Sydney West Physio

It happens in a split second: a ball hits the tip of your finger, or you catch your hand while tucking in a bedsheet. Suddenly, the end of your finger is drooping, and no matter how hard you try, you can’t lift it back up. This common injury is known as a Mallet Finger.

What are Mallet Finger Injuries?

A mallet finger occurs when the extensor tendon responsible for straightening the tip of your finger is damaged. There are two main types:

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Tendinous Mallet: The tendon itself tears.

Bony Mallet: The force is so strong that the tendon pulls off a small piece of the bone where it attaches despite no tear in the tendon. This is known as an avulsion injury.

In both cases, the “bridge” that allows your muscles to pull the fingertip straight is broken.

Mechanism of Injury

This injury is almost always caused by a hyperflexion force—essentially, an object hitting the tip of a straight finger and forcing it to bend further than it’s meant to. While common in ball sports like cricket or baseball, it frequently happens during mundane household chores.

Typical Symptoms

The “Droop”: The most obvious sign is the tip of the finger resting at a downward angle.

Inability to Straighten: You can push the finger straight with your other hand, but you can’t hold it there using its own strength.

Pain and Swelling: Especially around the outermost knuckle.

What to Do?

The golden rule for Mallet Finger is continuous splinting. To heal, the two ends of the tendon (or bone) must be kept in perfect contact. This usually requires wearing a specialised splint 24/7 for 6 to 8 weeks. Even removing it for a few seconds to wash your hands can “reset” the healing clock if the finger droops.

What if I leave it?

If left untreated, the imbalance of forces between your tendons in your finger can cause the middle knuckle to overextend while the fingertip remains bent, leading to a permanent “Swan Neck” deformity. This misalignment significantly disrupts the hand’s natural mechanics, making it difficult to perform basic tasks like gripping or buttoning a shirt.

Concluding Remarks

Early intervention is the key to avoiding a permanent deformity and promote adequate healing. Our hand therapists can make you a custom splint, ensure your splint fits correctly, monitor your skin health and guide you through a safe strengthening program once the tissue has knitted back together.

Achilles tendinopathy is a common overuse injury affecting the Achilles tendon—the strong band of tissue connecting your calf muscles to your heel. It often develops gradually when the tendon is exposed to more load than it can tolerate, making it particularly common in runners, active individuals, and people who suddenly increase activity levels.

Common symptoms include pain or stiffness at the back of the heel, especially during the first steps in the morning or at the start of exercise. The area may feel tender to touch, and in some cases mild swelling or thickening of the tendon can occur. Symptoms often improve with gentle movement but return with prolonged activity.

Why does it happen?

Achilles tendinopathy typically results from a combination of factors such as rapid increases in training, inadequate recovery, calf muscle weakness, reduced ankle mobility, or biomechanical issues like overpronation. Poor footwear or training on hard surfaces can also contribute.

How physiotherapy can help

Physiotherapy is one of the most effective treatments for Achilles tendinopathy. Management focuses on reducing pain, restoring tendon capacity, and preventing recurrence. Your physiotherapist may provide:

Targeted exercise therapy – Progressive loading programs to help stimulate tendon healing and improve strength.

Load management advice – Guidance on modifying activity levels to allow recovery while maintaining fitness.

Manual therapy – Techniques to improve ankle mobility and reduce muscle tone.

Education and prevention strategies – Advice on footwear, training progression, and long-term tendon health.

Recovery expectations

Tendon recovery takes time. With consistent rehabilitation, most people see significant improvement within 8–12 weeks, though full recovery may take longer depending on severity and activity demands.

If you’re experiencing persistent heel pain, early physiotherapy assessment can help you stay active and prevent the condition from becoming chronic.

Lisfranc injuries are a spectrum of injuries that refer to damage in the midfoot area, particularly affecting the joints and ligaments. Named after French surgeon Jacques Lisfranc de St. Martin, these injuries can range from simple ligament sprains to complex fractures and dislocations. Though relatively uncommon, Lisfranc injuries can have significant impacts on an individual’s movement and quality of life especially if not properly addressed.

Mechanism of Injury

Lisfranc injuries typically occur due to a sudden force or twist to the foot. Common causes include falls, sports accidents, and motor vehicle collisions. For example, a football player might sustain a Lisfranc injury if another player steps on their foot while it’s flexed downwards. Similarly, a gymnast might experience this injury upon an awkward landing. Essentially, any activity that places extreme pressure on the midfoot can result in a Lisfranc injury.

Structures Involved

The midfoot consists of several small bones and ligaments that connect the forefoot to the hindfoot. In a Lisfranc injury, the ligaments that support these bones can be torn, and the bones themselves may fracture or dislocate. The Lisfranc ligament, which stabilizes the arch of the foot, is often the primary structure involved. Damage to this ligament can lead to a collapse of the arch and subsequent foot instability.

