Achilles tendinopathy

There is no injury site more ancient than the Achilles heel. But thanks to the most modern scientific research, we can now manage pain in the Achilles tendon more effectively than ever.  

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Achilles tendinopathy: what it feels like

Achilles tendinopathy generally presents as pain at the base of the calf or the top of the heel. It often comes on after a change in exercise intensity (for example when suddenly training for the City to Surf!). People suffering from Achilles issues tend to feel this as an aching discomfort and often have trouble first getting it moving in the morning. The problem quite commonly niggles away under the surface for a while and sometimes then turns into a spike in more severe pain. 

Achilles tendinopathy: what it looks like

Your physio can assess you for the presence, stage and type of Achilles tendinopathy. They'll be able to differentiate it from other causes of pain in the area and test for the factors which may be contributing to the problem. These factors can be roughly divided into two categories:

Internal: an imbalance in strength, flexibility or control of your ankle, knee, hip, lower back or problems in the way all of these areas move together. 

External: an issue with how much work the tendon has been asked to do. This can be either too much, too little, or especially too much after doing too little for too long! 

Achilles tendinopathy: how to get the balance right

Tendons love to be used. How do we know this? When we study tendons and how they interact with the tissues around them, we discover that those tendons which regularly undergo some work get very nicely nourished by all the tissues around them. They are healthy, strong and adaptable. However, developing healthier tendons is a bit like learning ancient Greek to read about Achilles: it doesn't happen overnight. In fact, like learning a language, doing a little bit often is much better than trying to cram everything in all at once. Too much all at once and all you get is a headache. 

Now get out a pen and some paper

Here's a handy way to work out how quickly you can progress your tendon. Think back over each exercise session you've done over the last week. For each session, write down how hard it was on a scale of zero to ten. Then, record how long you exercised for. Multiply these two numbers together. Do this for each exercise session in the week and then add them together to get a total number. This number is what we call your 'acute workload' and it measures how hard you worked this week. 

Now go ahead and do the same to work out your average workload over the last three weeks. This is your 'chronic workload' and measures how hard you've usually been working. 

Now, here's where the maths comes in handy - divide your acute workload by your chronic workload. This number is your acute : chronic workload ratio. The 'golden zone' for this number is between 0.8 and 1.3 as you can see below.

 Gabbett TJ. The training-injury prevention paradox: should athletes be training smarter  and  harder? Br J Sports Med Published Online First: 12 January 2016. doi: 10.1136/bjsports-2015-095788

Gabbett TJ. The training-injury prevention paradox: should athletes be training smarter and harder? Br J Sports Med Published Online First: 12 January 2016. doi: 10.1136/bjsports-2015-095788

To put it simply, this means that if you're trying to work yourself harder and build your fitness, you're most likely doing right by your tendon if you only do about 30% more this week than you usually do on any given week

Too much maths? If you're worried that you're niggling away on an irritated Achilles or are trying to increase your exercise levels and are looking to prevent injury, pop in to see your physio who'll be able to take you through a thorough assessment of the relevant factors and help you devise a healthy way forward. Feel free to book online or call 9364 4073. 

 

exercise: me? why?

Exercise is catching on. If you've been paying attention to the media over the last six months, you might have picked up on the groundswell of attention that's been given to the effectiveness of exercise for various types of pain.

The weight of the research is ultimately a message of hope to people who are suffering from pain: exercise is a high value, low cost, effective strategy for managing a wide range of conditions from knee osteoarthritis to low back pain.

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One of the key things we're passionate about at LifeCare Applecross is helping people to participate in therapeutic exercise, particularly when they're in the vital stage of transitioning out of pain or injury. 

When we're helping people with this, we are often asked the question:

Why would I exercise when it seems to make my pain worse? 

This is quite a common sense question to wonder about. And we like being asked the question because it allows us to explore the following three ideas. When people grasp these, we find they're better able to overcome their concerns about exercise and take the first step towards experiencing its benefit. 

Firstly, the question makes common sense only if there's an assumption that pain is a measure of damage. If it were true that pain = damage, then common sense would say that the less pain, the less damage you are doing to yourself. The truth is, however, much more complex. Research clearly points to the fact that pain and sensitivity is influenced by a wide variety of different factors and that when it comes to painful movements, it cannot be assumed that when you are experiencing pain, your body is being damaged. Once people make this conceptual leap, it can radically change their relationship with pain and open up many possibilities for nudging, prodding, coaxing pain away. This idea can be summarised as hurt does not always equal harm. A good assessment from your physio or GP is the best way of being reassured that the short period of discomfort you experience when you move isn't doing you any damage. 

