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The low down on Hip Replacement

25.02.20

The low down on Hip Replacement

The current state of affairs

Hip 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.

Follow this link to read more - GLA:D program Pottsville and Cabarita Physiotherapy.

 

Back Pain: The Chain of Command

26.11.19

Back Pain

The Chain of Command

Your spine is essentially the chain that forms the ‘backbone’ of your entire body. Without it you would be a blob of muscles, organs and soft tissue piled on the floor. Your spine commands respect because it is the pillar that supports your body, allows you to walk, stand and sit, as well as touch and feel; because it forms the canal connecting the nerves from your body and limbs, to your brain. While your heart may be the vital organ that keeps you alive, without your spine you wouldn’t be able to move. There are three natural curves in your spine that give it an "S" shape when viewed from the side. These curves help the spine withstand great amounts of stress by distributing your body weight. Between the bony vertebra are spongy discs that act as shock absorbers. The lumbar spine (or lower back) connects the thoracic spine to the pelvis, and bears the bulk of your body's weight. Your spine is not rigid though. It allows movement through the intervertebral joints connecting the bony vertebra. These joints allow you to twist, to bend forward and backward, and from side to side. Large groups of muscles surrounding the spine, pelvis, hips and upper body all interact to allow for movements like walking, running, jumping, and swimming. However, there are also muscles deep in your body that work constantly just to maintain your posture when you’re sitting and standing. It is essential that all elements of the spinal ‘chain’ work harmoniously together to ensure fluid movement without overloading structures resulting in injury and pain. Any link in the chain that becomes ‘stuck’ will not only affect that spinal level but also the movement and strength of the chain above and below it. If the muscles around the spine are uneven in strength and length (flexibility) this too can affect the ‘chain’, altering the alignment and motion of the links. Taking care of your spine now will help you lower the chances of experiencing back pain later. Many of the steps you can take to improve the overall health of your spine involve nothing more than practicing better body mechanics, or how you move and hold yourself, when you do daily tasks and activities.

Taking Care of Your Spine

Pay attention to early warning signs or pain. Although back pain is very common and nearly every person will experience at least one episode of back pain in a lifetime, it is essential to address any symptoms promptly. It has also been shown in studies that early treatment and rehabilitation can prevent recurrent bouts of back pain and prevent the development of chronic lower back pain which can be very debilitating, stressful and depressing. It can affect your ability to work, play sport, socialise and sleep, all of which can further compound your pain cycle. Your back pain could be due to inflamed ligaments, damaged intervertebral discs, nerve irritation, bony formations on the spine, muscle imbalances such as weakness or a lack of flexibility, leg length differences, or muscle strains, to name just a few. Even the way we move (or don’t move) at work, school or sport can all be an underlying cause to the current pain.

How Pottsville and Cabarita Physiotherapy Can Help with Back Pain

Your physiotherapist can treat the pain or stiffness experienced from back pain using massage, soft tissue mobilisation, spinal manipulation, heat, acupuncture and other devices. It is important that you, together with your physiotherapist work through a rehabilitation program (specific exercises and stretches) to correct underlying muscle weaknesses, flexibility issues, and the  sequence in which the muscles around your spine work to provide stability.  A physiotherapist can also give you advice on correcting posture / technique for work and sport. Chat to us today about what we can do to help Ph: 0266764000 / 02667644577

Back Pain and Sleep Issues

One of the most common issues back pain sufferers experience is sleep disruption so we have put together an interactive Back Pain and Sleep Guide to help you banish those sleepless nights and wake up feeling refreshed. The guide includes:  
  • 6 Strategies for Improving Your Sleep
  • 8 bedtime stretches to relieve back pain (with video links)
  • Sleeping positions that will help relieve pain (with links to videos)
  • 7 Yoga Poses that will help cure most back pain issues
  • A morning stretch routine that will help ease pain from a restless night (with videos)
  Click this link to find out more and download the guide Disclaimer: This information 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. https://www.facebook.com/pottsvillephysiotherapy  

