The holidays are coming to an end, the kids will be going back to school and back into routine. It can be a busy and even stressful time trying to get school supplies, uniforms and schedules organised for the new school year. Fear not, we have put together a quick guide to ensure your kids have a healthy school year and avoid injuries from back to school related activities.
The New Year is almost upon us and chances are you are planning and setting some goals or at least thinking about how you want 2018 to unfold. Whether you have decided to get back into exercise, focus more on your health, run a marathon or tackle a long-standing injury – we are here to help!
It’s all well and good to set New Year’s resolutions, but the struggle comes in sticking to these resolutions and accomplishing them. Having the right resources and support around you can make all the difference! Your Physiotherapist is here to help you reach your goals.
These are just a few of the things your Physiotherapist can assist with to make 2018 a great year:
Are you a Mum? Was 2017 all about helping others? Maybe 2018 should be about “filling your own cup”, because how can you look after others if you are not healthy? Lauren loves to help Mums of all ages achieve their goals; whether it be improving their pelvic floor muscles, decreasing their aches and pains or feeling stronger.
Setting a New Year's Resolution to get back into running? Karolina treats many runners and can assist you in creating a plan, so you can get back to running and avoid injury! As a runner herself, Karolina can not only help you with any current injuries and injury prevention, but can also help you come up with the best training plan. Karolina can do a video analysis of your running to give you specific tips to have you running much faster and more efficiently!
Are you an athlete looking to make the most of your pre-season training? Or perhaps you have an injury that needs some rehab before the sporting season starts again. Courtney enjoys seeing the sporting population. She can help you perform at your best for the 2018 season.
By sharing your goals with others, you are more likely to achieve them. Be sure to let your Physiotherapist and the Embody Team know what your goals for the New Year are.
Call us on 6110 3331 or book online so we help you accomplish a healthy 2018!
Jingle Bells, Jingle Bells…It’s that time of year… That joyful season where we catch up with family and friends, eating and drinking far too much, giving and receiving gifts and enjoying the beautiful summer days! For most of us though, it is also a very busy period, where we rush around for last minute gifts, the shops and carparks are full of people, there is places to be and a long list of things to do. That’s cause enough for a headache! However, if headaches are a common occurrence in your daily life, you understand how debilitating they can be. Now might be a good time to resolve that pain. After all, you don’t want to have one of those horrible headaches whilst Christmas shopping, Jingle Bells paying on repeat!
There are many types of headaches. However, one of the most common forms of headaches are ‘tension headaches’. Just like the name suggests, these are most commonly a result of excessive tension caused by a variety of factors. Most people ignore these headaches, accepting the pain or they take medication, which is often ineffective. You don’t have to put up with these headaches and you shouldn’t. Physiotherapy treatment can be extremely effective in alleviating pain associated with tension type headaches. In fact, this is a common thing we treat at Embody.
Most tension headaches will be a result of the muscles in the upper back and neck being stiff. Factors such as stress, fatigue, poor posture and looking at a computer/phone for too long are some of the contributing causes.
A common symptom for tension headaches is the feeling of pressure in the head. Some people will experience the pain behind their eyes and particularly at the back of the head. Neck pain is a major cause of tension headaches and many people will experience a stiff and tender upper back. If you have a tension headache, it will be difficult and painful to move your neck.
Physiotherapy treatment has become one of the most prominent and successful treatment forms for alleviating tension related headaches. At your consult your Physiotherapist will assess you and determine the cause of your headache. They will assess the possibilities of why your neck may be stiff and address this. A variety of treatments will be administered depending on the individual. This may involve joint manipulation and mobilisation in the upper spine to address postural issues. Stretching and strengthening will also be prescribed to establish long term pain relief. Another treatment may be dry needling, you can read about this here.
Headaches? Call us on 6110 3331 or book an appointment online so we can help you with your health this Christmas.
What is Dry Needling?
Dry Needling is the insertion of a very fine, sterile needle into tight and stiff muscles (also known as ‘trigger points’). The aim is to relieve pain caused by these muscles by reducing tenderness. Dry needling can also help to increase the circulation to a muscle. It is an effective treatment for regaining movement and alleviating pain.
Dry Needling can be beneficial for a wide range of musculoskeletal problems, including (but not limited to): low back pain, tension headaches, shoulder pain, tennis elbow, buttock pain, calf tightness/spasms.
How does it actually work?
In simple terms the needle releases those stubborn tight muscles. Usually the needle is left in for a minute, or several minutes. The Physiotherapist may also ‘fan’ or move the needle to elicit a twitch. This causes the muscle to loosen and as a result alleviates pain in that area.
What does it feel like? Is it painful?
Most clients describe a cramping sensation, or a small electric shock feeling – some find it hard to describe, others don’t feel the needle go in at all!
Are there any side- effects?
