Achilles tendon. Inflammation is the body’s natural response to injury or disease, and often causes swelling, pain, or irritation. This inflammation is typically short-lived. Over time, if this is left resolved, the condition may progress to degeneration of the tendon- Achilles tendinosis, in which case, the tendon loses its organized structure and is likely to develop microscopic tears.

There are two types of Achilles tendonitis and it is based on which part of the tendon is inflamed:

  • Insertional Achilles tendonitis affects the lower portion of your tendon where it attaches to your heel bone.
  • Non-insertional Achilles tendonitis involves fibres in the middle portion of the tendon and tends to affect younger people who are active.

In both non-insertional and insertional Achilles tendinitis, damaged tendon fibres may also calcify (harden) and often bone spurs (extra bone growth) develop with insertional Achilles tendinitis. Achilles tendonitis may also increase your risk of sustaining an Achilles tendon rupture (tear).

Causes

Typically referred to as “overuse” conditions, Achilles tendonitis and tendinosis are often caused by the sudden increase in repetitive activity involving the Achilles tendon. This can put too much stress on the tendon too quickly, that can then lead to micro-injury of the tendon fibres. Because of this ongoing stress on the Achilles, the body is not able to repair the injured tissue. The structure of this tendon is then modified, resulting in continued pain and other symptoms. The Achilles tendon also has poor blood supply that makes it more susceptible to injury and may make recovery from injury slow.

Common factors that may lead to the development of disorders of the Achilles tendon include:

  • Weak and/or tight calf muscles
  • Rapidly increasing the amount or intensity of exercise within a short span of time
  • Hill climbing or stair climbing exercises
  • Presence of bony spurs in the back of your heel
  • Changes in footwear – especially changing from wearing high-heeled shoes to flat shoes
  • Wearing poor fitting, inappropriate, or worn out shoes during sporting activities
  • Exercising without adequate warm-ups and stretching
  • A sudden sharp movement which causes the calf muscles to contract and the stress on the Achilles tendon to be increased. This can cause the tendon fibres to tear.
  • Excessive mobility
  • Poor feet positioning and biomechanics (excessive pronation and flattening of the arches of the foot)

 

Symptoms

Achilles tendon pain: Causes. when to see a doctor, and treatment

 

Common symptoms include:

  • Pain and stiffness along the Achilles tendon especially first thing in the morning
  • Pain along the tendon or back of the heel that worsens with activity
  • Severe pain the day after exercising
  • Visible thickening of the tendon
  • Tenderness to touch
  • Bone spur
  • Swelling that is present all the time and gets worse throughout the day with activity

If you have experienced a sudden “pop” in the back of your calf or heel, you may have torn your Achilles tendon. Please seek urgent medical attention if you think you may have torn your tendon.

Diagnosis

If Achilles tendonitis or tendinosis is suspected, please deter from any activity or exercise which causes the pain. It is advisable to see your doctor or physiotherapist as soon as possible so that an accurate diagnosis may be made and appropriate treatment recommended.

You will be asked about the nature and duration of your symptoms and the medical professional assessing you will have a look at your foot and ankle. Ultrasound scanning may be used to evaluate the damage to the tendon and/or surrounding structures.

An MRI may be recommended if symptoms persist. X-rays may also be taken to rule out other disorders which may cause symptoms like Achilles tendonitis and tendinosis.

Achilles Tendonitis - Ankle - Conditions - Musculoskeletal - What We Treat - Physio.co.ukHow to Treat Achilles Tendinopathy with Physical Therapy - prohealthcareproducts.com

Treatment

Treatment will depend on the nature, severity, and length of the injury. Generally speaking, the longer the symptoms are present before treatment commences, the longer the timeframe until full recovery is attained.  Full recovery may take between three and nine months.

Initial treatment options in the early stages may include:

  • Rest – to avoid further injury to the area
  • Ice – to reduce inflammation
  • Elevation – to reduce swelling
  • Non-steroidal anti-inflammatory drugs to reduce pain and inflammation.

