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Physiotec Updates

Physiotec Updates

END OF YEAR ROUNDUP!

2015 in Review

2015 was a year of exciting change and growth for Physiotec. The clinic expanded physically, new staff came on board, our technology advanced, our physiotherapists further expanded their already high level of knowledge and we reached out to the community with involvement in sporting events, teaching locally and abroad and with social media.

The clinic expanded upstairs this year providing another large gym space, two more treatment rooms, a second waiting area, a meeting/teaching space for our staff and a second office. We have also taken on board a Patient Liaison Coordinator, Toni Corta. You may have heard from Toni who is responsible for helping track the progress of our patients with the aim of providing the best quality service possible. We pride ourselves on providing treatment that is up to date and informed by cutting edge scientific evidence. The information Toni collects will further help us determine which treatments provide the best outcomes in our patient population. Better outcomes achieved more rapidly for our clients continues to be our primary focus.

We also invest in technologies that can help us achieve this goal. Physiotec invested in an additional real time ultrasound machine used for muscle and tendon assessment, rehabilitation and biofeedback. Our ViMove system (wireless accelerometers for assessing movement) has undergone considerable advances with new programmes to assess and improve ‘core control’ and neck movement as well as advances in the knee and running modules. Our second gym has been equipped with a new reformer with a tower attachment and we also added a ladder barrel allowing a host of new exercise challenges. A spine corrector, two TWS sliders, a ballet bar, balance equipment, band stations, a weights station and much more can also be found in our new exercise area.

pilates gym new

Our physiotherapists are passionate about continually increasing their expertise. Our staff have been involved as treating physiotherapists in university research trials and have attended national Physiotherapy and Sports Medicine conferences and many workshops and lectures on topics such as Hip Pain, Hamstring Injuries, Bone Health, Women’s & Men’s Health (pelvic pain and pelvic floor function), Hypermobility, Dance Medicine, Running Injuries & Rehabilitation and Tendon Pain & Rehabilitation.

Our principal physiotherapist, Dr Alison Grimaldi has also contributed to the knowledge of other physiotherapists and health professionals in Australia and overseas through multiple presentations at the recent Australian Physiotherapy Association Biennial Conference at the Gold Coast and lectures and workshops presented at Pure Sports Medicine(London), PhysioUK (London), Centre for Sports and Exercise Medicine, William Harvey Research Institute (London), Neath Port Talbot Hospital (Wales, UK), the Sports Surgery Clinic (Dublin, UK) and the Australian Institute of Sport (Canberra).

Dublin lecture 2

Sports Surgery Clinic, Dublin

Alison also presented weekend courses for physiotherapists in Brisbane, Sydney, Melbourne and Canberra. She has continued her research involvement into management of gluteal tendon pain and hip joint pain through the University of Queensland and University of Melbourne and has co-authored three papers in peer reviewed scientific journals such as Journal of Orthopaedic & Sports Physical TherapyMedicine and Science in Sports and Exercise and Sports Medicine Journal.

Physiotec has been more connected to the world in 2015, with increased activity on Twitter and Facebook. We aim to help keep our followers up to date with the latest research in physiotherapy by providing information on useful links, blogs and tips on injury prevention.  Not only are we active on social media, but we also launched a new and easy to navigate website where you can browse our services, get to know the staff, and read more news in physiotherapy. Here is link to our new website: Physiotec

As part of our goal to get our clients more fit and active throughout their recovery, Physiotec staff and patients participated in the International Women’s Day Fun Run which raises money for Breast Cancer.

international women's day

We have also worked hard to help our patients to achieve their own activity and work related goals. Staff physiotherapist, Eric Huang, who is the founder of Brisbane-based cycling group M.I.A, helped some of our clients earn cycling medals while managing to gain podium placings himself.

MIA

mia podium eric

We have helped clients achieve lifelong goals of overseas travel and returning to work after years of disability, but it is often the everyday things that have the most impact – walking upstairs painfree for the first time in months, being able to attend family or social gatherings, achieving a good night’s sleep. We always love to see our clients overcome their difficulties and reach their personal goals.

What’s up in 2016?

In this coming year, our physiotherapists will be attending conferences and courses around the world. Alison will be attending the Low Back & Pelvic Pain Congress in Singapore and lecturing and presenting at the International Federation of Orthopaedic Manipulative Physical Therapists in Glasgow, UK. She will also be teaching in London, Wales, Ireland, Paris, Hong Kong, Singapore and New Zealand, as well as her regular Australian courses. Sharon will be attending the First International Ehler-Dhanlos and Hypermobility symposium in the USA. Kirsty, will once again be working with elite tennis players at the Australian Open in Melbourne. Eric will be continuing to further his knowledge and performance in all things cycling. Megan will be furthering her expertise in Women’s Health and Tony & Louise will be sharing their knowledge with some part time tutoring at the University of Queensland.