You may feel a temporary ache (or sometimes tightness) in the area – this should dissipate within 24 hours. Side effects are usually mild, and may include bruising, fatigue and a temporary increase in pain. Dry Needling is a safe technique, and the side effects are minimal compared to drugs or surgery.
Often people ask about the risk of infection. Strict regulations require an aseptic procedure, involving a sterilised needle, with single use (per client), alcohol swab wipes, adequate practitioner hygiene (hand washing) and correct disposal of needle (sharps bin). Infectious status must be declared via the client (usually via a New Client form) and likewise the practitioner is responsible to have no infectious status.
Trained health professionals have the anatomical knowledge and practice to avoid any areas of the body which may impose more risk. So yes, Dry Needling is very safe!
Ongoing muscle soreness or stiffness? Dry needling may well be the solution. Call us on 6110 3331 or book an appointment online to discuss how dry needling can help you.
8 Reasons to See a Physiotherapist
You may be aware that a physiotherapist is a healthcare professional who focuses on the musculoskeletal system. They help improve mobility, relieve pain, and much more.
But the exact reasons people come to physiotherapy vary as much as the treatments themselves. Why should you see a physiotherapist? Keep reading, and you may discover that you’re long overdue a visit.
1. Your doctor is too busy.
Physicians can treat physical injuries, but many don’t have the availability to spend the kind of time with a patient that a physio does. They also may not have the training to provide the particular kind of hands-on treatment that a physiotherapist does.
2. You need a diagnosis.
Or, you want a doctor’s diagnosis confirmed, or explained in greater detail. Physiotherapists are anatomy experts who can teach you more about your body and how it works.
And there’s no need to worry that you’ve come to the wrong place. Physiotherapists know when you need them, and they also know when you need a different specialist or physician.
3. You’re trapped at a desk.
Humans didn’t evolve to sit all of the time. Moreover, focusing on a screen constantly as you do so can distract you from being aware of any tension or problematic posturing that will eventually cause pain.
A physio will get you moving with purpose. You’ll increase your flexibility and learn more about what’s making you ache. This way, you can learn to build healthier habits that are easier on your spine.
4. You’re very active.
If you’re a competitive athlete, a physiotherapist will have this in mind as they aid in your recovery. They’ll take your fitness level into account and teach beneficial exercises to do on your own time.
This way, when you’ve got a clean bill of health, you can get back to what you love to do. You’ll leave with a greater understanding of what went wrong, and how to avoid it in the future.
5. You have lingering pain from a traumatic injury.
If you’ve suffered a traumatic injury, like a car accident, the hospital is (and should be!) the first stop on the road to recovery. Yet many of us know that months down the road, we’re left with lingering reminders of those injuries.
Physiotherapists understand that just because an injury has technically healed, it doesn’t mean that it no longer impacts your body. They can help you work through any remnants of the trauma.
6. You have chronic pain.
Treating conditions like arthritis and fibromyalgia often involve a multi-prong approach and lifestyle changes in order to enjoy lasting results.
Seeing a physio is essential to anyone who is trying to manage their life while dealing with chronic pain. Specialists in muscle and joints, physiotherapists are uniquely qualified to help you sort out what treatments (heat, cold) and exercises are appropriate, and when.
7. Returning pain is stifling you.
Consistent painful flare ups are a major sign that something needs to change. If you’re trying to avoid surgery, a physiotherapist is your best course of action.
Physios know how to relieve pain because they understand precisely what’s causing it. They can also help you alleviate other worrisome symptoms like numbness or tingling. Additionally, they’ll help identify what causes your flare ups, so you know how to avoid aggravating it further.
8. You’re focused on healing.
Finally, it’s very valuable to recognize that many kinds of illnesses - even mood disorders - take a toll on our bodies.
Building a relationship with a physiotherapist can take extra pain and pressure away, so you can concentrate on true healing and total wellness. It’s one of the most practical, evidence-based ways to care for yourself.
I recently went to a lecture for Physiotherapists discussing lower back pain in adolescents, with the focus being on pars stress fractures. I was surprised at some of the statistics for the prevalence of stress fractures, and decided that I would like to discuss it in this month’s blog. So if you are OR have a teenager with back pain, keep reading.
In athletic adolescents with back pain, up to 47% have spondylolysis (a pars stress fracture). This statistic is only 5% in athletic adults with back pain.
This means that HALF the teenagers who walk into our practice with lower back pain and whom are participating in an elite or ‘at risk’ sport, have a pars stress fracture. Huge statistics, that even I was surprised by.
In fact the most common causes of adolescent back pain are pars fractures, and/or poor control/loading/hypermobility disorders. Less common, but not to be missed, are disc injuries, scoliosis factors, Scheuermann’s disease and rheumatoid conditions.
What is a pars stress fracture?
A small stress fracture of the lumbar vertebrae, at a site called the pars interarticularis (see image). This is also known as a spondylolysis. The most common level for this is L5.