With this in mind, it is often unhelpful to just blaze your way through pain and expect to obliterate it through sheer force of will. This leads us to the second thing that really helps people who are in pain: knowing what kind of exercise will be helpful at their particular phase in transition out of pain and injury. For example, we often hear, 'I can't even walk for half an hour because my knee is so sore!' After a good assessment of the knee and the surrounding areas, we can often help people to exercise in ways which develop the qualities that are needed for the knee to be more comfortable with walking. This may mean developing strength around the knee with light resistance exercises, or perhaps improving movement through comfortable stretches. Once this modified form of exercise has been given time to do its work, a gradually progressed walking program can be started which allows steady progress towards your goals, as the body adapts slowly to what it is asked to do. This can be summarised as exercise smart, not too hard. With so many ideas on different ways to exercise and when to progress to harder forms, your physio can help you to exercise smart. 

The last concept to mention is the first part of the question: why would I exercise...? There are as many reasons to move as there are types of exercise! Exercise can be extremely effective at reducing pain and increasing tolerance to daily activities. What's more, there are the cardiovascular health benefits, social aspects, mental health gains and creative outlets that come along with living an active life. This can be summarised as exercise is really all that! Your physio can help to understand the types of benefits and the timeframes over which to expect them so you know you're on the right track. 

So, for all our readers who are asking, why would I exercise when it seems to make my pain worse? come in to have a chat about the what, how and why of exercise. Call us on 9364 4073 or book online if you'd like more help with getting moving.  

World Cup Fever

World Cup Fever (Australian strain): n. an ailment in which a month of sleep deprivation causes the following symptoms: drowsiness, grumpiness, work absenteeism and fierce debates about the use of the term 'football'. 

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You might not have known that sleep deprivation is related to another symptom: pain. 

And not just the emotional pain of watching the Socceroos bow out. There is a growing body of research that links the body's pain experience to quality of sleep. As this can be a vicious circle (pain can make it difficult to sleep and lack of sleep makes pain more noticeable), it is worthwhile considering strategies to assist your sleep if you struggle with ongoing pain. 

Sleeping spaces

Experts regularly advise that sleep is improved when your body learns to associate bed with rest. Not with surfing the net, texting, studying, not even with watching the World Cup! So pick up your laptop and get onto the couch, don't watch screens in bed. Also, if you're trying to fall asleep and can't doze off, experts recommend trying to get up and do something relaxing (reading, listening to music etc.) for a short time before returning to bed. This way, you don't lie in bed for hours on end getting more and more frustrated that you can't sleep, leading your body to associate your bed with frustration rather than with what it should be: relaxation. 

Routine

Sleep experts recommend sleeping at a regular time each night and waking at the same time in the morning. While this may seem impossible during the World Cup, perhaps the internet comes to our rescue. Try getting a good amount of sleep from a regular time and then waking in the morning to watch a replay of the match before anyone has told you the score. (This strategy may depend on how well Optus Sport's streaming is working). 

Professional help

If you're looking for more help than these simple strategies, a trip to your GP or psychologist could help you to have a more detailed plan for getting your sleep under control. If you're not sure if sleep is related to your pain, or you're not sure if anything is related to your pain because it seems completely random or has a mind of its own, then feel free to give us a call on 9364 4073 and we'll work with you to help to identify things that you might not have known were associated with your pain. In the meantime, enjoy the football! 

HBF Run for a Reason - training tips

Like many of you, on the 27th of May, I (Tallara) will be running the half marathon in the HBF run for a reason.

I'll be running for the 12 for Twelve team who are running 12 half marathons over 12 months to raise $100,000 for Beyond Blue to increase awareness surrounding mental health. If you're keen to get involved, through participating in their run club, monthly events or by donating, follow the link: www.12fortwelve.com

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I’ve run here and there in the past, but never anywhere close to the 21km I’ll be tackling in just under a months’ time. The things I’ve been doing to ensure I’m fit and injury free for the big day are:

Training Program:

A planned training program is essential for a number of reasons:

1) Injury prevention.

2) Ensure I’ll be able to make the distance on the day.

3) Motivation.

The first thing I did was make a rough plan for my 14 week training period. I included one distance run, starting at 5kms, 2 speed runs, 2 recovery days and 1 alternative run per week. An alternative run would either be intervals, hills or a timed run.

At the start of each week I’d plan out my runs based on my schedule for the week. I wasn’t too hard on myself if I missed a run. Balance is crucial!

Taper:

To ensure I would perform at my best I have included a 4 week tapering period prior to the event. I aimed to hit 18kms at the 4 week mark, then gradually reduced my distance.

Monitor:

Being able to track your progress is a great motivator and can be a great tool to identify when/where something has gone wrong in your training. Whether that be with a running watch or phone app (Strava, NikeRunClub, etc).

Footwear:

Before I began training I invested in a pair of running orthotics (as my feet roll in and I occasionally get ankle pain) and I checked the condition of my runners.

Like all things, the more you use your runners, the more they will wear out. A worn out running shoe may increase risk injury. A good guideline to maintain the integrity of your shoe is to get a new pair every 800kms.

Hopefully see you out there on the course! In the meantime, if you need any training advice, a pair of running orthotics, or help with achieving your best time, please don’t hesitate to give us a call on 9364 4073 or book online

Tallara's winter sports wisdom

This month at LifeCare Applecross, we're excited to welcome Tallara Clack to the team. 

