Author: Cumberland Physiotherapy

What is Incidental Exercise?

 

The difference between an office job and a labouring job is quite obvious: the office worker sits in a cubicle for 8 hours per day while the labourer is constantly moving, walking up and down ladders or stairs, and carrying heavy loads.

 

The labourer is performing what is known as “incidental exercise”:exercise that occurs just because he is moving. Incidental exercise typically is unplanned exercise that occurs during your normal daily routine.

 

In today’s society, there is an increasing percentage of people with disease associated with sedentary lifestyle. The good news is that including incidental exercise into normal daily life can help reduce the risk of developing disease.

 

Here are a few ideas…

• If you live within 5km of your workplace, walk or cycle to work.
• If you drive, park 1km or more away from work and walk.
• At every opportunity take the stairs, instead of the elevator.
• Walk your kids home from school and have quality chats together.
• Have a short indoor exercise routine that you do every time you wait for the kettle to boil.

 

If you work in an office…

• Take all phone calls standing up.
• Swap your chair for a fitball.
• Walk to your colleague’s office instead of calling them, or ask to speak while you leave the building for coffee runs or lunch-time walks.

At home…

• Put on some music and be more active while cleaning, gardening or hanging out the washing.
• Make your daily family time active: play a game out back or go for a ride through the park.

It’s important to note that incidental exercise does not replace that hour at the gym or of sport.However, incidental exercise will make the benefits of that hour last longer and help you feel better through the day.

 

 

 

Plantar fasciitis is the most common cause of pain at the rear of the foot. The plantar fascia is a fibrous tissue that originates on the heel bone and inserts into the toes, helping to provide stability and support to the arches of the foot.

 

Plantar fasciitis is the breakdown of the tissues of the plantar fascia, usually in the area that attaches to the heel. The cells within the tissue become disarrayed, changing the direction of pull and weakening the tendon, which can eventually lead to micro-tearing of the fascia.

 

WHAT ARE THE SYMPTOMS?

Plantar Fasciitis is characterised by gradual onset of pain at the base of the heel. The pain may be worse in the morning and eases throughout the day. Aggravating activities include standing, being inactive; stretching the foot, and the area will be painful to touch. In the early stages, activities such as running or dancing may ease the pain and only be painful afterwards, however as the condition develops further, pain may also be felt during exercise.

 

HOW DOES IT HAPPEN?

This condition usually develops slowly over time. Sudden heel pain following a traumatic incident is not usually classified as plantar fasciitis. Poor foot biomechanics, such as over pronation or supination (a kind of twisting movement within the foot) during walking or running places stress through the tendon. If this continues over time, the tendon begins to break down, causing pain.

 

Common activities that contribute to plantar fasciitis include walking with inappropriate or unsupportive footwear, running, and dancing. Other factors that may contribute to plantar fasciitis are lower limb muscle tightness, leg length discrepancy or muscle imbalance.

 

HOW CAN PHYSIO HELP?

There are various strategies your physio can use to assist with pain relief of the foot. Following a thorough examination of the lower limbs, your physio will decide if you require specific muscle stretching or strengthening. Often there will be a biomechanical abnormality in the gluteal or calf muscles that require attention. Once an exercise program is underway, strapping or orthotics, may be used to support the painful tissue. Generally, a stretching routine for the bottom of the foot will be prescribed, and tissue release using a golf or tennis ball may be added to the exercise regime.

Most practitioners agree that physiotherapy management and relative rest are best for plantar fasciitis, however, some people may need further treatment such as corticosteroid injections or surgery if physiotherapy is not effective in relieving the symptoms.

 

None of the information in this newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury

Back pain is such a common experience that it is estimated up to 80% of adults will have at least one severe episode of back pain in their lifetime. 

 

For many people, the pain quickly resolves and things go back to normal. However the first time this happens to you it can be scary, particularly as very severe pain can occur suddenly and without warning. Statistics, however, are on your side. Most of the time, acute low back pain resolves without consequence and doesn’t recur. If you happen to be in the middle of an episode, here are a few tips to help you get through.

1.    Avoid heavy lifting

While this may seem obvious, there are a few people who will always try to push through the pain. The expression “no pain, no gain” is in many cases outdated and if your work requires heavy lifting, it is more than reasonable to take a few days off.

2. Avoid too much rest.

On the other hand, lying in bed all day is bad for you as well. If you have severe back pain, gentle movement under the advice of a physiotherapist is much better for you than complete rest.