 How physiotherapy can help:

Physiotherapy typically focuses on two main areas: treatment and rehabilitation. Treatment may entail massage, shockwave therapy, acupuncture, gait re-education, and gentle stretching, whereas, rehabilitation predominantly entails strengthening of the Achilles and surrounding musculature.

Strengthening of the muscles surrounding the Achilles tendon facilitates healing in the tendon itself. Strengthening is attained through the utilization of specific exercises, that will be taught by your physiotherapist. It is common for the rehabilitation programme to take up to three months.

 

Exercises

 

 

By Physio Team Appointments & Fees, Exercises, Home exercises, Lockdown, online consultations, Physio, Pilates & Exercise Classes, Sporting, Studies, Therapy, Uncategorized , , , , , , ,

Stay safe, Stay fit

Our daily routine has been forced to change during the lockdown and it has never been more important to focus on your physical and mental health. The current situation we’re facing is strange, stressful, emotionally exhausting and there is no surprise that the motivation to keep fit has been a bit of a struggle. It is in these disquieting times that exercise can provide much-needed solace.

Research shows that being physically active helps lower cholesterol and blood pressure and can significantly reduce the risk of heart disease, stroke, and diabetes. Physical activity also maintains mass and bone density, reducing the risk of developing osteoporosis (loss of bone density), Sarcopenia (loss of muscle mass), and helps boost one’s immune system, as it flushes bacteria from the lungs and airways, increases white blood cell circulation and raises body temperature, all of which help the body fight infection.

How much Activity is Recommended?

Be active every day, in as many ways as possible. Aim for at least 2 ½ hours of moderate (or 1 ¼ hours of vigorous physical activity) spread throughout the week. The Ministry of Health outlines how much physical activity New Zealanders need to stay healthy https://www.health.govt.nz/your-health/healthy-living/food-activity-and-sleep/physical-activity/how-much-activity-recommended.

Create a Routine

Whether you are looking to maintain an exercise regime or just stay motivated from one day to the next, as your own four walls start to make you feel a bit stir crazy, many people find that it helps to have a set routine. It portions the day into bite-size chunks and allows you to feel a sense of accomplishment as you tick off the day’s tasks.

Few of us are lucky enough to have an exercise bike/treadmill at home. Fortunately, there are plenty of simple exercises that you can do around the house or with household objects that will work instead. If you do not have your own weights at home there are some surprising substitutes you can utilize instead i.e bags of rice or flour, a tin of beans and bottled water can be used, if you need something heavier you can always fill a carrier bag with a few items inside.

1. Squats

Directions:

Lie on the floor and rest on your back. Ensure that your knees are bent, and your feet are touching the floor.

Put your hands behind your head and then lift both your chest and your legs slightly but leave a gap between them.

Go back to the starting position and repeat.

2. Crunches

Crunches are another important exercise for your abs to strengthen your body core.

Directions:

Widen your feet parallel to your shoulder and extend your arms in front of you.

Bend your knees and your hips slightly and then do the traditional squat position.

Push up using your heels and repeat.

3. Stationary Lunge

Directions:

Stand up straight and put your right leg forwards and your left leg backward. It should look like you’re preparing to run.

Place your hands on your hips. Bend your right leg, leaving a little gap between the floor and the knee.

Then, switch your legs and do the same.

These bodyweight exercises are a great way to start your day and get the blood pumping in your body.

 

Safety during exercise outside

If you’re working from home, getting outside for physical activity will do wonders for your physical and mental health. Regular walking, running or cycling is a great way to stay active and healthy during lockdown, but it is important to keep your distance and stay more than two metres away from others. Plan your route when you’re thinking of heading out for a cycle/jog. If possible try to think of roads, neighborhoods, and parks that will be quieter and less congested. Follow the latest advice about whether you will also need to wear a mask.

