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What is an exercise physiologist?

20.01.20

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
Why should you see an AEP? AEPs are the experts in prescribing the right exercise to help you prevent/manage your chronic disease, help you recover faster from surgery or an injury, or help you to maintain a healthy lifestyle.   AEPs can help treat and/or manage:
  • 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
  • Obesity
  • And much more!
    What makes AEPs even more special is they know how to set goals and maintain motivation, these are two aspects that will most commonly see people fail at exercise. What to expect when seeing an AEP?   During an initial consultation with your AEP, you will undertake a comprehensive assessment in order to develop an exercise plan based on your unique requirements. This session will likely be a fair few questions about your health and history. A lot of people are concerned about what to wear to this appointment. We always say wear comfortable clothing as you may be asked to do a range of movements and bring some comfortable walking shoes as you may need to complete an aerobic assessment. After this session, you will be provided with a plan of action. Working with an AEP can be a truly rewarding process and they can make a hugely positive impact to your life. Our AEP, Sammy, has special interests in the areas of Cancer and Exercise, Osteoporosis and Clinical Pilates. To make a booking with Sammy our AEP  please call 6676 4000 or 6676 4577.  

Achilles Tendon Injuries

30.07.18

Achilles Tendon Injury

A tendon is a band of tissue that connects muscle to bone. The Achilles tendon, connects leg muscles to the heel bone, allowing you to walk and run.   Achilles tendonopathy is a common injury among runners, but may also occur in people with pronated feet, high arches, tight calf muscles and those who wear inflexible running shoes. Overuse of the Achilles tendon at the back of the heel occurs in the case of dancers, runners and walkers who exert a lot of stress on the tendon during their activities. It is a very painful condition and if one continues to put pressure on the tendon, it may snap, often with a loud popping sound. The primary symptom of an Achilles tendon injury is pain to the back of the heel, which increases with exercise and lessens when exercise stops. Achilles tendonopathy also manifests itself with warmth, swelling and tenderness at the site. Range of motion may be limited. Achilles tendonopathy can lead to small tears in the tendon, making it susceptible to rupture, however rupture may also take place without any previous Achilles tendon problems. If any of these symptoms occur, it is best to rest and elevate the leg while icing it and of course, see us or doctor as early as possible. Achilles tendon ruptures are most often seen among middle-aged people who play a sport on weekends or in their spare time.

Symptoms of Achilles tendon rupture are:

 Sudden pain in the back of the ankle which feels like a kick or a stab. It may turn into a dull ache.  Swelling between the heel and the calf.  Difficulty walking or rising up on the toes.

 

A rupture may be treated surgically or non-surgically, depending on the extent of the damage and your condition.

  Until you can get professional help, the RICE formula should be applied:  Rest. This is important as walking may cause further problems.  Ice. Use an ice pack wrapped in a towel. Never apply directly to the skin and leave on for twenty minutes.  Compression. Bandage the foot to prevent further swelling.  Elevate the leg at or above the level of the heart to decrease swelling. For non-surgical intervention, we (or a doctor) will recommend a brace or special insoles for your shoes, as well as physiotherapy. We will work with you to manage your pain with ice and instruct you in stretching exercises for the calf muscles. We will also help you modify your training schedule to match your recovery and advise you on wearing proper shoes to prevent further injury.  

Patello-femoral Knee Pain

16.04.18

Patello-femoral Knee Pain

Aching knees affect 25 % of the population and are commonly caused by dysfunction at the patella-femoral joint (under the kneecap). It is typically aggravated by bending movements such as sitting, walking up and down stairs or hills, jumping and running. It is also common during adolescence as the long bones are growing faster than the muscles, tendons and ligaments putting abnormal stress on the joints.

Causes

  • Unfortunately genetics have a part to play and this can’t be changes
  • Faulty bio mechanics due to muscle imbalances

Treatment

Treatment is very successful and we will look at correcting muscle imbalances throughout your lower back, hip, pelvis and leg. This is done by manual techniques to the knee cap, massage, acupuncture, exercise and taping.

Falls Prevention – Balance

19.03.18

Falls Prevention – Balance

What is a fall?

 
  • The World Health Organisation defines a fall as "inadvertently coming to rest on the ground, floor or lower level, excluding intentional change in position to rest in furniture, wall or other objects". Falls in older people cover a wide range of events, including:
  • trips on raised obstacles (eg. loose rugs, cords, mats) or uneven surfaces (eg. footpaths, roads)
  • slipping on wet or highly polished surfaces
  • tumbles and stumbles down steps or stairs
  • falling off a ladder or stepladder
  • falling over in a shopping centre or while using public transport.