Who is most at risk?
This injury often occurs in a young sportsperson whose sport involves repetitive or excessive extension and/or rotation of the lumbar spine. Such sports include gymnastics, ballet, cricket (fast bowlers), tennis, rowing, diving, track and field throwing, pole vault and high jump. Other risk factors include: a growing/maturing skeleton, heavy training loads, poor lumbo-pelvic control and posture. These are teenagers who usually have poor awareness, can’t dissociate their pelvis/lumbar from hip movements, have weak glutes and tight/weak hamstrings, an increased lordosis and can’t eccentrically contract their hip flexors.
What are the signs and symptoms?
- Unilateral lower back pain - in a focal area. This can sometimes refer into the buttock/thigh of the same side.
- Tenderness over the site of fracture.
- Pain with lumbar extension (bending backwards/arching lower back) and rotation or side-bending to this side.
- Pain during their sport.
Do they need a scan?
Yes. Diagnosis is confirmed by imaging, and MRI is the preferred choice here (this will show any bone marrow oedema). Often if we suspect a Pars Fracture, we refer to a Sports Physician who will then refer on for appropriate imaging. They may also consider a SPECT or a CT scan. X-rays will only pick up the late stages of a fracture (when it has been there for several months), and may miss it during the bone oedema/early stages – where the chance of healing is at it’s best.
A scan is often repeated throughout rehab to ensure that the client is on the right track and if further rest is needed. In an elite sporting setting it is not uncommon to have 3+ MRIs. However, amongst the general population price and convenience must be factored in. As a minimum, one MRI is recommended for diagnosis and another at the 2-3 month mark (to track progress). You do not want to leave the second MRI too long in the case that it is too late to make changes to rehab if the fracture has progressed. Some companies will offer bulk billing options for this.
What is the management/treatment?
- First and foremost – activity modification. This usually means rest from their sport. This is an extended rest, and most Sports Doctors and Physio’s will recommend 3-4 months off (as a minimum). This is CRUCIAL for healing, there are no quick fixes. A pars fracture picked up early has a good chance of healing. However, if diagnosis is delayed or the client does not adhere to this rest, then the chances of healing (or fracture ‘union’) are less likely and this opens the risk of lower back pain and problems into adulthood.
- During this rest period, rehabilitation should be done. This should be done with a Physio or Exercise Physiologist (and usually involves the team coach or strength and conditioning staff at their sporting club). The goals of rehab are individual, but usually involve:
- Core control and strengthening – particularly transversus abdominus and multifidus.
- Gluteal strengthening.
- Lengthening hamstrings (which are usually in spasm).
- Postural corrections and awareness – especially if excessive lordosis.
- Anti-lordotic bracing is currently still debated. It is generally not standard practice to prescribe one of these. However, if the client is unable to correct or control their excessive lumbar arch then this may be warranted in the initial month of rehab.
- By around week 12 we get the client to recommence running/sprinting sessions.
- At later stages (usually around week 16-20) – sport specific drills. This may involve technique correction if this is an issue. Sport specific training should be done for 4-6 weeks before competing.
- Hands on treatment will sometimes be recommended if there are tight muscles that need manual release or if there are stiff thoracic segments (usually lumbar spine is hypermobile and doesn’t need mobilising).
Should Exercise Rehabilitation be supervised?
Yes! As much as possible. Initially we are trying to correct poor postures and movement patterns. If the client is doing an exercise with poor technique then it might not have the benefits it should OR could even worsen things. Our adolescent clients tend not to be the best with remembering/adhering to their exercises either, so supervised sessions ensure they are getting their rehab done with the best form possible.
How can I prevent a pars stress fracture?
- Increase sporting load gradually. For a growing adolescent, it may be appropriate to choose one sport at a given time. Teenagers more at risk are those participating in multiple sports at the same time, particularly if heavier load (involving lots of running and jumping).
- Take at least one or two days off from sport each week.
- Maintain good hip mobility (including hamstring and glute length), good core and gluteal strength.
- If your child is very active and complains of lower back pain, then seek the attention of a Physio or Sports Physician. Remember, early diagnosis has a far better shot of healing!
Written by Courtney Kranz, Physiotherapist and Pilates Practitioner at Embody Physiotherapy + Pilates.
1. Brukner P & Khan K, CLINICAL SPORTS MEDICINE, 4th Edn, McGraw-Hill Australia. North Ryde, NSW.
2. Cavalier R et al. (2006). Spondylolysis and Spondylolisthesis in Children and Adolescents: I. Diagnosis, Natural History, and Non-surgical Managament. J Am Acad Orthop Surg, 14:417-424
3. Perth Radiological Clinic, Sports Imaging Series; Speakers: Sandra Mejak, Nick Jones & Peter Counsel. 4th May 2017.