 

3. Avoid long car or plane trips

 

If possible, now is the time to avoid long distance travel. If you absolutely must travel, speak to your physiotherapist about how to manage your pain during the trip.

 

4. Avoid listening to horror stories

 

There are always stories about pain that never went away, requiring surgery, which only made it worse. While worst case scenarios do happen, being fearful is a negative factor in a healthy recovery. That terrible story is probably not going to happen to you and hearing these stories is only going to impact your recovery negatively.

 

5. Avoid delaying treatment

 

While your pain may go away on its own, it is important to have a professional assess your condition to screen for any serious injuries and advise you on how to best manage your pain while you are getting better. They can also help you recover as quickly as possible.

 

6. Don’t expect a miracle cure

 

Back pain is complicated, and a single treatment that works for everyone does not exist. It is important to follow the directions of your physiotherapist and work with them to set reasonable and realistic goals for your recovery.

The shoulder is an amazing joint with incredible flexibility. It doesn’t attach directly to the spine, like the hip joint; instead, it is held to the body through a complicated system of musculature and indirectly by the collarbone (clavicle) to the front of the rib cage. Many other joints in the body are extremely stable, thanks to the structure of the bones and ligaments surrounding them. However, the shoulder has so much movement that some stability is sacrificed. It is for this reason that shoulder dislocations are a relatively common occurrence.

 

What is a dislocation and how does it happen?

As the name suggests, a dislocated shoulder is where the head of the upper arm is moved out of its normal anatomical position to sit outside of the shoulder socket joint.

Some people have more flexible joints than others and will unfortunately have joints that slip out of position easily without much cause. Other people might never have a dislocated shoulder except for a traumatic injury that forces it out of position. The shoulder can dislocate in many different directions, the most common being anterior. This occurs when the arm is raised and forced backwards in a ‘stop sign’ position, which can occur in many situations.

 

What to do if this happens

The first time a shoulder dislocates is usually the most serious. If the shoulder doesn’t just go back in by itself (spontaneous relocation), then someone will need to help to put it back in. This needs to be done by a professional as they must be able to assess what type of dislocation has occurred, and often an X-ray needs to be taken before the relocation happens.

A small fracture can actually occur as the shoulder is being put into place, which is why it is so important to have a professional perform the procedure.

 

How can physiotherapy help?

Following dislocation, your physiotherapist can advise on how to allow the best healing for the shoulder. It is important to keep the shoulder protected for a period to allow any damaged structures to heal as well as they can.

After this, a muscle-strengthening and stabilization program can begin. This is aimed at helping the muscles around the shoulder to provide further stability and prevent future dislocations.

 

The information contained here is not a replacement for proper medical advice. Always see a medical professional for assessment of your individual condition.

Most of us are familiar with the post-exercise soreness that comes after a particularly strenuous exercise session. This pain, which is usually accompanied by stiffness and weakness, is often referred to as Delayed Onset Muscle Soreness, abbreviated to DOMS.

 

It is unclear exactly what the purpose of this pain is, as it is most intense 24-48 hours following an intense exercise session. However, we do know that muscles experiencing DOMS show signs of microtears throughout the tissues and the effects are worse following eccentric (controlled extension) exercises more than other types.

 

While DOMS is not indicative of any serious injury and has no lasting side effects, it can be very uncomfortable and is problematic for anyone who needs to perform again quickly, such as an athlete in a tournament stretching over a few days.

 

A person suffering from DOMS may also be at a higher risk of injury if they continue to play sport at their usual level. Understandably, many people are interested in how to avoid or reduce the effects of DOMS.

 

There is plenty of anecdotal evidence on how to reduce DOMS, however high-quality research is limited and there is certainly no quick fix to this problem.

 

When it comes to avoiding DOMS, both a warm up before exercise and a cool down afterwards are important. Many experts also recommend using a foam roller on affected muscles following exercise. And while many people, particularly long-distance athletes are fond of using anti-inflammatory medication to reduce pain after exercise, the evidence shows that its effectiveness is limited and perhaps not worth the side effects of using the medication regularly.

 

Other advice includes gentle exercise, such as 20 minutes on a stationary bike, and mild stretching. Massage is not generally recommended, although some people may find it helpful. Staying hydrated during sports is always important, and keeping your fluid intake adequate while experiencing soreness afterwards can also help. If you are particularly brave, ice baths have recently been shown to have mild benefits in pain reduction.