What a fall is not:

 
  • Falls in older people are not accidents. Similarly, falls are not an inevitable or unavoidable part of life. The causes of a fall can usually be identified and the sequence of events leading up to the fall can be predicted and therefore can be prevented.
  • Unintentional falls continue to be the leading cause of injuries requiring hospitalisation in Australia.

Risk factors for falls

 

Physical inactivity

 
  • Physical activity has been shown to be the most promising falls prevention strategy, both as a single intervention and as a part of a multi-factorial approach.
  • Research shows that specific exercises such as Tai Chi, balance, gait training and strength building group classes or individualised in-home programs reduce falls risk by 12% and the number of falls by 19%.
  • These interventions can also increase the time before a person falls for the first time. A physical activity program should be specific for individuals and include exercise that challenges balance at a moderate to high extent with a attendance twice weekly.

What you can do to prevent this

Physical activity is key to preventing falls and improving well being!  A holistic program including:
  • Proprioceptive retraining – challenging your body on unstable surfaces such as wobble discs and bosu balls helps to retrain your ability to recognise where your body is in space.
  • Strengthening – a full body strength program including lower limb, upper limb and core strengthening will help to mitigate the loss of muscle mass common in the older population. Exercises such as squats, bridges, push ups and calf raises are useful examples of this.

Other modifiable risk factors for falls

Incontinence
  • Problems with bowel and bladder control can impact on an older person's ability to stay active, healthy and independent.
  • Incontinence, urinary frequency and assisted toileting have been identified as falls risk factors for residents in residential aged care facilities.
  • Physiotherapy can assist with incontinence.
Feet/footwear
  • Sore, aching or tired feet make it difficult for an older person to stay active and independent, and can affect the way they walk.
  • Some types of footwear such as slippers, thongs or scuffs, and wearing socks without shoes can increase the risk of falls.
Low vision
  • Low vision, impaired vision, a change to vision or vision affected by medication can increase the risk of an older person falling. Vision impairment ranks sixth in the world's major causes of loss of wellbeing, and the prevalence of vision loss increases with age.
Medication
  • There is strong evidence that falls risk is increased by medications which act on the central nervous system, such as those used to treat depression, sleep disorders and anxiety.
  • For those using these medications to assist with sleep disorders and anxiety related health issues, there is a need for longer term support and use of non-pharmacological alternatives such as relaxation, reducing caffeine intake, increasing physical activity and meditation in the first instance.
Home safety
  • The relative risk of falls can be reduced by 20% in those with a history of falling by an occupational therapist conducting a thorough home risk assessment and arranging the recommended modifications.
  • Tidying up behind you and not leaving objects on the floor can also help to prevent falls.
Nutrition
  • Nutrition is an important factor in falls prevention, as frailty results from a loss of muscle mass and strength, neuromuscular impairment, immobilisation and malnutrition.
  • Older Australians are at risk of developing nutritional health problems due to reduced energy needs and a decreased ability to absorb nutrients.

Falls can be prevented!  Staying healthy and active, maintaining strength and balance, identifying falls risk factors and improving home safety will help to minimise the risk of falling.

Talk to your physiotherapist today about minimising your falls risk factors or join our fit for life program.

 

What is Clinical Pilates and why has it made such an Impact?

What is Clinical Pilates and why has it made such an Impact?