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Tallara graduated from Curtin University with a BSc in physiotherapy.

She enjoys treating a wide range of musculoskeletal conditions, with special interest in treating neck and back pain. Tallara also has experience working with sporting teams, previously being involved with Melville City Football club and has a keen interest in gymnastics and netball.

Tallara utilises an evidenced-based approach with the goal of empowering patients and getting them back to their best. She uses a combination of manual therapy techniques including manipulation, dry needling and massage along with exercise based rehabilitation and Pilates.

Tallara enjoys helping sportspeople achieve their best and so she's giving out her top three tips for all those who are getting into their winter sports this time of year: 

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Winter is just around the corner...and with that comes the start of winter sports, whether that be soccer, netball, rugby or football. After a long period of time off, athletes are particularly susceptible to injury in this stage. So what can you do to reduce this risk? My top 3 tips on preventing injuries this winter season include: warming up, load management and listening to your body. After all, prevention is ALWAYS better than the cure.

Warm Up:

The warm up prepares the body for exercise, which is especially important in colder temperatures. Most people do some form of a warm up. But what constitutes an effective warm up? A warm up should involve cardiovascular, strengthening, balance and plyometric exercise, along with dynamic stretches and high intensity sports-specific drills.

There has been much controversy recently surrounding stretching. Evidence suggests that for some sports static stretching immediately prior to performing can in fact be detrimental to performance, reducing muscle power, speed, reaction time and endurance. Dynamic stretching prior to play on the other hand has shown to have a positive effect on injury prevention.

To guide you through the nuances, there are many fantastic resources available for injury prevention:

Netball: knee.netball.com.au

Soccer: FIFA 11+ program

Football: Footy First

Rugby: Rugby Safe

Load Management:

Managing your sporting load is critical in preventing injury. A periodised training program is a great way to ensure that your training load is managed appropriately. Balance between load and recovery is key. For example, tendons love load. It stimulates cell activity within the tendons which makes them stronger. However when tendons are loaded too much, too fast they can undergo stress and strain. Balance between these two processes is essential. This can be maintained by allowing the tendons to recover, giving them time to adapt. This usually takes about 48 hours as tendon cell activity is relatively slow.

Listen to your body:

Finding balance isn’t always easy. Listening to your body can be a good point of reference. When there is an imbalance within the tissues, they reach a critical point where you may start to experience pain or decrease in performance. This is a good time to back off and give the tissues a chance to recover.

If you need assistance implementing strategies to prevent injury this winter season please don’t hesitate to give us a call on 9364 4073 or book online.

Nice swelling, nasty swelling.

We all know the feeling... toppling over on the ankle and then slowly feeling your shoe tighten. What's going on? Where's all that swelling coming from? Why does your body decide to swell when it feels so nasty?  

anatomy-ankle-sprain

Nice swelling

Swelling is an important part of your body's response to injury. When your nerves detect some distress in an area (say, damage to your ankle ligament), one of the strategies it uses to protect you is to tell the body to send its healing cells to the area, along with a soup of molecules. The healing cells process the damaged tissues, deciding which parts need to be taken away and discarded and which parts are suitable for repair. This is great because without this process, your ligament would stay damaged and you'd never get back to what you need to do. 

Nasty swelling

So swelling is a pretty handy healing mechanism. You'd struggle without it. But at times, some aspects of swelling can be unhelpful. This is particularly the case if the body overdoes the swelling response and all the extra cells and molecules in the area cause the part to become unnecessarily stiff and sore. At other times, the body forgets to switch off the swelling response and inflammation hangs around for longer than is really required, making you sorer than you have to be. 

Assessment

The best way to determine whether swelling is nice or nasty is to have a comprehensive assessment of your injury. Your physio is trained to do this and to give you the best advice on how to let swelling do its job without allowing the body part to get too stiff and stuck. Depending on your injury, this might involve rest, ice, compression, elevation, crutches, gentle exercises or a whole range of other techniques. Once you know how to work with the swelling, you can help it to do its job of repairing your tissues. That way you can get moving again... and get that shoe to fit around your ankle like it used to!

If you have any queries about your injury or want to know more about how to respond as soon as it happens, call us on 9364 4073 or book online

The best surface in the state

Perth Stadium opens this weekend! From all accounts, the surface will be state of the art. The turf was grown at Serpentine, mixed with 10% artificial grass for durability, cut 40mm thick and laid out under the sun (as well as under five 'grow lights' which will become more important in winter). Safe to say the surface will be the best in the state for elite sport.

The best surface in the state

 But what's your best surface? While we might dream of playing at Perth Stadium, most of us will do our exercise on other surfaces. But that's not a bad thing, it all depends on what you're going for:

A challenge

If you want to push beyond your normal routine, mixing up your walk or run with a bit more resistance can help. This might involve knee deep water at the beach, hills, or following your friend who's that little bit fitter than you on their route! Running or walking on sand will challenge your strength as well as the small muscles which detect changes in your surface and contribute to your balance. 

