10 Steps to manage Chronic Pain
- Be Realistic
- Get Involved
- Learn Relaxation and the Value of Distraction
- Recognise Thoughts and Feelings
- Safe Movement
- Set Priorities
- Set Realistic Goals
- Know your Basic Rights
- Rediscover Hope
By using these strategies you will find that you can:
- Regain control
- Increase your sense of wellbeing
- Step out of the pain – tension – stress cycle
- Begin to get your needs met
- Lessen suffering
14 Tips to get a better night sleep
- Eat for sleep: your body needs whole grains, nuts and green leafy vegetables to produce melatonin and serotonin – the sleep hormones
- Have your last meal 2 hours before bed so that digestion is complete, your blood sugar has stabilised and your body is ready for rest and rejuvenation. Make sure you are not going to bed hungry
- Drink enough water so you are not waking up thirsty during the night
- Make a lavender spray for your pillow (with water and pure lavender essential oil) lavender produces a deeper more restorative sleep
- Have a hot shower or bath 1-2 hours before bed – we sleep better on a decreasing temperature. As you get out of the hot bath your temperature will slowly decrease triggering sleep hormones to kick in
- Put lavender essential oil and magnesium salts in the bath. Magnesium is a known muscle relaxant and will help you wind down
- Have plants in your room to keep the air fresh (especially if you close all the windows)
- Switch off all electronic devices 2 hours before bed – back lit devices prevent melatonin from being released (which is our sleep hormone)
- If your mind is busy try reading a book in bed to calm the mind.
- Check your room temperature is somewhere between 18 and 25 degrees
- Expose your eyes to sunshine as soon as you wake up to stop melatonin and balance the bodies sleep / wake cycle
- Have a sleep routine: aim to go to bed and get up at the same time every day
- Avoid alcohol in the evening– it might help you to get to sleep but your sleep will be lighter, disruptive, and less restorative.
- 10pm is when melatonin production should be at its highest - so be sure to get to bed by 10pm every night.
What is the Pelvic Floor?The Pelvic Floor consists of muscle and connective tissue, which form a sling across the base of the pelvis (like a hammock). It is a group of muscles even though it is referred to as a single muscle. The pelvic floor has three openings that run through it, the urethra, the vagina, and the rectum The Pelvic Floor –
- Supports the pelvic organs, specifically the. bladder, vagina, uterus and bowel
- Contributes to the closing pressure of the urethra, vagina and anus
- Is important for bladder and bowel control and sexual function
- Withstands abdominal pressure which is increased during coughing, sneezing, vomiting, lifting, laughing etc
- Works with abdominal and spinal muscles to support your spine
- Assists with pregnancy and childbirth
Signs of a weak Pelvic Floor
- Urine loss when you cough, sneeze, lift or exercise
- Frequency – passing urine more then 6-8 times a day
- Urgency –
- an urgent need to pass urine
- Unable to hold until you find a toilet
- Prolapse – you may feel a bulging, dragging or heavy sensation
- Poor control of wind
- Decreased sensation and tone in the vagina during intercourse
- Difficulty evacuating bowel motions
- Unable to completely empty when you pass urine
- Frequent urinary tract infections due to poor bladder emptying
What to do about DOMS (Delayed Onset Muscle Soreness) What causes it- Intense training can cause micro damage to muscles which leads to lactic acid being release within the muscle – this causes the pain and stiffness we feel after exercise. What to do
- Light exercises like walking and swimming help to loosen the muscles and improve circulation
- Ice bathing is what the pro athletes do
- Foam rolling
- Gentle yoga
- Drink a lot of water
- Drink protein shakes after heavy weights sessions to help prevent muscle breakdown and soreness.
What is Stress Urinary Incontinence?Stress urinary incontinence is the involuntary release of urine during laughter, coughing, lifting of objects or any movement that increases pressure on your bladder. Urine is composed of water, electrolytes, and other waste material that has been filtered out of the blood in your kidneys. Urine is then transported via the ureters to your bladder, where it is stored. Once full, the muscles in the wall of your bladder contract forcing urine through the urethra and out of your body. Sphincter muscles and pelvic floor muscles keep the urethra closed to avoid leakage of urine. These muscles relax at the same time the bladder contracts in order to allow urine to exit your body.