We will also be joined by visiting psychologist, Carolyn Uhlmann, who has a focus on providing support for patients coping with acute and chronic pain, chronic illness or caring for a loved one with health problems. She can also assist those who are learning to adjust and cope with changes in health, medical events, mobility and independence.

With the new staff members, new gym, new Pilates programs, running assessments and spinal assessments, you can expect that we will be offering more at Physiotec as we continue to grow.

 

Osteoarthritis and Running

Osteoarthritis and Running

Does running accelerate the development of osteoarthritis?

There are so many misconceptions about running and how bad it can be for your joints. You may have

heard many friends and family members comment on this and they may have even tried to convince you to stop running and go swimming instead. Here is what the scientific research tells us so far:

Osteoarthritis (OA) is a musculoskeletal condition that involves degeneration of the joints and impact during weightbearing exercise such as running and may contribute to joint loads. There is very little evidence however, that running causes OA in the knees or hips. One study reported in 1985 by Sohn and Micheli compared incidence of hip and knee pain and surgery over 25 years in 504 former cross-country runners. Only 0.8% of the runners needed surgery for OA in this time and the researchers concluded that moderate running (25.4 miles/week on average) was not associated with increased incidence of OA.

In another smaller study of 35 older runners and 38 controls with a mean age of 63 years, researchers looked at progression of OA over 5 years in the hands, lumbar spine and knees (Lane et al. 1993) . They used questionnaires and x-rays as measurement tools. In a span of 5 years, both groups had some participants who developed OA- but found that running did not increase the rate of OA in the knees. They reported that the 12% risk of developing knee OA in their group could be attributed to aging and not to running. In 2008, a group of researchers reported results from a longitudinal study in which 45 long distance runners and 53 non-runners were followed for 21 years. Assessment of their knee X-Rays, revealed that runners did not have a higher risk of developing OA than the non-running control group. They did note however, that the subjects with worse OA on x-ray also had higher BMI (Body Mass Index) and some early arthritic change in their knees at the outset of the study.

Is it better to walk than to run?

It is a common belief that it must be better to walk than to run to protect your joints. In a recent study comparing the effects of running and walking on the development of OA and hip replacement risk, the incidence of hip OA was 2.6% in the running group, compared with 4.7% in the walking group (Williams et al 2013). The percentage of walkers who eventually required a hip replacement was 0.7%, while in the running group, it was lower at 0.3%. Although the incidence is small, the authors suggest the chance of runners developing OA of the hip is less than walkers.

In the same study, Williams and colleagues reinforced that running actually helped keep middle-age weight gain down. As excess weight may correlate with increased risk of developing OA, running may reduce the risks of OA. The relationship between bodyweight and knee OA has been well-established in scientific studies, so running for fitness and keeping your weight under control is much less likely to wear out your knees than being inactive and carrying excess weight. 

Is there a limit?

Recent studies have shown that we should be doing 30 minutes of moderate exercise daily to prevent cardiovascular disease and diabetes. But with running, researchers still have not established the exact dosage of runners that has optimal health effects. Hansen and colleagues’ review of the evidence to date reported that the current literature is inconclusive about the possible relationship about running volume and development of OA but suggested that physiotherapists can help runners by correcting gait abnormalities, treating injuries appropriately and encouraging them to keep the BMI down.

We still do not know how much is “too much” for our joints. However, we do know that with age, we expect degenerative changes to occur in the joints whether we run or not. Osteoarthritis is just as common as getting grey hair. The important thing is that we keep the joints as happy and healthy as possible.

How do you start running?

If you are not a runner and would

like to start running, walking would be a good way to start and then work your way up to short running intervals and then longer intervals as you improve your fitness and allow time for your body to adapt.

Therfore, running in general is not bad for the joints. It does not seem to increase our risk of developing OA in the hips and knees. But the way you run, the way you train and how fast you change your running frequency and distance may play a role in future injuries of the joints.

But that’s another story. Watch this space for more running gems….

Image by: Pixabay

References:

Cymet and Sinkov 2006. Does Long Distance running cause OA. The Journal of the American Osteopathic Association, June 2006, Vol. 106, 342-345.

Hansen et al 2012. Does Running cause osteoarthritis in the hip or knee?. Physical Medicine and Rehabilitation. 4 (5) 117-121.