Rehab

When first getting back into exercise after a stint on the sidelines with injury, it's always best to start with a surface that gives your body the most assistance. In the very early stage, depending on your injury, doing some walking or jogging in the pool might help to support your joints by decreasing the body weight going through them on each step. Moving up onto a flat, supportive surface like even grass or a treadmill generally is a good next step before pounding the hard pavement or challenging yourself on the more difficult surfaces like sand or hills. 

Performance

When training for peak performance, it's wise to be working yourself on a surface as similar to your playing surface as possible. If you're a footy player, this will mean grass. As a basketball player, you want to get used to changing directions and landing on the surface you'll be competing on. If you're a beach volleyball player... you get the picture. 

Physio

If you're worried that the surface you're training on is too easy, too difficult or contributing to an injury, your physio can assess you and then help you create a balanced program of exercise that will both challenge and protect you. And if you have ambitions to play at Perth Stadium, we'd love to help you get there! 

To make an appointment, call us on 9364 4073 or book online. 

How well do you know your neck?

There are seven bones in your neck. Each has its own role. Think of them like the parts of a movable, adaptable jigsaw. 

Some bones are so specialised that they get their own names. The bone closest to the skull is called the atlas (in Greek mythology, Atlas is the god who is commonly depicted as holding up the globe), the bone beneath it is called the axis, and then the names start getting a little less creative: C3, C4... C7. 

Cervical spine vertebra

This is one of the bones in your neck. The large triangular hole is there for a reason: it's a strong canal for your spinal cord to run through. The smaller holes on either side protect the arteries that transport the blood to the brain. 

The dozens of muscles around the neck get their cues from the brain via small nerves which run to the muscles and instruct them on when to tense up (all the time if you're stressed!) and when to relax (almost all the time if you're asleep). 

There's also a strong and complex network of ligaments and discs joining the bones of the neck into a sturdy, unified whole. So the jigsaw of the neck is not just the way the bones sit together, but the way the muscles, bones, nerves, discs, ligaments and blood flow all support each other to keep you thinking, moving and active. 

Think that's pretty amazing? So do we. Want to know more about your neck? Your physio's happy to tell you more. 

 

Welcome, Jacinta

We're excited to welcome the newest member of our physiotherapy team to LifeCare Applecross!

Jacinta Profile

Jacinta has 20 years of experience in the physiotherapy profession, graduating from Curtin University in 1997. She initially worked at Mercy Hospital, gaining valuable experience in orthopaedic surgical conditions and post-natal care. Since then Jacinta has predominantly worked in private practice, treating a wide range of musculoskeletal conditions. She has a particular interest in sporting injuries, and has worked as a team physiotherapist for East Fremantle Football Club, and the Perth Orioles Netball team. More recently, Jacinta has developed an interest in the management of pregnancy and post-natal conditions, including back and pelvic pain.

Jacinta is a qualified Clinical Pilates instructor, and strongly believes in the value of activity and exercise for maintaining health and fitness throughout all life stages, and assisting clients to achieve their optimal wellbeing.

Personal Interests

Jacinta is a keen (albeit slow!) recreational runner, and recently completed her first marathon. She also enjoys travelling overseas, and camping with her family.

Qualifications

BSc (Physiotherapy) (Hons)

Clinical Pilates Instructor

The whole LifeCare Applecross community is glad to have Jacinta's expertise at the practice. To make an appointment with Jacinta, call us on 9364 4073. 

Eddie's travel tips

Eddie's back at LifeCare Applecross after a stint abroad. He's got some travel tips for anyone who's looking to leave their pain at home and head off on their own adventure:  

Beijing - Great Friends for the Great Wall 

When undertaking any new strenuous exercise (eg. hiking the Great Wall of China through the Beijing heat) do choose a good group of friends who'll encourage you all the way and give you the moral support that you need. Don't go it alone! 

Great Wall of China

Moscow - Learn from Ivan the Terrible  

There's some speculation that Ivan (1530-1584) was so Terrible, partly because he used mercury to ease his back pain. This quite literally went to his head. Don't use strategies to ease your pain which cause more problems than they solve. Do use healthy strategies like exercise, pacing and sleeping well.  

Tallinn - Sauna culture

When thinking about healthy ways to ease the aches and pains, there's nothing like a bit of warmth in your lungs and birch-branch whipping to relax down the muscles and get the blood flowing (at the very least the birch-branch whipping will distract you from your pain!). Do stay hydrated. When jumping into cold water after a sauna, don't go head first, the rapid cooling of your head could have nasty results.

Sauna culture

Switzerland - New ways to get to work

If there's one place in the world that's as water-loving (and as expensive) as Perth, it's Switzerland. There are many picturesque cities on the convergence of lake and river. In Lucerne, when the river's flowing well, it's not uncommon for people to swim home from work. Do: water-proof-bag your laptop. Don't: let your imagination stop you from finding creative ways to get active.  

Above all, whether staying at home or hitting the road over the holiday season, keep active, stay relaxed and don't let pain get in your way. Let us know if we can help!