Clinical Pilates has been shown to reduce the onset, persistence and recurrence of pain by addressing the neuromuscular dysfunction it is associated with. Clinical Pilates is largely concerned with training local spinal and pelvic stabilising muscles to work efficiently throughout functional activity. It is particularly important in the rehabilitation of spinal pain amongst other motor control problems and is associated to what researcher’s term “specific stabilisation exercises” or “motor control exercise”. With the latest research emerging, evidence-based Physiotherapists have re-evaluated their management of low back pain with a shift towards this type of exercise rather than focus on strength and endurance, which is perhaps more appropriate in the advanced stages of rehabilitation. CLINICAL PILATES involves the following components which are particularly helpful to aid in the rehabilitation of low back pain:
  1. Teaches co-activation of Transversus Abdominis (TA), Pelvic Floor (PF) and Multifidus (MF) muscles
Research into muscle dysfunction in patients with LBP has identified motor control impairments in the deep muscles of the trunk. These muscles normally contract in anticipation of movement to increase stability of the spine and pelvis. This anticipatory function is lost in patients with LBP and not restored with the resolution of symptoms  therefore requiring specific retraining.
  1. Teaches correct muscle activation patterns
A focus on low load high repetition optimizes tonic recruitment of the Type 1 stability muscles. Researchers suggest a prolonged low intensity (submaximal) contraction is effective in retraining the stability function of TA and MF. Further research proposes that specific exercises to train the deep abdominal muscles address any motor control deficits and this stability can provide the basis for more skilful functional activities.
  1. Trains local and global stability systems
Functional spinal stability is dependent on the integration of local and global muscle systems . Clinical Pilates progresses from basic exercises which recruit stability muscles separately to more complicated exercises that involve the larger, more superficial global abdominal muscles. Researchers  suggest specific exercises which isolate the local muscles independently from contraction of the global muscles has proved to be the most beneficial way of targeting them in rehabilitation programs and ensuring that the correct muscles are being activated.
  1. Trains neutral stability before end range stability
Clinical Pilates teaches participants the idea of neutral spine and encourages initial training in neutral and non-provocative postures. Spinal Instability occurring through injury or degeneration can contribute to an increase in the range of the neutral zone which is thought to be a primary source of LBP. This increased zone can be reduced to within physiological limits by re-educating the active system, more specifically the local stabilizers, thus relying less on the passive spinal structures to maintain posture.
  1. Progresses static stability to dynamic
This is in line with spinal stabilisation research programs which progress individuals into functional activity and sport specific exercises.
  1. Direction specific
Researchers  showed that performing exercises in a direction that does not reproduce symptoms was met with better outcomes than those exercised in provocative directions or with no direction preference. By employing this preference in Clinical Pilates the therapist is able to effectively “treat” the patient whilst they complete their rehab. For example, a patient with discogenic LBP requires extension biased exercises versus a patient with spondylolithesis with flexion biased exercises. Our Clinical Pilates program focuses on correcting the causative factors which have contributed to acute and recurrent conditions under the supervision of a Physiotherapist. It is a specific and progressive program aimed at Transverse Abdominus, Multifidus, Pelvic floor and Gluteal muscle control to help stabilise the spine, correct posture and improve strength, balance and confidence with movement. Our small groups, which still provide individual attention, are a great option once pain settles and can lead to enhanced compliance, better improvement and a more successful outcome in the long term versus home programs.

The Juvo board is transforming fitness

12.11.17

The Juvo board is transforming fitness

Juvo (Latin for help or assist) Deliberately designed with settings to benefit people of every fitness level, Juvo Board lets you safely reach new heights of health through a near-endless array of uniquely exhilarating workouts — all on one elegant apparatus. We have been enjoying the benefits at our Pottsville and Cabarita Clinics, and in Pilates Classes at our Cabarita studio.

The Juvo board as 3 positions;

Form The juvo board is shaped to safely support good form in all your exercise movements and positions

Balance

Instability workouts are remarkably beneficial for the body. Fully engage your core, enhance your balance and make the healthy mind body connection    

Elevate

Low impact functional strength training with Juvo elevate is great even for people who struggle with light workouts and can also be used to help you progress to more advanced exercises.    

It's time to discover exactly how Juvo Board will transform your approach to fitness and health.

 

Patellofemoral pain

06.11.17

Experiencing knee pain while walking, running, squatting, kneeling, going up or down stairs or slopes?

You may have a condition known as Patellofemoral pain syndrome.