11 Lifestyle changes you need to make to CURE your HEADACHE

11.06.19

• Correct your posture: think tall all the time, avoid sitting and holding your head up with your hands. • Consider your ergonomics especially your computer set up and how you use your digital devices.  In particular, avoid a forward chin position and sustained head and neck rotation. • Learn to breathe properly: gentle breathing in and out through the nose with movement occurring at the solar plexus not in the shoulder region.  Breathing should be silent and invisible. You should feel the sides of your chest wall expanding as you breathe in, not your shoulders rising or your belly expanding. • Manage your stress levels, you may need to start a meditation practice.  There are many great apps (e.g.- head space, smiling mind etc) to help you get started.  This is particularly important if you clench or grind your teeth. • Get adequate sleep.  Aim to sleep with your head in a neutral position not rotated or side flexed. Aim for an absolute minimum of 8 hours every night. • Eat clean food: avoid processed food, excess alcohol and coffee.  Eat plenty of vegetables! • Drink a lot of water (at least 33ml per kg of body weight / day) add an extra 250ml for every caffeinated drink (such as coffee) you have. • Avoid carrying anything other than a very light bag on your shoulder • Avoid extending the head / looking up for long periods • Watch the position of your head while exercising – ensure you maintain a neutral head position, (i.e. – not look up or around). • Do not over do it when exercising particularly when using your arms and upper body.

OSTEOARTHRITIS OF THE KNEE – Day to Day Tips

26.02.19

Day to day Tips 

 
  • Pace your activities through the day – don’t tackle all the physical jobs at once.
  • Wear low-heeled shoes with soft, thick soles (trainers are ideal). Thicker soles will act as shock absorbers.
  • Use a walking stick to reduce the weight and stress on your painful knee.
  • Use the handrail for support when climbing stairs.
  • Don’t keep your knee still in a bent position for too long, it will stiffen up.
  • Think about modifying your home, car or workplace to reduce unnecessary strain on your knee.
  • Learn to relax your muscles and let the tension out of your body.
  • Use heat/ice packs to help eases pain and stiffness.
  • Knee braces for osteoarthritis are available.
  • Speak to your doctor or therapist first for recommendations or referrals for any of the above.

Cancer and Exercise

      The potential benefits of exercise during and after treatment are significant and research has proved its effectiveness. Exercise during chemotherapy can help ease side effects, such as fatigue and nausea, and can help to boost the immune system of those undergoing cancer treatments. Chemotherapy side effects can sometimes make exercising tough, but it’s recommended to try to be as active as possible during treatment. Benefits of an appropriately prescribed exercise program in this population include improved:

  • Muscle mass, strength, power
  • Cardiorespiratory fitness
  • Physical function
  • Physical activity levels
  • Range of motion
  • Immune function
  • Chemotherapy completion rates
  • Reduced anxiety and depression

What is Osteoporosis?

22.10.18

What is Osteoporosis?

Osteoporosis is a condition in which the bones lose calcium, become fragile and tend to fracture readily. It is most common in women over 40 years of age. Your doctor may organize a bone density scan to see if you have, or are at risk of developing osteoporosis.

What causes Osteoporosis?

  Throughout life bone tissue is very active and is constantly being ‘remodelled’. Microscopic amounts of bone are continually being removed and reformed. The bone continues to thicken until your early 20’s, this is your peak bone mass. After about 40 or 50 years more bone is removed then laid down, and gradually the density decreases. During menopause the decline in oestrogen levels results in an accelerated bone loss.  

Who is at risk?

 
  • Over 40 years old
  • Family history
  • Caucasian
  • Women after menopause
  • Smokers
  • High intake of alcohol, salt, caffeine
  • Sedentary lifestyle
  • If you have dieted during your life and limited intake of calcium rich foods.
 

Exercise and Osteoporosis

  Research shows that regular lifelong weight bearing exercise and light weight training has a positive effect on bone density. Swimming and cycling although good for your fitness are not as beneficial as walking, dancing, tennis or gentle weight bearing circuit classes. Bone is a living tissue and responds to the stress of weight bearing exercise by becoming stronger. You need to aim for at least three sessions per week. IT IS NEVER TOO LATE TO START, even if you are past your peak bone mass, exercise will reduce bone loss and help delay the progress of Osteoporosis. Pottsville Physiotherapy Fit for Life circuit classes incorporate weight bearing exercise, light resistance training and balance / coordination training to help maintain your bone density, improve your posture and balance and help prevent falls. Exercise to avoid: If you have been diagnosed with osteoporosis you will need to avoid excessive twisting, bending, heavy lifting, jolting, dynamic sit ups, and high impact activities such as running and jumping.

Exercise Tips

 
  • Warm up first
  • Slow and controlled movement
  • Don’t hold your breath
  • Do not push into pain

Other Treatments

 
  • Your doctor may prescribe medications i.e.- hormone replacement therapy
  • Diet and or supplements to ensure adequate calcium intake (your doctor or a dietician can advise you on this)
  • Lifestyle factors—quit smoking, decrease salt, alcohol and caffeine intake (these all limit calcium absorption)

How much calcium do I need?

