Viewing posts categorised under: Clinical Exercise program
The low down on Hip Replacement
The current state of affairsHip replacements are becoming increasingly common. Currently 1.3 people in every 1,000 will undergo a hip replacement operation, and more than 1.2 million are carried out each year worldwide. The biggest risk factors for needing a hip replacement are age and arthritis, with 85% of people having a hip replacement, also having osteoarthritis. In terms of gender, women have a higher risk of needing a hip replacement (58%) compared with men (42%). Hip replacement surgery in patients aged 45-54 has also doubled in the past 10 years.
What can we do, to reduce the risk of needing a hip replacement?Physical activity helps. Running decreases your risk of developing osteoarthritis by 18% and as osteoarthritis is present in 85% of people who undergo a hip replacement, this has a knock-on effect in reducing your risk of needing a hip replacement by 35-50%. And if you’re not up for running that’s OK, walking can also reduce the risk of needing hip surgery, although by a smaller percentage (23%). Almost half of the protective effective of being physically active comes from weight control. The higher your BMI, the greater your risk of needing a hip replacement.
And what can you do if you’re already experiencing hip pain?If you need a hip replacement then the sooner you have it, the better the outcome is likely to be and the quicker you will recover from your operation. This is because the more pain you suffer prior to having surgery, the more compensations and adaptations the muscles and soft tissues will have made around the joint, in an effort to try and protect it and you from that pain, and the harder that will be to re-train once you’ve had the operation. That’s not to say it can’t be done, it will just take a bit longer and need a bit more of an investment in your time and energy. The good news is that outcomes from hip replacements are very good. Developments in materials and surgical techniques, mean that the artificial hips are lasting longer, and success rates are very good, with more than 80% of people experiencing pain relief and functional improvement, meaning their daily lives become easier and they’re able to do more.
We hope you find this information helpful and if you have any questions or queries, please feel free to get in contact with us 6676 4000 or 6676 4577.
We are running the GLA:D program as a preventative for surgery for hips and knees with osteoarthritis.
What is an exercise physiologist?An Accredited Exercise Physiologist (AEP) is a university qualified allied health professional who specialises in the delivery of exercise and lifestyle programs for healthy individuals and those with chronic medical conditions, injuries or disabilities. AEPs possess extensive knowledge, skills and experience in clinical exercise delivery. They provide health modification counselling for people with chronic disease and injury with a strong focus on behavioural change. Working across a variety of areas in health, exercise and sport, services delivered by an AEP are also claimable under compensable schemes such as Medicare and covered by most private health insurers. When it comes to the prescription of exercise, they are the most qualified professionals in Australia. What makes AEPs different to other exercise professionals?
- They are university qualified
- They undertake strict accreditation requirements with Exercise and Sports Science Australia (ESSA)
- They are eligible to register with Medicare Australia, the Department of Veteran’s Affairs and WorkCover, and are recognised by most private health insurers
- They can treat and work with all people. From those who want to improve their health and well-being, to those with, or at risk of developing a chronic illness
- Diabetes and pre-diabetes
- Cardiovascular disease
- Arthritis and osteoporosis
- Chronic respiratory disease and asthma
- Depression and mental health conditions
- Different forms of cancer
- Musculoskeletal injuries
- Neuromuscular disease
- And much more!
Feeling The Pinch?
The Stubborn Shoulder Impingement SyndromeDo you get a sharp, debilitating pain in your shoulder when you are performing tasks like brushing your hair, putting on certain clothes or showering? During these movements, where you raise your arm out to the side and then upwards over your head, do you alternate between no pain and pain? For example, during the first part of the moment you don’t feel any pain, and then suddenly your shoulder “catches” and there is sharp pain, followed by no pain again as you continue to move your arm upwards. These are all signs of a condition called Shoulder Impingement Syndrome (SIS), where the tendons of the rotator cuff muscles that stabilise your shoulder get trapped as they pass through the shoulder joint in a narrow bony space called the sub-acromial space. Impingement means to impact or encroach on bone, and repeated pinching and irritation of these tendons and the bursa (the padding under the shoulder bone) can lead to injury and pain. Shoulder complaints are the third most common musculoskeletal problem after back and neck disorders. The highest incidence is in women and people aged 45–64 years. Of all shoulder disorders, shoulder impingement syndrome (SIS) accounts for 36%, making it the most common shoulder injury. You shouldn’t experience impingement with normal shoulder function. When it does happen, the rotator cuff tendon becomes inflamed and swollen, a condition called rotator cuff tendonitis. Likewise, if the bursa becomes inflamed, you could develop shoulder bursitis. You can experience these conditions either on their own, or at the same time. The injury can vary from mild tendon inflammation (tendonitis), bursitis (inflamed bursa), calcific tendonitis (bone forming within the tendon) through to partial and full thickness tendon tears, which may require surgery. Over time the tendons can thicken due to repeated irritation, perpetuating the problem as the thicker tendons battle to glide through the narrow bony sub-acromial space. The tendons can even degenerate and change in microscopic structure, with decreased circulation within the tendon resulting in a chronic tendonosis.