What Causes Stress Urinary Incontinence?It is caused by a lack of support to the bladder outlet, this is due to both pelvic floor and connective tissue weakness. These tissues act like a hammock to resist the downward pressure on the bladder during increased abdominal pressure e.g.- when coughing
There are several causes for stress urinary incontinence, these include:Hormonal changes During the week before your menstrual cycle, estrogen levels fall, causing symptoms of stress urinary incontinence to worsen. Additionally, as a woman goes through menopause, estrogen levels also fall causing the pelvic floor muscles to weaken. This results in less muscular pressure around the urethra, making stress urinary incontinence more likely. Pregnancy If you are pregnant, you may experience stress urinary incontinence due to hormonal changes and the enlarging size of the uterus. During pregnancy, estrogen levels are lower, leading to less muscular strength in the sphincter and pelvic floor muscles. Additionally, as the fetus grows extra weight is placed on your bladder. Childbirth Vaginal delivery can damage your pelvic floor muscles making urine leakage more likely. The supporting tissues of your bladder can also be damaged during vaginal delivery causing a cystocele, or prolapse of your bladder, symptoms of which include urinary incontinence. You may not know you have suffered damage to your pelvic floor until after you have gone through menopause, when the pelvic floor muscles are further weakened due to a fall in estrogen levels. Poor exercise choices Hysterectomy and other surgery Some exercises will exacerbate a week pelvic floor, these include running, jumping or any high impact exercise. Other exercises which stress the pelvic floor include sit-ups and deep lunges. The bladder and uterus are very close together and have common supporting ligaments and muscles. Surgery to, or removal of your uterus as in a hysterectomy, risks damage to the supporting structures of your bladder. If these supporting structures are damaged, a cystocele is likely to occur. Symptoms of a cystocele include urinary incontinence. Illnesses When you are ill and suffering from severe coughing, the pelvic floor muscles may fatigue and allow temporary stress incontinence due to an increase in abdominal pressure experienced while coughing. Obesity Obesity can increase the abdominal pressure on the bladder leading to urinary incontinence.
How is Stress Urinary Incontinence treated?Treatments of stress urinary incontinence are tailored to suit your individual problem.
The following should be considered:
Pelvic floor muscle strengtheningStrengthening the supporting muscles of your bladder is very effective in helping stress urinary incontinence. Biofeedback, or the use of special computer equipment to measure muscle activity, can help improve muscle control. Electrical stimulation can also assist in strengthening the pelvic floor muscles. • Deep abdominal or core strengthening • Learning the knack – this is when you contract your pelvic floor and deep abdominal muscles prior to coughing (or whatever triggers your incontinence) • Lifestyle changes • Posture • Adjusting activities e.g.- avoid jumping until your symptoms improve • Weight loss if necessary • Vaginal splinting if necessary
Studies show 85% of women with Stress Incontinence are cured with Physiotherapy treatment
To prevent urinary incontinence, you should consider the following:• Routine performance of pelvic floor muscle strengthening exercises • Cessation of smoking • Avoidance or correction of obesity, or chronic cough • Increased daily intake of fiber and fluid to prevent constipation, a risk factor for urinary incontinence • Avoidance of bladder irritants such as alcohol and caffeine • Staying physically active. Individuals who are physically active are less likely to develop urinary incontinence • Discussing the possibilities and risks of estrogen replacement therapy with your physician
Why do you love Pilates: Pilates is the most effective exercise for my body. Since turning 40 my body seems to want to fall apart at every opportunity it gets, but Pilates is holding me together - keeping my muscles strong and supple. I love teaching Pilates and see people move from a chronic pain state to being able to do the activities they want to do in life. One of the great things about Pilates is that anyone can do it and we can tailor the exercises to give you a perfect workout whether you're an elite athlete or about to have your 90th birthday. What is the best thing about being a physiotherapist? I have been a Physio for over 20 years now and I still get such a thrill helping people: whether it is reducing pain, improving movement, helping people with exercises or empowering people to make the lifestyle changes needed to live a healthier life. Best relaxation tip: On a day to day basis focusing on slowing down the breath and breathing more gently. My favourite way to relax is a hot bath with magnesium flakes, some lavender essential oil and a cup of herbal tea - works wonders! Best lifestyle tip: Sleep more and sleep with a regular pattern. (9.30-6.30 works for me) A good night's sleep fixes everything! Oh and gratitude: I try to start and finish the day with thoughts of gratitude for a happier more positive mindset. Favourite activity: As long as it is in nature it doesn't matter: bush walking, surfing, strolls on the beach Favourite recipe: Oh so many to choose from, I love to cook delicious and nutritious food for myself and my family. At the moment our favourite breakfast is an acai bowl, I sneak all sorts of goodies into it: acai, chia seeds, flax seeds, avocado, spinach, bananas, berries, then sprinkle it with some nuts, seeds and fruit - a great healthy start to the day. A typical Sunday: I love to get out into the sunshine first thing in the morning usually down to the beach with my family and our dog, a stretch session, then settle in to relax with breaky, a coffee and the newspaper. The afternoon is spent outdoors, usually at the beach having a surf and playing on the beach or if the weather doesn't allow for outdoor activities curling up with the kids for a Sunday afternoon movie.