Take a Bit of You Time

Fill your own cup first…Being healthy is not just about maintaining an exercise regime and eating right, it is also about staying mentally healthy too. If you are in isolation with your family, it is easy to spend the day making sure they are happy and entertained, but don’t forget to take a bit of time for you. Do a quick meditation or yoga routine while the kids are watching TV or maybe just go into the garden and take a few deep breaths to relieve some stress!

During this time of uncertainty, something we can take control of is our health and well-being. So, whatever your situation, try to keep active, eat healthily, and stay hydrated.

Ngā mihi and stay safe

Arthritis
By Physio Team Exercises, Injury, Physio, Therapy , , , ,

ARE YOU IMPACTED BY ARTHRITIS ON A DAILY BASIS?

What is Osteoarthritis?  

Osteoarthritis is a condition that causes pain, discomfort and stiffness at our joints. It is the most common form of arthritis worldwide.

The intensity of the pain is different for each individual person. Osteoarthritis can occur at any joint, however it most commonly impacts the hips, knees and hands.

 

Signs/Symptoms

The symptoms of osteoarthritis usually start gradually and increase over time. You may experience pain, tenderness and clicking/crackling sounds with movement.

Swelling: Commonly occurs around the affected joints and soft tissues.

Pain: Joint pain usually increases during/after activity or movement. It can also increase due to inactivity.

Stiffness: Can be present first thing in the morning or after activity.

Reduced range of motion: You may be unable to move the joint freely through the normal range.

Causes:

In normal day to day life we are constantly loading our joints causing low level damage. The majority of the time our bodies heal naturally and you never experience any symptoms.

Osteoarthritis occurs when the cartilage that cushions our joints breaks down over time. This can lead to bony growth within our joints and inflammation. Eventually, our connective tissues that support our joints deteriorate.

Risk factors for developing Osteoarthritis:

  • Previous joint injury- Sporting or old injuries
  • Age– Increased risk as you get older.
  • Sex – More common in females
  • Family history- There is some evidence of family/genetic links.
  • Obesity- Being overweight increases the stresses and strains on our joints.

Diagnosis

Clinical examination of the joint: assessing for signs of swelling, tenderness and/or loss of motion. Gathering information on the injury history and symptoms.

X-ray: Cartilage loss does not appear on X-ray imaging. However a narrowing of space between the bones can be seen. Bony spurs around the joint can also be identified.

MRI: Magnetic resonance imaging: Provides detailed images of soft tissue and bony structures. For the majority of cases it is not used to diagnose osteoarthritis but can help in more complex cases.

Treatment options: Conservative management

Osteoarthritis requires long-term management. Although there is no cure for osteoarthritis, treatments can reduce pain and get you moving better.

Mild symptoms/early stages:

  • low impact exercises – walking, swimming, cycling, strength training
  • reducing overall body weight (if overweight)
  • wearing supportive footwear
  • using aids/walking devices to reduce overall joint loading

Medication:

If your symptoms are more severe and you are finding the pain difficult to manage, speak to your GP or pharmacist about painkillers or anti-inflammatory drugs.

Physiotherapy:

  • Detailed assessment of your individual needs
  • Structured and progressive rehabilitation plan
  • Advice on self management

Non-conservative management:

If symptoms are more severe and you are not getting relief from the above options, you may benefit from procedures such as:

Steroid injection

An injection may be indicated to relieve persistent pain, following a trial of conservative management.

Surgery

Joint replacement surgery is an option in more severe cases, again following a trial of conservative management. Note: there is rehabilitation required before and after surgery. It is not a quick fix option.

How we can help

  • Provide a detailed assessment and advice on your current symptoms and best treatment options available.
  • Prescribe you a structured plan
  • Onward referral to a specialist or further imaging if indicated
By Physio Team Exercises, Injury, Physio, 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.

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.

  • 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