A common injury of the knee is a tearing of the ACL (Anterior Cruciate Ligament). This ligament is very important for stability of the knee and often needs to be repaired surgically. The primary function of the ACL is to keep the bottom surface of the knee joint from sliding forwards during movement. An unrepaired knee may feel unstable or give way suddenly.

Not all ACL injuries require surgery and some may heal well with proper rehabilitation, however for those who do need surgery, there is a significant rehabilitation period afterwards.

What does the surgery consist of?

Every surgeon will have a slightly different technique for surgery. The most common approach is the arthroscopic approach, which uses a small camera and allows the surgeon to make only small incisions into the knee. They will then replace the torn ligament with either a graft from a tendon or ligament at another part of the body or using a synthetic graft.

How long does rehabilitation take?

Full rehabilitation following surgery can take up to nine months and rehabilitation is divided into different stages. As all surgeons will have different protocols for their approaches to surgery, time frames will vary for everyone.

Initially after surgery, the graft will be quite weak while a new blood supply is being established. It can take up to 12 weeks before the graft is at its strongest point and evidence shows that it may never have the strength of the original ligament.

In the early stages, rehabilitation will be focused on restoring movement to the joint and strengthening the muscles around the knee without putting any undue stress on the graft.

As the graft begins to heal and strengthen, rehabilitation can progress to include stability and control exercises and gradually build up to a complex program that prepares the knee for a full return to sport.

The path to full rehabilitation from a knee reconstruction can be a long and bumpy one, however there are high success rates with this surgery, particularly when followed up with full physiotherapy rehabilitation.

This information is not a replacement for proper medical advice. Always see a medical professional for assessment of your individual condition.

Every profession has a unique perspective of life that can only be achieved from years of experience in that area. Here are three things that experience has taught your physio:

1. Problems that seem to arise for “no reason” are usually a result of disuse or lack of movement.

It’s common to want to know why pain has occurred; however it’s not always easy to identify a cause. What you come to learn as a physiotherapist is that pain and injury are just as likely to arise from disuse and inactivity as they are to develop from a direct trauma.

Our bodies are made to move and modern day life simply doesn’t allow for enough movement. We certainly shouldn’t be sitting as much as we are as this allows our joints to stiffen, muscles to shorten and weaken, and nerves to become extra sensitive.

There is also evidence that movement is essential for joint health, due to the movement of joint fluid that provides nutrients to the joint structures. The reason physiotherapists are always advocating for more movement is because we see the long-term effects of disuse on a daily basis.

2. Bad habits are hard to break, but the best time to make a change is today.

Today’s slightly stooped posture is tomorrow’s fixed hump back. It doesn’t happen overnight, but seeing every stage of the progression walk through your door is like seeing evolution in fast forward. It makes you want to address change early, when it is easiest to make a positive effect.

Other habits that should be formed early are incorporating as much exercise into your routine as possible. It’s harder to be fit and active in your 60s if you weren’t active in your 30s. Being active now is arguably one of the most important things you can do to ensure you have a comfortable and healthy later life.

3. Pain is affected by so much more than just tissue damage.

Your beliefs and attitudes about pain can have a huge impact on how you experience pain. Being fearful and anxious will amplify pain. The worst-case scenario is actually very unlikely and seeking the treatment of a physiotherapist can help to ensure the best outcomes possible.

Golfer’s elbow is defined as chronic degeneration of the tendon on the inside of the elbow, usually due to overuse. As its name implies, it is a condition common in golfers. However, as with all sporting injuries, this condition can affect anyone. Golfer’s elbow is similar to Tennis elbow, occurring on the inside of the elbow rather than the outside.

What are the symptoms?

Typically, someone suffering from this condition will experience pain on the inside of the elbow, forearm and possibly extending down to the hand. The pain will be worst with activities that require gripping of the hand and movements of the wrist. Less common is the experience of pins and needles in the hand.

How does it happen?

The exact cause of this condition is unknown, however it is generally thought to occur when the forces transmitted through the tendon become too great. This can be due to increased demands on the tendon or reduced quality of the tendon tissues.

As the tendon is attached to muscles that bend the wrist and provide grip strength, activities such as golf, rock climbing or manual work that involve gripping objects can easily create forces that damage the tendon.

Conversely, factors such as poor blood supply or simply the normal processes of aging can reduce the quality of the tendon. If the tissue is not functioning well, then even simple but repetitive movements in an office job can cause Golfer’s elbow.

There are a few other known contributing factors for Golfer’s elbow, such as poor posture, neck dysfunction, a recent change in activity and a history of trauma, such as a fall onto an outstretched hand.

What is the treatment?