MAGNESIUM Magnesium is an essential mineral required by the body for maintaining normal muscle and nerve function, keeping a healthy immune system, maintaining heart rhythm, and building strong bones. Magnesium is also involved in at least 300 biochemical reactions in the body. One of the roles of magnesium is a calcium channel blocker which means it helps muscles to relax. A deficiency in magnesium can lead to many problems but what concerns us as Physiotherapists is it can lead to muscle spasms, cramps and trigger points as well as migraines and osteoporosis. Signs of deficiency include (but are not limited to) dizziness, muscle cramps, muscle weakness and fatigue. Conversely, consuming too much magnesium typically causes diarrhea as the body attempts to excrete the excess. What can I eat to boost my magnesium levels
- Green leafy vegetables (silver beet, spinach and broccoli), nuts and seeds (including brazil nuts, cahews, almonds, hazelnuts and sunflower and sesame seeds) it is also found in grains like brown rice, rye and wheat and fruits such as figs and apricots.
What Causes neck pain?
- Poor posture: Ligaments become overstretched, muscles become tired and joints and nerves are put under strain. Slouching your shoulders with your head forward, sleeping in awkward positions, or working with your head down for long periods can all cause neck pain.
- Stress: Increases tension in the muscles.
- Arthritis: degeneration in the joints of the neck.
- Injuries from motor vehicle accidents, sport or occupational accidents commonly lead to whiplash where the head is thrown forward or backward.
How to prevent neck pain
- Posture: Think tall, lift your chest, relax your shoulders, tuck your chin in and keep your head level. Remember the posture around your pelvis is important too.
- Sleeping: A down or molded pillow is usually best. Avoid sleeping on your stomach.
- Relaxation: Learn to recognize when you are tense, relax your shoulders, avoid clenching your jaw, and take a few deep breaths.
- Heat: A heat pack on your neck will help to alleviate muscle spasm.
- Work: Avoid holding your neck in one position for long periods. Stretch and change position frequently, even if it is just a few shoulder rolls.
- Exercise: Keep your neck joints and muscles flexible and strong by performing the exercises prescribed by your physiotherapist as part of your daily routine.
Five ways to tell if your headache is caused by your neck ?
- Does your pain start at the top of your neck and then spread around to the front of your head?
- Does moving your neck make the pain worse?
- Does prolonged sitting make your headache worse?
- Do you have light headedness or dizziness?
- Is your headache eased by pressure to the base of the skull?
- Check your posture, think tall. Your shoulders should be relaxed, your chin tucked in and your head level. Your neck should feel straight and relaxed.
- Check your sitting position: especially if you are in a sustained position for long periods. You may need to stretch frequently throughout the day.
- Check your pillow: A memory foam pillow is best for most people. Do not use more than one pillow.
- Relax: watch that you are not clenching your teeth, or hunching your shoulders. Learn to recognize when you are tense and learn how to relax. Taking deep breaths or applying a heat pack to the tense muscles may help.
- Exercise: You need to keep your muscles and joints flexible and strong. You will be prescribed an exercise program that is appropriate for you.