Swimmer's Shoulder

At this time of year, the clear, crisp waters of Cottesloe, Coogee and Dunsborough are at their most inviting. Most of us love to get down there as much as we can during the summer, many use the beaches as a great place to exercise. Some of the crazier ones are even planning to swim to Rottnest in February! But for a small portion of swimmers, a sore shoulder is the thing standing in the way of their enjoyment of WA's best water. 

Dunsborough

Swimmer's Shoulder

Swimmer's shoulder is an umbrella term for a variety of conditions which can develop as a result of repetitive shoulder movements. If you notice your shoulder gets sore the longer you swim, or are worried that there's a bit of discomfort hanging around, here are two ideas to help you out: 

Variety

Swimmer's Shoulder is generally a problem of repetition. It makes sense then that the simplest way to avoid this is with variety. Mix some backstroke or sidestroke in with your swimming routine to give a breather to the parts of the shoulder which are worked in freestyle. Make sure your breathing technique is one in which you rotate to both sides of your body so that one shoulder isn't working harder than the other to consistently lift your neck out of the water.

Assessment

Ensuring there's healthy variety to your swim is a good first step. But this isn't always possible (those training for a competition) and sometimes variety doesn't take you all the way to pain-free swimming, or perhaps not as soon as you'd like. If this is the case, a thorough swimming-oriented physio assessment can help to identify the underlying causes of the pain and then address them. Your physio will assess the shoulder joint, muscles, tendons and any signs of inflammation. They'll even look further afield to understand if any issues with the neck or the nerves are contributing. A quick check early after the onset of pain can often help to prevent a more difficult problem from developing and get you started on an individualised program of recovery. 

If you're hoping to make the most of the West Aussie summer and are worried that your shoulder is going to stand in your way, we're happy to help by chatting about the variety in your program or assessing your shoulder for underlying issues. Call us on 9364 4073 or drop in to 8 Riseley Street for an appointment.

Mother's Day - Remedial Massage Vouchers

Need the perfect gift for your Mother? 

Maybe your Mother-in-Law? Grandmother? There's a remedial massage to suit everyone here at LifeCare Applecross Physiotherapy. Our two friendly and experienced massage therapists, Rudu and Nicole, recognise the value of personal preferences for a well rounded, effective and memorable massage experience.

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What will this involve? 

Remedial Massage has a very broad scope. In fact, it's really an umbrella term which covers many different modalities. On one end of the spectrum, there are the deeper mechanical approaches such as Myofascial Release Technique, Deep Tissue Massage and Trigger Point Therapy. At the other end of the spectrum your therapist might incorporate some of the light and relaxing modalities such as Manual Lymphatic Drainage, Swedish Massage, Trager and even energy based modalities like Healing Touch, Pranic Healing and Reiki. Your consultation is the perfect opportunity for you and your therapist to determine which of these approaches will best suit your treatment plan. Many clients ask for a fusion of these deeper and lighter approaches. 

Some clients prefer to be in conversation with their therapist while others would rather be quiet and zone out during their session. Feel free to clarify this with your therapist if you feel the need as well! 

Why LifeCare Applecross?

One of the advantages of investing in a professional remedial massage is that your session will be initiated by a thorough consultation when your therapist will listen, communicate and reflect on the appropriate course of treatment. Careful consultation will maximise your treatment time and allow your therapist to zone in and tackle the relevant areas right off the bat.

Another advantage of Remedial Massage at Lifecare Applecross Physiotherapy is the fact that our massage therapists work in close collaboration with the other health care professionals on our team. It can be very reassuring to know that your therapist is kept ‘in the loop’ with assessments, findings and diagnoses made by their colleagues. Your session will also be adequately documented so that there is a reference of your treatment, allowing for the fine-tuning of your treatment goals.

Hopefully we shed some light on the subject, feel free to give us a call on 9364 4073 if you have any other queries. You can purchase individual massage vouchers or packs from our reception. Our two excellent therapists, Rudu, our male therapist and Nicole, our female therapist, both love what they do and look forward to showing you the value and efficacy of this wonderful therapy that works! Just ask any of their regulars!

contagious sport

As physios, we're passionate about keeping people active. By treating injuries and preparing people to prevent them, we like to think we do our bit to keep our community fit and healthy. But we also realise we're not the only ones in this game... Parents, coaches, friends and volunteers are all just as important as physios.

junior sport

It's long been a trend in Australia that young people drop out of sport as they transition from childhood to adolescence and into adulthood. In truth, injuries are only one of the reasons why kids stop playing sport (there are many other significant barriers to participation such as lack of enjoyment, cost and time commitments). Looking at the picture of Australian health in this way, we recognise that it's the whole community that has a role in helping kids keep up the habit of exercise.  

One of the most easily addressed aspects of sport participation for young people is the enjoyment factor. For lots of kids, sport is a great way to enjoy time with friends, express themselves creatively and challenge themselves a little in the process. Junior sport is about fun, encouragement, inclusiveness and team work. By focusing on these aspects of junior sport, we all encourage kids to make healthy activities into future habits.