Patellofemoral pain syndrome is one of the most common knee complaints of both the young active sportsperson and the elderly. Patellofemoral pain syndrome is the medical term for pain felt behind your kneecap, where your patella (kneecap) articulates with your thigh bone (femur). This joint is known as your patellofemoral joint Patellofemoral pain syndrome, is mainly due to excessive patellofemoral joint pressure from poor kneecap alignment, which in time, affects the joint surface behind the kneecap (retropatellar joint). Physiotherapy inventions help strengthen one’s quadriceps and hips, which subsequently aids in restoring the biomechanics of the patellofemoral joint. Physiotherapists are able to advise and design customised exercise programs to improve the strength of your knee and leg muscles and help you maintain good general fitness. If you are experiencing patellofemoral pain, or any pain in your knee and joints, it is important to have your condition assessed by a physiotherapist. Patellofemoral pain typically develops because of 1 of 3 different reasons 1. Excessive pronation of the foot (flattening of the arch). It doesn't matter if you have high arches or flat feet, it depends on how much your arch flattens from non-weight baring to weight baring. This can be addressed in the short term with the use of orthotics but a strengthening program of the muscles that support your arch is recommended. 2. Weak quadriceps (weak thigh muscles). The quads are the largest muscle group in the body that we use to extend our knee. Important for walking, running, squatting, and climbing stairs. We can test your maximum isometric contraction and compare it to your unaffected side to see if this is a contributing factor and address any deficit with an appropriate strengthening program. 3. Weak hip abductors (gluteal muscles). Gluteus medius and minimus help to keep our pelvis level while walking and running. If your opposite hip dips then the knee you are standing on will drift inwards causing poor alignment of the patellofemoral joint. This deficit can be picked up with good observation skills and strength testing.    

Upper Crossed Syndrome – What is it? And how can Remedial Massage help?

28.09.17

Upper Crossed Syndrome 

What is it? And how can Remedial Massage help?

  Upper Crossed Syndrome (UCS) is an extremely common musculoskeletal imbalance of the upper body. It is usually caused by poor posture or repetitive tasks in prolonged standing or sitting positions. texting As a consequence certain muscles become chronically tight, while others become long and weak. This muscular imbalance results in rounded shoulders/upper back, winging/tipping shoulder blades, and a forward head position with a poking out chin. The-Forward-Head-Posture-Fix The muscles affected in this common syndrome are the Pectoralis Major and Minor muscles in the chest, the Sub-Occipital muscles at the base of the skull and Upper Trapezius and Levator Scapulae in the upper shoulder/neck which all become overactive, short and tight. This excessive shortening of muscles causes an imbalance between muscles groups. Muscles such as Mid-Lower Trapezius, Rhomboids and Serratus Anterior of the upper back and the deep cervical flexors in the neck therefore become underactive, long and weak. The musculoskeletal imbalances of UCS can result in an array of pain or discomfort presentations. For example mid- upper back pain/tightness, neck pain/tightness, headaches, or pins and needles down the arms, just to name a few. Also overtime if untreated, these muscular imbalances can affect the position of the skeletal system leading to other chronic conditions such as shoulder instability, shoulder impingement and shoulder bursitis. Luckily Remedial Massage and correctly prescribed exercises can dramatically help with this condition. Remedial Therapists can use their skills in soft tissue work to release the tight, short and overactive muscles, and can give simple homework stretches/exercises. This is extremely important for while these large powerful muscles such as the Pecs or Upper traps remain tight, it is very challenging to properly strengthen the weak muscle groups. Remedial Therapists can also use techniques to stimulate the long, weak and underactive muscles encouraging them to activate and strengthen. Remedial Massage can be used as an effective complementary treatment for UCS,  alongside Physiotherapy allowing the exercises prescribed by Physios to be most effective. If you feel like you relate to any of these symptoms, don’t wait, find the time to care for yourself and book some Remedial treatment today so you can move and feel your best!

Why get a functional Screen?

15.09.17

Why get a functional Screen?

  Firstly to properly answer this question we must ask ourselves …

                                                                   …. WHAT IS A FUNCTIONAL SCREEN?

A functional Screen is a test (or group of tests) that assesses mobility and stability throughout the body. This will identify areas of the body that may be tight, weak or dysfunctional. It identifies asymmetries within the body. The measures obtained are compared to norms so that you know exactly where you sit in regards to others (certain variables such as height and age are taken into account)

Here at Pottsville and Cabarita Physiotherapy some of the Functional Screening tools we use include;

  • FMS (Functional Movement Screen)
  • SFMA (Selective Functional Movement Assessment)
  • Y balance (Upper limb / lower limb balance and Stability)                   
Caba and Ptty physio-98bestbusines   We may also use;
  • Treadmill Running assessment (With video analysis)
  • Posture Assessment (Using the latest app)
                                                                                           + Others… Caba and Ptty physio-95Caba and Ptty physio-100

This moves us on to the next question…… Why should we get a Functional Screen?

