Our physiotherapist, Dr Chen has written an article summary about headaches associated with Hypermobile Ehlers-Danlos Syndrome (hEDS) and Marfan Syndrome. Click here to link to her blog post.
Our physiotherapist, Dr Chen has written an article summary about headaches associated with Hypermobile Ehlers-Danlos Syndrome (hEDS) and Marfan Syndrome. Click here to link to her blog post.
If you are pregnant or planning a pregnancy and you are unsure about the current guidelines for physical activity and what is safe, this is a must read! An excellent team of experts have appraised over 27,000 manuscripts and abstracts (Davies G & Artal R., 2019) in order to bring us the most up to date information and guidelines on physical activity during pregnancy.
Physical activity during pregnancy:
(Mottola MF, et al., 2018)
There are other considerations specific to the mother during pregnancy and physical activity. These include, but are not limited to, the pelvic floor and risk of overload/prolapse as well as pelvic pain. If you are planning a pregnancy/already pregnant and have a history of pelvic pain or pelvic floor concerns, it is important to see your physiotherapist before commencing physical activity. Here at Physiotec, your women’s health physiotherapist can assess your pelvic floor muscles to ensure you are using them correctly, assess and address other areas of concern such as low back pain or pelvic pain and advise you on the safest exercises during pregnancy as well as into the post-natal period. You might also like to join one of our Pilates classes to stay strong or build strength and control before, during or after your pregnancy.
It’s spring time and for many it’s a sign to start getting fit for summer. For those who had been hibernating during winter it is worth taking note of these following tips to bulletproof yourself for the months of running ahead.
If you have pain running and you’re unsure about why, STOP! Go see your GP or Physiotherapist, find out why you have a problem and then deal with it. Many running related pains are easily dealt with, but some, if left untreated, can become chronic problems.
Enjoy your running! Every session you do doesn’t have to be better than the last one. Schedule easy runs for yourself where you don’t worry about pace and just enjoy a nice easy trot!
When is it safe to begin resistance training?
It is a common misconception that resistance training in children stunts growth. Many parents and coaches remain convinced that weight training will result in short stature, due to potential damage to the growths plates (epiphyseal plate).
In actual fact, The Australian Strength and Conditioning Association (ASCA) have developed a position stand on youth resistance training, which is in contrast to these beliefs.
At PhysioTec, we believe there is a place for strength and condition in children. We maintain that supervision is essential, and believe that this is an ideal time to condition young developing children and adolescents to a level where there body can not only withstand, but excel in their chosen field.
Are you still unsure?
Well, if a child is ready to participate in organised and structured sports, such as cricket, football, rugby and basketball then they are generally ready to perform a supervised resistance-training program. This will allow them to handle even the most intensive sporting schedules
Consistency with training is vitally important. Those who train week in and week out will experience steady improvements in fundamental lifting skills, strength and muscularity over time. Assess your weekly routine and see when you can fit in at least 2-3 30-45 minute sessions per week into your schedule
The “RAMP” system provides a method by which warm-up activities can be classified and constructed. This system identifies three key phases of effective warm-ups.
Activities included in the ‘Raise’ section can be used to increase body temperature and blood flow. The ‘Activate and Mobilise’ section can be used to optimise strength, control and dynamic flexibility around areas central to performance in the gym. The ‘Potentiation’ section provides an ideal time to carry out activities such as speed and plyometric training in order to prepare the body to work at maximal capacity.
You do need to be very strict with your exercise form, and you need to learn the right type of form for your body on various lifts. This is especially important for bigger exercises like squats and deadlifts where the risk of injury is inherently higher than, say, dumbbell curls. Developing competency in the major compound lifts such as the deadlift, squat and lunge will reduce the likelihood of injury in the gym and can ensure you train consistently throughout the year and reach your goals.
To make a muscle grow, it must be stimulated on a regular basis. Compound exercises are designed to stimulate a lot of muscles throughout the body. For example the deadlift stimulates the forearms, traps, lats, scapular retractors, spinal extensors, glutes and hamstrings, even the core and quad muscles This helps explain why deads are such a great exercise. However, if all you did was deadlift, your pecs, delts, and biceps wouldn’t come close to reaching their full hypertrophy potential. Make sure your programs regularly incorporate enough exercises that combine to thoroughly hit the entire body.
Progressive overload is the most important aspect in the strength game. If you embark on a strength training regimen and fail to get stronger, you won’t gain much muscle. You must use heavier loads and perform more reps over time.
As you get more experienced in the gym, you should see dramatic strength progress compared to your beginning level in a squat variation, a deadlift variation, some kind of upper body press, and an upper body pull. And if you want to be your absolute best at anything, be it squats, deadlifts, bench press, power cleans, or even Turkish get-ups, then you need to perform the lifts consistently to groove the neuromuscular patterns and maximize motor learning. Failing to do so will leave unachieved progress on the table.
Nutrition is key when it comes to strength development. The best training program in the world is no match for a poor diet.
If you want to develop strength and perform optimally, then you must take nutrition seriously. You need to take in the right amount of calories and the right blend of macronutrients for your goals and physiology. You don’t have to be perfect 24/7, but eating a consistent amount of carboydrates, protein and fats can help with strength and hypertrophy gains.
Some folks need more sleep than others and some can perform well with less, but you should still care about your sleep (quantity and quality) and prioritize it. Make a genuine effort to be consistent with your sleep schedule if you’re serious about getting results. Failure to do so will hinder your pursuit of strength and hypertrophy.
Regarding stress, your goal shouldn’t be to eliminate it altogether, but rather to optimize it. It’s good to be challenged in life, but there’s a fine line between eustress (positive stress, like a good workout) and distress (negative stress, like 65 hours a week at a job surrounded by toxic co-workers). Aim to stay in eustress most of the time for maximum results. Step back and analyze your life choices and habits. This is an area in which many lifters can make adjustments that lead to immediate results.
At Physiotec, we see many people with persistent hip and lower back pain. A lot of them are fearful regarding resistance training or are unsure what types of exercises are appropriate for them. There is often a misconception surrounding resistance training regarding its potential to be harmful or unsure for patients with persistent pain. At Physiotec, we aim to create an environment, which promotes strengthening in a safe and graduated way.
There are many benefits of resistance training including improving muscle mass and bone density, injury and falls prevention and overall movement patterns. In our new strength and conditioning gym, you have a unique opportunity to be closely monitored by a physiotherapist who combines their excellent knowledge of pain science and resistance training in the overall management of your condition.
All our assessment and management programs are 100% individualized to suit your specific needs. Whether you are young or old or are experienced or inexperienced with resistance training, our Gymstart program offers you a new and exciting approach to the management of your presentation.
Ever hurt yourself on a Friday night or Saturday and wished you could have your injury seen to? Did you know Physiotec now offers Injury Clinic every Saturday from 11:30am-1:30pm. One of our skilled Sports Injury & Performance Physiotherapists will be on staff every Saturday to cater for the acute injuries sustained during Friday night/Saturday. The right advice and early management makes all the difference. Get treatment/advice now. Don’t wait!!!
We also have a normal clinical service and pilates on Saturday morning, but reserve places with one of Sports Injury & Performance team specifically for acute injuries that require urgent assistance.
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.
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).
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 Therapy, Medicine 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.
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.
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.
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
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
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.
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.
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.
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
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