Recently, there have been some helpful reminders of this in the media. As we transition into a new season of winter sport for 2017, let's make sure we're all doing our bit to prepare our youngsters for active lives by thinking creatively about how to make sport fun, and in doing so, the most important results - a healthier community - will take care of themselves.

If your child is finding it difficult to do the activities they enjoy because of injury or if you need some help brainstorming ideas for making exercise beneficial and fun, call us on 9364 4073 or pop in for an appointment.  

The Worst Pain of the Year

A physio blog in January.... Oh no. You're probably expecting to be told to forget about all the good food that you had over Christmas and cast your mind bravely ahead to the exercise that you plan to do this year. In fact, the opposite is true. 

Think back to the best meal you had at Christmas. It might have been the turkey which went so well with the cranberry sauce or the cherries which were the deepest, richest red you've ever seen. It could have been the pudding that came just after you'd had enough time to digest the main meal or even the leftovers on Boxing Day that tasted so much better once all the fuss was over and you could finally put your feet up on the couch to watch the cricket.

The Worst Pain of the Year

In thinking back to your best meal, it's likely that your most intense memory doesn't just involve your memory of its taste alone, but also of the smells, the setting, the people you were with, the time of day, the drink in your hand. And that's not surprising given the fact that it's well known that all the sights, sounds and smells associated with food are part of the experience of eating. In fact they can make all the difference as to what type of flavour the food produces.

What does that possibly have to do with physio? 

The truth is, the same is true of pain. Your experience of pain is one that draws on all kinds of sensations that the body takes in. This includes what's going on in the injured body part, what's going on in the rest of the body as well as what's going on in the world around you. 

Okay, but still, what does that have to do with physio?

Your physio is able to help you to identify the different factors that may be contributing to your pain, including ones you might not have thought about much. Your physio is then able to help you to improve these factors. That's because your physio recognises that pain (like flavour) develops out of a variety of processes and so it will also be reduced by a variety of strategies and methods. 

This means that when you see a physio about your pain, you'll almost never just get one thing to solve the problem. You'll get multiple strategies which will all work together to help you to heal and to minimise your pain. 

So next time you eat a brilliant meal, think about all the things that are making it such an intensely enjoyable moment. And next time you're in pain, think about all the factors which are making it such an intensely painful moment. If you need help with reversing this pain or want to understand why it hurts so much, just give us a call on 9364 4073 and we'll be more than happy to help. 

#Onelegphysio

Don't think you spend much time balancing on one leg? Well, did you know that when you're walking, you're actually spending three-quarters of your time with just one leg in contact with the ground?

That's right, your ability to control your body on just one leg is pretty important. And when you add the challenge of talking on the phone, balancing a child on your hip or breaking into a jog, the skill of balance becomes even more important in avoiding injuries, falls and embarrassment. 

Onelegphysio

As physios, we spend a lot of time trying to train this skill. That's why as a profession, we're trying to raise awareness in our communities about the importance of balance. And what better way to know how your balance is than to test it? The average person can balance on one leg for 33.4 seconds. So right now, stop reading this post, stand up, get your stopwatch out and time yourself.

How did you go? 

If you're really good at balancing on one leg you're probably still reading this as you keep your balance. Too easy. Good on you. But the world record for one leg balance is 76 hours and 40 minutes so you still have a little way to go. 

You won't be surprised to learn though that you don't really need 76 hours of one leg balance. What you do need is balance sufficient to what your individual requirements are. If you're a casual walker, you need some decent balance to avoid injuries and falls (and the odd cyclist who might swing by). If you're a footy player or a netballer, you'll need some better balance to land on one leg, take off and change direction. 

A great way of getting a better feel for where your balance is at is to progress through the 'difficult dozen' at oneleg.physio. In trying these different challenges, you'll get a better understanding of all the factors that contribute to your balance (muscle strength, concentration, environment etc.) There are some pretty difficult ones there so make sure the exercises are safe for you, if in doubt just give us a call (see below). Once you find your limit and discover more about how your balance works, feel free to post your successes at #onelegphysio so others can be inspired to develop their balance skills, boost their sporting performance and decrease their risk of injury as well.   

For specific concerns about your balance and individualised exercises, speak to your physio by booking an appointment on 9364 4073. We have a whole range of strategies and exercises that can be really helpful in developing brilliant balance and would love to see everyone in our community that little bit more comfortable on one leg! 

A disc is not really a disc

It might surprise you to learn that a disc isn't really much like a compact disc (CD), a floppy disk, a frisbee or even a discus. In fact, the term disc is a little misleading because the strong, dynamic, malleable structures that bridge the gap between your vertebrae are not really like discs at all.

What are they like then? Well, it's a little hard to say (which is why people have used the imperfect term 'disc'). What we can say is that they are remarkably unique and resilient structures... Here are four facts to help you get to know them a little better. 

 

really a disc

1) Discs are naturally robust structures. 