  Young adults - 800-1200mg per day Menstruating women800-1000mg per day  Men800  Pregnant/lactating women  - 1200mg per day Post menopausal women(no oestrogen) - 1500mg per day Post menopausal women(oestrogen) - 1000 - 1200mg  per day Adults over 65 years -  1500mg per day     Food                                                       Amount                                              Calcium (mg)   Low fat milk                                         1 glass (250ml)                                                 405 Soya beverage                                   1 glass                                                                  365 Yoghurt                                                200g                                                                      330 Whole milk                                         1 glass                                                                  300 Hard cheese                                       1 slice (30g)                                                        285 Canned sardines inc bones           (50g)                                                                     275 Processed cheese                            30g                                                                        190 Oysters                                                10                                                                          190 Tofu                                                       100g                                                                     130 Almonds                                              50g                                                                        125 Baked beans                                       1 cup (240g)                                                       108 Canned salmon, inc bones            100g                                                                      90 Cottage cheese                                 100g                                                                      60mg Broccoli                                                60g                                                                        15mg   Pottsville and Cabarita Physiotherapy 6676 4000 visit www.osteoporosis.org.au

Back Pain: The Chain of Command

29.08.18

Back Pain: The Chain of Command

Your spine is essentially the chain that forms the ‘backbone’ of your entire body. Without it you would be a blob of muscles, organs and soft tissue piled on the floor. Your spine commands respect because it is the pillar that supports your body, allows you to walk, stand and sit, as well as touch and feel; because it forms the canal connecting the nerves from your body and limbs, to your brain. While your heart may be the vital organ that keeps you alive, without your spine you wouldn’t be able to move. There are three natural curves in your spine that give it an "S" shape when viewed from the side. These curves help the spine withstand great amounts of stress by distributing your body weight. Between the bony vertebra are spongy discs that act as shock absorbers. The lumbar spine (or lower back) connects the thoracic spine to the pelvis, and bears the bulk of your body's weight. Your spine is not rigid though. It allows movement through the intervertebral joints connecting the bony vertebra. These joints allow you to twist, to bend forward and backward, and from side to side. Large groups of muscles surrounding the spine, pelvis, hips and upper body all interact to allow for movements like walking, running, jumping, and swimming. However, there are also muscles deep in your body that work constantly just to maintain your posture when you’re sitting and standing. It is essential that all elements of the spinal ‘chain’ work harmoniously together to ensure fluid movement without overloading structures resulting in injury and pain. Any link in the chain that becomes ‘stuck’ will not only affect that spinal level but also the movement and strength of the chain above and below it. If the muscles around the spine are uneven in strength and length (flexibility) this too can affect the ‘chain’, altering the alignment and motion of the links. Taking care of your spine now will help you lower the chances of experiencing back pain later. Many of the steps you can take to improve the overall health of your spine involve nothing more than practicing better body mechanics, or how you move and hold yourself, when you do daily tasks and activities.

Taking Care of Your Spine

Pay attention to early warning signs or pain. Although back pain is very common and nearly every person will experience at least one episode of back pain in a lifetime, it is essential to address any symptoms promptly. It has also been shown in studies that early treatment and rehabilitation can prevent recurrent bouts of back pain and prevent the development of chronic lower back pain which can be very debilitating, stressful and depressing. It can affect your ability to work, play sport, socialise and sleep, all of which can further compound your pain cycle. Your back pain could be due to inflamed ligaments, damaged intervertebral discs, nerve irritation, bony formations on the spine, muscle imbalances such as weakness or a lack of flexibility, leg length differences, or muscle strains, to name just a few. Even the way we move (or don’t move) at work, school or sport can all be an underlying cause to the current pain.

How Physiotherapy Can Help with Back Pain

Your physio can treat the pain or stiffness experienced from back pain using massage, soft tissue mobilisation, spinal manipulation, heat, acupuncture and other devices. It is important that you, together with your physio work through a rehabilitation programme (specific exercises and stretches) to correct underlying muscle weaknesses, flexibility issues, and the sequence in which the muscles around your spine work to provide stability. A physio can also give you advice on correcting posture / technique for work and sport. Should you need referral to another professional your physio can also help with this, for example, a dietician to counsel on a meal plan to achieve a healthy body weight. Being active can also help prevent as well as cure back pain. Chat to us today about what we can do to help. Ph 02 6676 4000

Back Pain and Sleep Issues

One of the most common issues back pain sufferers experience is sleep disruption so we have put together an interactive Back Pain and Sleep Guide to help you banish those sleepless nights and wake up feeling refreshed. The guide includes: • 6 Strategies for Improving Your Sleep • 8 bedtime stretches to relieve back pain (with video links) • Sleeping positions that will help relieve pain (with links to videos) • 7 Yoga Poses that will help cure most back pain issues A morning stretch routine that will help ease pain from a restless night (with videos) Click this link to find out more and download the guide Disclaimer: This information 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 Truth About Discogenic Lower Back Pain

The Truth About Discogenic Lower Back Pain

What is it?