What Causes Shoulder Impingement?Generally, SIS is caused by repeated, overhead movement of your arm into the “impingement zone,” causing the rotator cuff to contact the outer tip of the shoulder blade (acromion). When this repeatedly occurs, the swollen tendon is trapped and pinched under the acromion. The condition is frequently called Swimmer’s Shoulder or Thrower’s Shoulder, since the injury occurs from repetitive overhead activities. Injury could also stem from simple home chores, like hanging washing on the line or a repetitive activity at work. In other cases, it can be caused by traumatic injury, like a fall. Shoulder impingement has primary (structural) and secondary (posture & movement related) causes: Primary Rotator Cuff Impingement is due to a structural narrowing in the space where the tendons glide. Osteoarthritis, for example, can cause the growth of bony spurs, which narrow the space. With a smaller space, you are more likely to squash and irritate the underlying soft tissues (tendons and bursa). Secondary Rotator Cuff Impingement is due to an instability in the shoulder girdle. This means that there is a combination of excessive joint movement, ligament laxity and muscle weakness around the shoulder joint. Poor stabilisation of the shoulder blade by the surrounding muscles changes the physical position of the bones in the shoulder, which in turn increases the risk of tendon impingement. Other causes can include weakening of the rotator cuff tendons due to overuse, for example in throwing and swimming, or muscle imbalances between the shoulder muscles. In summary, impingement usually occurs over time due to repetitive overhead activity, trauma, previous injury, poor posture or inactivity. When your rotator cuff fails to work normally, it is unable to prevent the head of the humerus (upper arm) from riding up into the shoulder space, causing the bursa or tendons to be squashed. Failure to properly treat this instability causes the injury to recur. Poor technique or bad training habits such as training too hard is also a common cause of overuse injuries. Over time pain can cause further dysfunction by altering your shoulder movement patterns which may lead to a frozen shoulder. For this reason, it is vitally important that shoulder impingement syndrome is rested and treated as soon as possible to avoid longer term damage and joint deterioration.
What are the Symptoms of Shoulder Impingement?Commonly rotator cuff impingement has the following symptoms:
- An arc of shoulder pain approximately when your arm is at shoulder height and/or when your arm is overhead
- Shoulder pain that can extend from the top of the shoulder down the arm to the elbow
- Pain when lying on the sore shoulder, night pain and disturbed sleep
- Shoulder pain at rest as your condition worsens
- Muscle weakness or pain when attempting to reach or lift
- Pain when putting your hand behind your back or head
- Pain reaching for the seat-belt, or out of the car window for a parking ticket
Who Suffers Shoulder Impingement?Impingement syndrome is more likely to occur in people who engage in physical activities that require repeated overhead arm movements, such as tennis, golf, swimming, weight lifting, or throwing a ball. Occupations that require repeated overhead lifting or work at or above shoulder height also increase the risk of rotator cuff impingement.
How is Shoulder Impingement Diagnosed?Shoulder impingement can be diagnosed by your physical therapist using some specific manual tests. An ultrasound scan may be useful to detect any associated injuries such as shoulder bursitis, rotator cuff tears, calcific tendonitis or shoulder tendinopathies. An x-ray can be used to see any bony spurs that may have formed and narrowed the sub-acromial space.