Just watch your favourite sporting event and you'll see what immense forces the spine can cope with. It's true that discs can sometimes be a source of pain and (frustratingly) sometimes after you don't think you've done much at all! But anatomically and structurally, discs are strong and amazingly adaptable structures. They are made up of two features: a gel-like centre (nucleus pulposus) wrapped in a series of strong fibrous rings (anulus fibrosis).   

2) Discs never 'slip'. 

Discs are firmly connected to the bones of your spine, so a disc will never 'slip out of place'. However, discs can bulge or herniate. When they do this, they sometimes irritate a nerve or release chemicals that do this. There are many important things your physio is able to do to help you with this (see point 4 below) but the treatment will never involve 'pushing a disc back into place' because they never 'slip' in the first place.  

3) Degenerated discs are the wrinkles of the spine.

A common cause of stress for people who have recently had a scan of their spine is all the 'degeneration' that they see on the report! Don't panic though, discs degenerate naturally. In fact, there are many findings on your scans which may be like wrinkles - signs of a bit of ageing but not necessarily causing you much of a problem at all. It's always best to discuss your scans with your physio or your doctor who can assess your spine and connect the picture with way your back is in flesh and bone. 

4) Disc pain is treatable.   

The body has a remarkable ability to restore the normal function of a disc after it has been irritated. This does sometimes take a little time, but your physio can help you to accelerate this process through treatment and advice. Depending on your particular case and guided by a thorough assessment by your physio, this might include exercises, positioning advice, taping, manual therapy, muscle retraining, referral to other services and a whole lot more. 

So if you think you might have an issue with a disc or are worried about what that might mean, get to know your discs a little better by booking in with your physio on 9364 4073. 

Paralympics

As physios, we're always inspired by people who push boundaries through hard work and determination. In just under a week, thousands of athletes will be displaying the athletic prowess that only dedication and hard work can achieve. Here's a bit more info to make it easier to switch on and follow the Paralympics:

Paralympics

When are the Paralympics? 

The Rio Paralympic Games run from the 7th to the 18th of September. 

Who is competing?

More than 4,000 athletes are taking part this year from 160 nations. Australia are sending 179 competitors to the games. 

Which sports are played?

There are 22 sports at this year's Paralympics including 2 new sports: para-canoe and para-triathlon. There are only two sports at the Paralympics that don't have an Olympic counterpart: boccia (like bocce) and goalball (an indoor-soccer-like game for visually impaired athletes using a bell-filled ball). Other sports include athletics, cycling and wheelchair basketball, rugby and tennis.

How do the classifications work?

Doctors, physios and other health professionals are involved in assessing and classifying athletes to ensure fair and equal competition. The class of competition is designated by letters and numbers. Usually, the higher the number, the higher the functional potential of athletes in that class. 

What's happening in Western Australia?

Perth has a very vibrant wheelchair sports association, running sports from wheelchair tennis and rugby to powerlifting, athletics and archery. To get involved, see wheelchairsportswa.org.au

 

Delayed Onset of Muscle Soreness

A few days after finishing the HBF Run for a Reason, you might be feeling a little worse for wear. The quads could be burning, the calves feeling tighter than they've ever felt before. You might be experiencing DOMS - Delayed Onset of Muscle Soreness. 

Muscle Soreness

What is DOMS?

DOMS is muscle ache that usually peaks within 24-72 hours post exercise. When performing heavy exercise, the muscles fibres undergo microscopic damage. DOMS is related to the muscle repair process which occurs when the body is adapting to an unaccustomed load. This is particularly noticeable after performing eccentric exercise (which involves the muscles working while lengthening) such as jogging or walking down a hill. Some people think that DOMS is associated with lactic acid buildup however the best evidence suggests that it doesn't actually play a role.  

Have I done too much?

Moderate DOMS can actually be quite a normal response to increasing exercise intensity. So if you're a little stiff and sore following the HBF Run for a Reason, don't stress too much. What's even more encouraging is that DOMS seems to have a protective benefit: experiencing DOMS after an exercise session makes it less likely you'll experience it again soon. It's all part of the body's remarkable ability to increase its capacity in response to what you ask it to do. In saying that, significant muscle or joint pain during exercise is not a normal part of exercise and if there's a sharp sudden onset or swelling, it's best to stop and seek an assessment to rule out muscle strain or joint sprain. 

How Can I prevent it in the future? 

This is probably what you want to know! There are several ways to help prevent significant DOMS. One of the most commonsense strategies is to gradually build up exercise over time. A good steady progression of exercise intensity over a number of weeks will ensure that your increase in fitness and strength will come with minimal discomfort! A good warm-up and cool-down also makes sure the muscles are supple and flexible, decreasing the pain and stiffness that can result from intense exercise. If your DOMS is significant, it may be best to stick to lower intensity exercise (walking, gentle swimming or cycling) for a few days before getting back to full intensity workouts, ensuring your muscles are at full capacity and ready to cope with the load. If you're still struggling more than three or four days after exercise, come and see your physio and we'll get you back on track!