Lane et al. 1993. The Risk of OA with Running and Ageing. Year Longitudinal Study. Journal of Rheumatology (20) 461-468

Sohn et al. 1985. The Effect of Running on pathogenesis of OA in hips and knees. Clin Orthop Res (9) 106-109

Williams 2013. Effects of Running and Walking on OA and Hip Replacement Risk. Med

Sci Sports Exerc. 45 (7) 1292-1297

Why should I exercise during and after Pregnancy

Why should I exercise during and after Pregnancy

For Mums and Mums to be…

Have you ever experienced some pain in the pelvis  or in the hips during or after pregnacy?

Poor pelvic control or instability is a condition more common in women and is most likely to occur during or post –pregnancy.  During pregnancy, a hormone called relaxin is released in the body to allow the ligaments to stretch to accommodate the fast growing baby. With another human being growing rapidly, the pelvis does undergo an increase in loading, which some women cope with a little better than others – this can be due to genetic factors such as natural pelvic and ligamentous structure, or the background muscle conditioning you had prior to the pregnancy.

DON’T WORRY THOUGH…. remember that “instability” does not mean your pelvis is physically out of place but rather your muscles around the pelvis are not providing adequate’ force closure’ or mechanical compression or support around the pelvis while the ligaments are lax.

Who is more at risk of developing Pelvic pain due to pelvic instability?

Research has shown that  women who are involved in strenous work, or have a previous history of low back pain and a history of lumbo-pelvic (lower back and pelvis) pain during previous pregnancies are at risk. Although, direct trauma to the pelvis such as a fall can also result in pelvic instability.

How can Physiotherapy Help?

Use of Physical Aids

Physiotherapy can help by identifying the cause of the pain around the pelvis, whether it is originating from the lumbar spine or from pelvic instability. Off loading the pelvis may be important in reducing the symptoms such as using crutches or walking sticks. Tape or pelvic/abdominal belts  can also provide some compression around the pelvis, assisting with stability in the shorter term.

Postural and Movement Education

Being aware of movements or postures that may overload the pelvis, and optimising muscles support around the lumbar spine and pelvis are the most  important factors in managing this condition. Some specific advice on what movements or positions you may need to avoid or adjust can make a big difference in avoiding pain aggravation.

Specific and Appropriate Strengthening Exercises

Improving activation of the deep supporting muscles around the pelvis is also extremely important for providing dynamic control, so

despite laxity in the ligaments, your muscles can assist in compensating for the reduced support that ligaments can give during your pregnancy. Using real time ultrasound to train deep abdominals and pelvic floor muscles, and some of the deep hip/pelvic muscles are beneficial to someone who has pelvic instability. This is followed by a progressive strengthening program matched to the needs of the individual. Your physiotherapist can recommend appropriate Pilates and Pilates-based exercises as well as monitor your progress throughout your pregnancy and even after your pregnancy.

Transversus Abdominis Ultrasound At Rest
Ultrasound retraining of the abdominal wall – Transversus abdominis

If you are suffering from pelvic pain due to instability, see a Women’s Health Physiotherapist and get some good advice on pain management, training in deep muscle activation and an appropriate exercise program.

Image Courtesy of keerati of freedigitalphotos.net

References:

Vleeming et al. (1992). An integrated therapy for peripartum pelvic instability. A study of the Biomechanical effects of Pelvic Belts. American Journal  of Obstetrics. 166 (4): 1243-1247

Wu et al. (2004). Pregnancy-Related Pelvic Girdle Pain (PPP)I: Terminology, Clinical Presentation and Prevalence. European Spine Journal. 13:575-589

Hypermobility and Injuries: What is their relationship?

Hypermobility and Injuries: What is their relationship?

Hypermobility and Injuries

Have you been told that you are double jointed? You may have heard this term before to describe being more flexible than usual. Well, your joints are not “ double” but passive structures such as ligaments and connective tissue allow more stretch than normal.  Continue reading

Back into the Spring of Things

Back into the Spring of Things

Back into the Spring of Things: How to get back on track after the lull in the Winter

In winter, it is normal to feel less motivated with exercise and physical activity. Now that the days are getting longer and nights are shorter we can help you get into the spring of things! Research has shown that being active has many health benefits and helps decrease your risk of chronic disease. But if you don’t know where to begin, here’s a list of activities that are inexpensive and fun, especially if you do them with friends, to help you get started:

Outdoor Activites

Gladwell and his colleagues in 2013 reported that exercise performed outdoors helped increase levels of physical activity and decreased the rate of perceived exertion – that is, for the same amount of energy burnt, it felt easier to exercise outdoors than indoors. Psychological benefits of exercising outdoors include improvement in mood and reduced stress levels. Outdoor activities are not only confined to thrill seeking activities but also include simple activities such as walking or cycling around the neighbourhood, around the park or hiking or trail-riding in the bush. Green exercise is good exercise! Trade the treadmill walking for outdoor walking near the river or amongst the trees.