What does the Treatment Involve?There are many structures that can be injured in shoulder impingement syndrome. How the impingement occurred is the most important question to answer. This is especially important if the onset was gradual, since your static and dynamic posture, muscle strength, and flexibility all have important roles to play. Your rotator cuff is an important group of muscles that control and stabilise the shoulder joint. It is essential the muscles around the thoracic spine and shoulder blade are also assessed and treated as these too work together with the entire shoulder girdle. To effectively rehabilitate this injury and prevent recurrence, you need to work through specific stages with your therapist. These stages may include:
- Early Injury: Protection, Pain Relief & Anti-inflammatory Treatment
- Regain Full Shoulder Range of Motion
- Restore Scapular Control and Scapulohumeral Rhythm
- Restore Normal Neck-Scapulo-Thoracic-Shoulder Function, including posture correction
- Restore Rotator Cuff Strength
- Restore High Speed, Power, Proprioception and Agility Exercises
- Return to Sport or Work
- The information contained in this article is intended as general guidance and information only and should not be relied upon as a basis for planning individual medical care or as a substitute for specialist medical advice in each individual case.
The role of Accredited Exercise Physiologists in the treatment of CancerExercise has been established as an effective adjunct therapy for the management of cancer. People with exercise interventions have been shown to experience fewer and/or less severe treatment related side effects and have enhanced physical and psychological outcomes after a cancer diagnosis. This current evidence has led to calls for exercise to be incorporated into routine cancer care throughout all phases of the cancer care continuum – before, during and after treatment. Current evidence-based guidelines recommend all people with cancer:
- Avoid inactivity and return to normal daily activities as soon as possible following diagnosis
- Progress towards and maintain participation in regular moderate to vigorous intensity aerobic exercise and resistance exercise each week
- Exercise recommendations should be tailored to the individual’s abilities noting the specific exercise programming adaptations may be required for people with cancer based on disease and treatment related adverse effects.
- improve functional ability/capacity
- improve health related quality of life across various domains including physical, mental and social wellbeing, cardiorespiratory fitness, muscle strength, endurance, and power
- reduce cancer-related fatigue
- reduce psychosocial distress, and
- positively influence body composition.
- cancer-specific mortality for certain cancer types including breast, colorectal and prostate cancers
- cancer recurrence for certain types of cancer including breast, colon and prostate cancers
- all-cause mortality and development of new cancers
- developing comorbid conditions including cardiovascular disease, osteoporosis and diabetes
Moving Beyond Cancer at Cabarita and Pottsville PhysiotherapyMoving Beyond Cancer is an exercise class specifically designed by an AEP for people at any stage along the cancer continuum. The class enhances not only the physical wellbeing, but also the mental wellbeing to the lives of those with cancer. The exercises are tailored to the individual’s abilities, the program is patient-centred, and is responsive to individual patient needs, goals and preferences. An initial assessment is conducted by an AEP prior to joining the class. The classes are individualised exercise programs in a small group setting (1-5 participants). All sessions are EPC and Health Fund rebatable. For more details of our Moving Beyond Cancer Class follow this link
Moving Beyond CancerIf the effects of exercise could be purchased in a pill, it would be prescribed to every person with cancer. Even if the exercise pill had just a few of the positive health benefits that exercise provides, it would still be viewed as a miracle drug Exercise and Sports Science Australia’s (ESSA) current evidence-based guidelines recommend all people with cancer to exercise regularly to help combat cancer and cancer treatments People with cancer who exercise regularly have lower risk of dying from cancer, lower risk of the cancer coming back, and fewer and/or less treatment related adverse events
Moving Beyond Cancer Class Information
- Safe and effective exercise program specifically designed for people with cancer and cancer survivors
- Involves individualised exercise programs in a small group (1-5 participants) delivered by an Exercise Physiologist
- Counteracts the adverse effects of cancer and its treatment
- Enhances both physical and mental wellbeing
- Is based on the latest scientific research
Benefits of Moving Beyond Cancer:
- Improved health and wellbeing
- Reduced severity of anxiety and depression
- Increased energy levels and reduced fatigue
- Improved lung function
- improved strength and increased muscle mass
- maintained physical function and ease in activities of daily living
- improved balance and reduced falls risk
- improved state of mind and reduction in stress levels
- improved heart function and reduced risk of heart disease, diabetes, osteoporosis and other forms of cancer
- improved bone strength and joint function
- improved quality of life