Attn: All coaches

How familiar is this story? Your junior sporting team starts the season with promise and ambition, winning matches for fun... By mid-season though, a few key injuries have weakened the team and caused that humiliating slide down the ladder. 

At least when it comes to knee injuries, the answer may well be here. 

This newsletter summarises five key ways to prevent knee injuries. Before putting them into practice, we'd recommend visiting knee.netball.com.au for excellent pictures, videos and guidelines related to the exercises we'll discuss. This site is a great resource not only for netballers but for all budding sports stars looking to prevent knee injuries.

Warm Up

Purpose: To prepare the body - legs, arms, heart and mind - for activity by raising the heart rate and increasing blood flow. Practicing footwork in controlled exercises paves the way for more unpredictable training and match scenarios. 
Examples: Jog forwards and backwards, bottom flicks forward and backwards, high knee march, side skipping.

Strength

Purpose: Strength training around the knee, ankle, hip and trunk develops a stable base for movement. The better the muscular system is equipped to control movement, the less stress the ligaments are placed under which prevents strains and ruptures. 
Examples: Squats, bridges, planking, side-planking.

Balance/Landing

Purpose: In order to get the best performance out of strong muscles, specific balance and landing training is essential. Absorbing the force of landing evenly throughout all the joints of the leg ensures no single joint is overloaded. A good landing technique is soft and involves: hips bent, knees bent, feet straight ahead, knees in line with feet and trunk stable. 
Examples: balancing on one leg and throwing the netball between partners/ handballing the footy, jumping and landing with good technique on both legs and then one leg, jumping forward/backwards/L/R and catching ball.

All coaches

Agility

Purpose: Agility exercises practice dynamic movements which help to build a sense of control and power in match-like tasks. Building these exercises into training sessions helps to improve performance and prevent injuries. 
Examples: Decelerating shuffle, zig-zag running, side-to-side shuffling while passing/ handballing.

Physio

Did you know that physio can help with up to 80% of anterior knee pain? If you have any concerns about injury or vulnerability, an appointment with a physio will either put your mind at ease or give the player specific strategies which can help them to return to full training and match-play as quickly as possible. 

Our friendly physio's love working with local sporting clubs so if there's anything you think we can help you with, call us on 9364 4073, and we'd be happy to chat.

Your type of exercise

No matter what injury, age, body type, sport, job or attitude, there's an exercise option that's just right for you here at LifeCare Riseley Physio.

What type of exerciser are you?

THE RECOVERER

Exercise for you: Clinical Pilates
Run by: Pilates-trained physiotherapist

Suffering from pain, recovering from injury or trying to reach sporting excellence? An exercise program developed by a Pilates-trained physiotherapist helps you get back to doing all the things you love. After an initial assessment which reveals your strengths and weaknesses, your physio will help you to develop individual rehab goals.

Close supervision and feedback on body awareness, alignment, breathing, control, flowing movements and precision helps you move better and feel great. Your individual program can be designed to reinforce a set of home exercises so that you're not only making progress within each session, but between them as well.

physical-exercise

THE REFORMER

Exercise for you: Reformer class, mat class
Run by: Pilates instructor

For those who are keen on an individualised whole body workout that retrains posture, develops relaxation and improves control, our Pilates instruction classes are just the thing. Pilates-trained instructors will guide you through a refined series of exercises; they have hundreds to choose from! This is a good option for people who are not experiencing a specific pathology needing rehab but are looking to rebuild a balanced body. We find many people get hooked on exercise and enjoy keeping up their regular Pilates time with an instructor guiding them through a program that is forever adapting, just as you are.

THE EXPECTANT EXERCISER

Exercise for you: Pregnancy class
Run by: Women's health physiotherapist

These classes are for women at any stage of pregnancy, but ideally those in the second and third trimester. Keep coming until your due date (or beyond)!

The classes are run as a six week block, with one class per week. The classes involve an hour of Pilates-type exercise with a focus on stretching, toning, breathing, relaxation, posture and pelvic floor activation. This is done with the use of a mat, exercise ball, theraband and hand weights. Different options are available to ensure that all levels of fitness and Pilates experience are catered for!

THE WISE WALKER

Exercise for you: Osteo class
Run by: Physiotherapist

Our osteo class is designed for building strength, balance, flexibility and bone density. There are a wide range of exercises that are adjusted to your needs; all done to the backdrop of great conversations and plenty of laughter. Come and meet all the energetic exercisers!

THE FLEXIBLE BOUNDER

Exercise for you: Kids Pilates
Run by: Pilates-trained physiotherapist

Particularly helpful for kids with hypermobility, there's plenty of excitement to keep the entertainment factor high. Pilates comes alive as a series of therapeutic exercises are turned into muscle games that challenge balance, control and stability. This class is great at developing good patterns of movement from an early age, helping kids of all body types to enjoy exercise, prevent injury and promote development!

For all the latest session times and availabilities in our popular classes, or for an assessment with a physio to determine which one is best for you, call us on 9364 4073.