Golfer’s elbow usually develops slowly, and healing can be a long process. The first step to effective treatment is accurate diagnosis, as many other conditions have similar symptoms and need to be excluded first by a medical professional.

Once a diagnosis of golfer’s elbow has been confirmed, treatment is aimed at allowing tissues to heal and regenerate. This will require a certain level of rest, and changes to the forces affecting the tissues, sometimes through bracing or taping.

Specific exercises have been shown to assist tissues in coping with and responding to load; these are called “eccentric” exercises. Other treatments include increasing blood flow to the area to promote healing. In chronic and severe cases, injections of corticosteroids are used, and in severe cases surgery may be undertaken.

The information in this article is not a replacement for proper medical advice. Always see a medical professional for assessment of your individual condition.

Many of us associate aging with a decline of skills and quality of life. However, the truth is not as black and white as this. While certain skills and functions do tend to suffer as we age, surprisingly there are many abilities that actually improve as we grow older.

Recent studies have shown that happiness is U-shaped, proving that the mid-life crisis is real, with the ages between 40-60 holding the highest amount of stress and responsibility for adults. It seems that happiness increases steadily after this period, with the average 80 year old reporting themselves to be as happy as the average 20 year old.

There is also evidence that your beliefs about aging can act as a self-fulfilling prophecy. If you are positive about ageing, then your experience will be more positive than if you have negative beliefs about it.

It’s not only good news about your mental health though. Studies have also shown that while your short-term memory might decline, other skills such as creativity can actually increase. One of the biggest reasons for a decline in skill and function is the disuse that comes with retirement from work. Keeping active and mentally stimulated can be enough to keep your skills up to speed.

It has also been shown that confidence grows in both genders as we age. Making decisions becomes easier as we know ourselves better and have a wealth of experience to draw on when a tricky situation arises.

Certain physical skills such as strength and agility might decline, however it seems that other aspects of physical ability might increase, including endurance. There are many triathletes who are in their 70s, 80s, and unbelievably even in their 90s. In the absence of any serious disability, it might be the case that age is an excuse rather than an actual hindrance to being active.

Verbal ability and vocabulary are also skills that improve as we age, which may explain why crosswords are so popular with the elderly. Making the most of your abilities at every age is important, so try not to let age be a barrier to trying new things and keeping active.

Physiotherapists are dedicated to helping people stay active at any age and can help you with achieving your goals. Speak to your physiotherapist for more information.

Ankle sprains are extremely common, however, this doesn’t make them easy to cope with when they happen to you. If you’ve ever spent two weeks hobbling around on crutches after an unfortunate twist, you’ll understand just how painful and difficult they can be.

 

What are they?

 

Ankle sprains refer to a tear to the ligament fibres of the ankle. Commonly, a person will roll their ankle inwards and tear the ligament on the outside. Occasionally, the ankle will twist outwards and the ligaments on the inside of the ankle are torn and even less commonly, the fibres of the ligament that hold the two bones of the lower leg together tear (high ankle sprain). A sprained ankle will usually be painful, swollen, bruised, difficult to walk on and in some cases unstable.

How does it happen?

 

Ankle sprains can occur from something as simple as putting weight onto your leg when you think your foot is flat even though it’s not. The most typical pattern is of a person jumping and landing on the outside of their foot or simply slipping and twisting their ankle. A sprained or twisted ankle is one of the most common injuries presented to emergency departments around the world. This is important as a severely sprained ankle can actually have very similar symptoms to a broken ankle and will need an X-ray.
A medical professional should assess any severe sprain. However, there are some guidelines to help decide if a sprained ankle needs X-ray.

1. You are unable to put weight on the ankle immediately after the injury.
2. You are unable to take more than 4 steps immediately after the injury.
3. Pain on the bony edges of the outer foot and ankle.

How long do sprains take to heal?

 

Depending on the severity of the tear, from one to six weeks. Your physiotherapist is able to help with recovery and ensure nothing slows down the healing. Following any injury of the body, joints may remain a little stiff and lose strength and control. Even though the injured tissues have healed, the ankle doesn’t move quite the way it used to. This means that your risk of twisting it again is higher than before the injury.

How can physiotherapy help?

 

Correct rehabilitation can help to prevent recurring injuries. As well as providing support to the unstable ankle, your physiotherapist will help you to strengthen any weak muscles and restore balance and control through exercise. They are also able to correct any abnormal movement of the joint following swelling.

The information in this newsletter is not a replacement for proper medical advice. Always see a medical professional for assessment of your individual condition.