As we all know, our spines are made up of vertebrae which are connected with each other by discs. These discs are responsible for absorbing the shock our spine experiences and they also allow and limit our movements. These discs are made up of an outer layer called the annulus fibrosis while an inner layer consisting of a gelatinous material known as the nucleus pulposis. This can be best describe as your jam filled doughnuts. When someone proclaims that “I have slipped my disc” they are actually describing a the pain they felt on their lower back which is really called the discogenic lower back pain. Even though the disc itself has not slipped, this has become the generic term for such injury. A more precise and to the point description of discogenic lower back pain is the disc bulge or a disc herniation, but this will also depend on how severe the injury may be. Disc bulge happen when an internal disruption of the disc and the inner gelatinous nucleus material or the nucleus pulposis moves to the outer edges otherwise known as the annulus fibrosis. This creates a bulging effect. The outermost part of the disc is highly innervated (nerve supply), and this bulging can cause serious discomfort.

Mechanism of Injury

An injury to the spine, otherwise known as disc bulge or herniation may be caused by lifting heavy objects, pain can also be triggered by minor activities such as bending to pick things up from the floor. A person can be injured without his knowledge because the inner part of the disc has no nerve endings that will trigger pain, it is only when the outer part begins to show signs of tearing that pain is felt. And this is best describes as “the straw that breaks the camel’s back”. Aside from repetitive heavy lifting of objects, sitting for a prolong period of time is also a common cause of injury to your lower back because it places great stress to the discs. Individuals who suffer lower back injuries often have some pre-existing condition regarding their proximal stability or weakness to their postural muscles. Signs and Symptoms
  • Severe pain is felt on one side of the lower back, down to one leg and it is also common that the same pain is felt even down to the toes
  • Once pain is felt, bending forwards and other movements are restricted especially when getting up from sitting. 
  • When experiencing neurological signs such as pains of pins and needles, numbness, weakness or bladder and bowel dysfunctions a careful consideration must be given because these may be signs of more serious disc injury.
Treatment Management
  • The most common treatment method to follow is the McKenzie Technique  - It involves proper exercise that reduces the pressure on the injured disc and it allows healing.
  • While dealing with the posterior disc bulge or herniation of the disc, extension based exercise is essential . 
  • Taping the lower back can help maintain comfortable posture and can help reduce muscular spasm to relieve pain.
  • Spinal mobilization and soft tissue massage to restore movement. 
  • Clinical Pilates can help regain stability of the proximal muscle.
  Self Management
  • Find out more about body position and certain activities to avoid pain and allow healing to your back.
  • Enrol in a Pilates based strengthening program.
  • Improve your posture by using lumbar rolls.
 

10 top tips for Cyclists

03.08.18

10 top tips for Cyclists

 

Common injuries in Cyclists include knee, lower back, neck and shoulder

 
  1. Make sure your bike is suitable for the type of riding you are doing

  2. Make sure your body fits the bike

  3. Have a great pedalling technique

  4. Vary your riding from day to day

  5. Stretch and activate, slow build your effort as you start your ride

  6. Target sleep, stress, diet and alcohol

  7. Eat well especially during and after a ride of 2 hours or more

  8. Have a strong and consistent recovery routine

  9. The recovery ride – An easy one our ride at high cadence and low power is essential to good recovery after a hard day.

  10. Massage

Overactive Bladder Syndrome (Urge Incontinence)

16.05.18

What is the Pelvic Floor?

The pelvic floor is a set of muscles that spread across the bottom of the pelvic cavity like a hammock. The pelvic floor has three openings that run through it, the urethra, the vagina, and the rectum.

The functions of the pelvic floor include:

 
  • To support the pelvic organs, specifically the uterus, the bladder, and the rectum
  • To help provide sphincter control for the bladder and bowel
  • To withstand increases in pressure that occur in the abdomen such as coughing, sneezing, laughing, straining, and lifting
  • To enhance the sexual response
   

What is Urge Urinary Incontinence?