                         
  1. IMPROVE PERFORMANCE

  2. PREVENT an INJURY & PAIN

    Improve performance

If you are engaged in competitive sport (or just want to improve your personal performance), then a Functional Screen is essential to identify the weak and tight areas of your body that are impairing optimal performance. In all of our bodies, certain muscles have a tendency to become inhibited or weak and this leads other muscles to compensate. This pattern of compensation will continue indefinitely, impairing performance and is very likely to eventually lead to an injury. We will use the appropriate screening tools and photos/ videos to ensure you understand exactly what is going wrong with your body and from there we will develop a specific, individualised exercise program to recorrect these flaws. This will result in improved biomechanics and performance! It is hard to know just how well you could potentially perform without having a Functional Screen / Biomechanical assessment.  

 Prevent an Injury and Pain

If we can identify parts of the body that are tight, weak and dysfunctional, then by re-correcting these areas then we can prevent an injury from occurring in the first place. A functional Screen will tell us (and therefore you) what level of risk you have of sustaining an injury. If an injury has already occurred (even if it is subtle) then quite often it will cause us to compensate in some way. This can then increase our risk of having ANOTHER injury occur. All of a sudden we “feel like we are falling apart” and it takes us much longer to recover.                

World Physiotherapy Day September 8th 2017

28.08.17

Each year, on 8 September, we celebrate World Physiotherapy Day, a global event recognising the incredible role physiotherapists play in the community and the relationships that patients have with their physiotherapist. The theme for this year's World Physiotherapy Day is 'add life to years'—aligning with the World Confederation for Physical Therapy. The message builds on the findings of WHO’s World Report on Ageing and Health and a range of reports indicating the contribution and cost effectiveness of physiotherapy in healthy ageing. Physiotherapists are health professionals who have a key role in helping people with long-term conditions achieve their goals, fulfil their potential and participate fully in society. They work with people to maximise movement and functional ability. If you have problems that affect your mobility, ask a physiotherapist, the qualified experts in movement and exercise. On World Physiotherapy Day, we promote awareness of the benefits of physiotherapy in the prevention, maintenance and treatment of injuries to ensure all Australians can add life to years. (Source: Australian Physiotherapy Association)

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To Celebrate World Physiotherapy day 2017 all the Physiotherapists have been interviewed, Below are their responses.

DAN What is the best thing about being a physiotherapist? Without a doubt helping people to achieve their goals. Seeing people transform themselves following an injury so that eventually there are stronger and moving better than pre injury is the ultimate goal and gives the most satisfaction as a Physio. If someone tells me that they feel better that what they did pre injury or they are able to do something that they haven't been able to do in a long time than I know I have done a good job. MELISSA 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. MATT What is the best thing about being a physiotherapist? Very simply – to be able to help others. To spread knowledge and address an issue, one step at a time. To meet several hundred faces each year and work through each issue, each injury, one at a time. To self-empower people with knowledge and understanding that they can have for the rest of their lives. The physical component of treatment is obviously an integral part of physiotherapy but it is the knowledge base that I believe is indispensable. Obviously it is a huge bonus to be able to watch people improve and observe them going from a painful state to pain-free. It can be an extremely draining job but I can honestly say I wouldn't want to be doing anything else – I have never enjoyed it so much. JOEL What is the best thing about being a physiotherapist? I enjoy the mental Challenge of problem solving with clients in a vulnerable situation, helping them understand whats going on ans what we can do to assist. De - escalating someone who has thought the worst of their situation, Instilling in them optimism and confidence is a great outcome and good feeling. CARLY  What is the best thing about being a physiotherapist? Being able to help people reach the goals that are most important to them. No matter how big or small, it's really rewarding to be a part of that journey. I also love that physio can take you in so many directions. From the clinic to the sports field, the possibilities are endless! KAI What is the best thing about being a physiotherapist? The best thing about being a Physiotherapist is being able to help people in need and have a positive impact on someone's life. It's awesome to be able to help people understand what is causing their pain and particularly when someone has that light bulb moment when they understand exactly what is going on with their body. It's also great to be able to meet a wide range of people and to help people achieve their goals. DARLA What is the best thing about being a physiotherapist? The best part about  being a Physio is having the opportunity to help people reach their goals. I love that as a Physio no day is ever the same. I get to meet so many different people and work with them to achieve their personal goals whether it be recovering from an injury or fitness & health goals. MARIUM What is the best thing about being a physiotherapist?
The best part about being a physio is definitely the way you get to surprise patients with what they're capable of doing with their bodies. Most people believe that they'll be stuck with their aches and pains forever or can only reach a certain stage with their sporting careers. It's a great feeling knowing that I can help make a difference in patient's every day lives.