Walking & Running

An outdoor activity such as walking, especially one that accomplishes 10,000 steps a day, can help reduce the risk of developing chronic diseases such as cardiovascular disease, obesity and diabetes (Brown et al 2006) and in a study done in Rockhampton where they walked 10,000 steps for 15 weeks, it was found that the participants reported improved well-being and fitness levels. Using a pedometer to track the number of steps has been found to be effective in increasing physical activity (Chan et al 2004) and significantly decreases Body Mass Index (a measure of determined by height and weight) and blood pressure (Bravata et al 2007). Walk to work if you can and incorporate it to your daily activities.

If walking on the streets is not exciting enough then hiking or nordic walking (walking while using poles) also benefits resting heart rate, exercise capacity and improves quality of life of people with various diseases (Tschentscher et al 2013).

You then may be able to progress to increasing your pace and start adding some jogging or light running intervals to increase the intensity of the exercise. If you have never been much of a runner though, it might be a good idea to have a running assessment and get some instruction on good form and training techniques from your physiotherapist. Always progress a new activity slowly, and if you do develop niggles anywhere, don’t ignore it, pop in for a check-up and advice so we can keep you on the road.

Back into the Spring of Things - beach_running

Cycling

Is your work near your home? Then ditch the car and ride the bike. In Brisbane city, we have access to public bicycles and they are situated in different, easy access locations around the city. Just like walking, researchers have found strong evidence for fitness and health benefits and moderate evidence for risk factors for cardiovascular disease (Oja et al 2013).

Did you know that countries such as Netherlands and Germany have included promotion of safe walking and cycling in their campaign for improving public health (Pucher, Dijkstra 2003). Just recently in July, the Australian Walking and Cycling Inc (AWCC) was formed and it is the only national forum in Australia that has focused on research and promotion of mobility in Australia. They have recently joined forces with the Heart Foundation, which aims to prevent premature death caused by cardiovascular disease in Australia. Be part of the movement! Live long!

mountain_biking

Clinical Pilates

Now, if you are limited by time or musculoskeletal injury, Pilates is a good way to get active if grunting in the gym and crossfit are not your thing. Pilates-based exercise and functional strengthening have been very popular in recent years, especially for people who enjoy performing slow, controlled movement. In fact, for rehabilitation, this form of controlled movement retraining and strengthening under the guidance of a physiotherapist, can provide an ideal foundation for return to normal daily activities and for dynamic higher level sports or work tasks. There is evidence that Pilates helps improve functional ability and decrease pain in people with chronic low back pain (Wajswelner et al 2012). It can also help improve dynamic balance (Johnson et al 2007) which would be beneficial both if you are feeling a little unsteady on your feet, or for higher level sporting activities where balance and control is critical for performance and injury prevention.

As we mentioned above, green exercise is good exercise. You get the best of both worlds with the outdoors all around with our Pilates classses. Try it out.

barrel exercise annie

Now we have given you something to think about, have you decided what activity you would like to spring back into? Once you have decided, set a goal and train for it.

Here are some useful links to activities around Australia for events you may be interested in:

https://www.runningcalendar.com.au/

http://www.cycling.org.au/Events/Events-Calendar

If you are still not sure where or how to start, come and see one of our highly trained physiotherapists to help you spring back into action.

References:

Bravata et al (2007). Using Pedometers to increase Physical Activity  and Improve Health: A Systematic Review. The Journal of the Americal Medical Assoc. 298 (19)

Brown et al (2006) 10,000 Steps Rockhampton: Evaluation of a Whole Community Approach to Population Levels of Physical Activity. Journal of Physical Activity and Health 1:1-14

Johnson et al (2007). Effects of Pilates-based exercises on Dynamic Balance. Journal of Bodywork and Movement Therapies . 11 (3)

Oja et al (2103) Health Benefits of Cycling: A systematic Review. Scandinavian Journal of Medicine and Science in Sports. 21(4)

Pucher,Dijkstra (2003). Promoting Safe walking and Cycling to Improve Public Health: Lessons from the Netherlands and Germany. American Journal of Public Health . 93(9)

Tschentscher et al (2103).Health Benefits of Nordic Walking. American Journal of Preventive Medicine . 44(1)

Wajswelner et al (2012). Clinical Pilates vs. General Exercise for Chronic Low back pain: Randomized Control Trial. Med Sci Sports Exerc . 44 (7)