Urge urinary incontinence is the involuntary release of urine following a sudden strong urge to urinate. This urgent need to urinate may occur during the day and often at night as well. Urgency, frequency and nocturia (going too frequently in the night) are symptoms of an ‘overactive or irritable’ bladder. The smooth muscle pump of the bladder is spasming or contracting giving rise to this urgency. 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.

Signs and symptoms of urge urinary incontinence include:

 
  • The strong urge to urinate followed by the leakage of urine
Many women also experience triggers, or anything that increases the urge to urinate including running water, cold, or the thought of urinating.

 

What Causes Urge Urinary Incontinence?

The dysfunction is a combination of problems with the bladder, urethra, vagina, pelvic floor and nervous system. The first step is to understand that the urgency that you feel is generated centrally through the nerve connections from the bladder to the brain. The nerves to the brain get confused. They cannot tell whether the bladder is actually full or whether they are receiving a false and urgent message, these stimulus trigger the brain to mistakenly tell us to go to the toilet. We need to deny the urge to fix the circuitry problem.

There are several causes for urge urinary incontinence, these include:

Alcohol and Caffeine Alcoholic drinks and caffeine cause your bladder to fill more quickly and can trigger a strong uncontrollable urge to urinate. Bladder irritants Carbonated drinks, citrus juices, artificial sweeteners, tea, and coffee can irritate your bladder and worsen urge incontinence. Even teas and coffees without caffeine are irritants. Nicotine is also a bladder irritant. Dehydration When dehydrated, your urine becomes very concentrated. This highly concentrated urine can irritate your bladder and worsen urge incontinence. Urinary tract infection During a urinary tract infection, bacteria can irritate your bladder. This can result in strong urges to urinate, increased frequency, and incontinence. Constipation The bladder and rectum have a common nerve supply. Constipation causes compacted stool in the rectum which over-activates these nerves, increasing urinary urgency and frequency. Overactive bladder Overactive bladder is when nerves send signals to the bladder at the wrong time, causing it to contract at an inappropriate time leading to incontinence. Aging As you age, the capacity of your bladder to store urine decreases and the frequency of overactive bladder symptoms increases. The risk of overactive bladder also increases with various blood vessel disorders, seen more commonly in the elderly. Interstitial cystitis This is a painful condition that involves inflammation and scarring of the bladder wall. Symptoms include painful, frequent urination as well as urinary incontinence. Hysterectomy and other surgery The bladder and uterus are very close together and have common supporting ligaments and muscles. Removal of the uterus as in hysterectomy, risks damage to structures supporting the bladder. If these supporting structures are damaged, a prolapse or cystocele is likely to occur. Symptoms of a cystocele include urinary incontinence. Additionally, surgery may damage the nerves that supply the bladder, also leading to urinary incontinence. Bladder cancer or bladder stones Symptoms of bladder cancer or bladder stones include urinary incontinence, urgency, frequency, and painful urination. Other symptoms include blood in the urine and pelvic pain. Neurological damage Any neurological disorder such as multiple sclerosis, Parkinson's disease or stroke can cause urinary incontinence by interfering with the nerve signals that control the bladder. Additionally, if the nerves supplying the bladder or pelvic floor muscles are damaged, urinary incontinence may result.  

How is Urge Urinary Incontinence treated?

Treatments of urge urinary incontinence are tailored to suit your individual problem. The following should be considered: Pelvic floor muscle strengthening Strengthening 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. Bladder training Bladder retraining is the technique used to try to increase the capacity of the bladder and decrease the sensitivity of the bladder. By teaching your bladder how to store more urine without leaking or giving uncomfortable spasms, you will have more time between voids, less discomfort and more freedom to go out. This is a disciplined program to suppress an overactive bladder. Expect the program to take at least 3 months to have a positive effect Defecation training Medication to calm the bladder, this is normally initiated after 3 months, talk to your doctor Vaginal oestrogen, if you are post menopausal Surgery – very rarely  

Normal bladder function

  • fluid intake of 1.5- 2 litres
  • normal frequency of voiding (passing urine) 4 – 6 times a day (every 2-3 hours) and perhaps once at night
  • each time you void, you should pass 250 – 500ml (1-2 cups) of urine
  • if you get the urge to void, you should be able to comfortably defer until it is convenient for you to go to the toilet
  • when you pass urine, it should flow in a steady continuous stream, without hesitation, until your bladder is empty
  • you should not need to push or strain to pass urine
  • you should be able to pull up on your pelvic floor when the flow of urine is finished, before you stand up
  • urine should be pale yellow coloured, it may be darker in the morning as it is more concentrated.
If your urine is always dark it is a sign that you are not drinking enough.