 Typical Symptoms

Symptoms of a Lisfranc injury can vary depending on the severity but commonly include:

Pain and swelling in the midfoot area.

Bruising, especially on the top and bottom of the foot.

Difficulty bearing weight or walking.

Visible deformity in severe cases, where the midfoot appears misaligned.

If you experience these symptoms following an injury, it’s crucial to seek medical attention promptly.

What to Do?

Initial treatment for a suspected Lisfranc injury includes the R.I.C.E. method: Rest, Ice, Compression, and Elevation. Avoid putting weight on the affected foot and use crutches if necessary. Visit a healthcare provider for a definitive diagnosis, which may involve physical examination, X-rays, or other imaging studies. Treatment can range from conservative approaches, like casting and physical therapy, to surgical intervention in more severe cases.

Concluding Remarks

Lisfranc injuries, though not as well-known as other foot injuries, can have significant consequences if left untreated. Early diagnosis and appropriate management are key to ensuring a good recovery and preventing long-term complications. If you suspect a Lisfranc injury, don’t delay seeking professional medical advice. With proper care, most people can return to their normal activities and enjoy an active lifestyle once again.

Bone healing is a fascinating process that our bodies naturally undergo after a fracture. Understanding this process can help you appreciate the remarkable way your body works to repair itself. Let’s break down the stages of bone healing, including primary and secondary bone healing, in simple terms.

 Primary Bone Healing

Primary bone healing occurs when the broken bone ends are closely aligned and stable, usually achieved with surgical intervention like plates or screws. This type of healing is similar to how bones grow during development. Here’s what happens:

Osteoclast Activation (Week 1-2): Osteoclasts, specialized bone cells, remove damaged bone tissue at the fracture site.

Osteoblast Activity (Week 2-4): Osteoblasts, another type of bone cell, produce new bone tissue to bridge the fracture gap.

Bone Remodelling (Months to Years): Over time, the new bone tissue is remodelled to regain its original shape and strength. This stage can take several months to years.

 Secondary Bone Healing

Secondary bone healing is more common and occurs when the bone ends are not perfectly aligned or when the fracture is stabilized with a cast or brace rather than surgery. This process involves several stages:

Haematoma (Days 1-7): Right after the fracture, the body sends blood to the injury site, forming a blood clot called a hematoma. This clot provides the initial framework for healing and attracts cells that begin the repair process.

Soft Callus Formation (Weeks 1-3): The hematoma gradually turns into a soft callus made of collagen and cartilage. This soft callus stabilizes the fracture but is not yet as strong as bone.

Hard Callus Formation (Weeks 4-6): The soft callus is replaced by a hard callus of woven bone, which is stronger but still not as durable as the original bone.

Bone Remodelling (Months to Years): Similar to primary healing, the hard callus is remodelled over time. The new bone tissue is gradually reshaped and strengthened to resemble the bone’s original structure.

Bone healing is a complex yet efficient process that our bodies manage remarkably well. Whether through primary or secondary healing, understanding these stages can give you a clearer picture of what to expect during recovery.

Always follow your healthcare provider’s advice to ensure the best possible outcome for your bone healing journey.

Facing knee surgery can be daunting. But what if there were steps you could take beforehand to improve your outcome and get back on your feet faster? Enter prehabilitation, or “prehab” for short. This proactive approach focuses on strengthening and conditioning your knees before surgery, optimizing your body for a smoother recovery.

Prehab offers a multitude of benefits for those undergoing knee surgery, including:

Reduced Recovery Time: Studies suggest prehab can significantly decrease the time it takes to regain mobility and function after surgery. Stronger muscles support healing and make rehabilitation exercises more manageable. This translates to a quicker return to your daily activities.

Improved Surgical Outcomes: Prehab prepares your body for the surgical process itself. Stronger muscles and improved circulation can reduce the risk of complications like infections and blood clots. This allows surgeons to perform the procedure with greater ease and potentially optimizes the surgical outcome.

Enhanced Pain Management: Prehab exercises can improve pain tolerance and reduce post-surgical pain. By strengthening the muscles around the knee, you provide better support and stability, leading to less discomfort.

Increased Confidence and Mental Well-being: Prehab empowers you by taking an active role in your recovery. Knowing you’ve prepared your body beforehand can alleviate anxiety and boost your confidence about returning to normalcy.

Improved Long-Term Function: Prehab focuses not just on regaining pre-surgical function, but also on building long-term strength and stability. This can help prevent future injuries and promote a healthier lifestyle.

What Does a Prehab Program Look Like?

A prehab program typically involves a combination of exercises tailored to your specific surgery and needs. Here are some common components:

Strength training targetting the muscles surrounding your knee joint, particularly the quadriceps, hamstrings, and calves. Stronger muscles provide better support and stability for your knee.

Flexibility training to improve your range of motion and reduce stiffness in the knee joint. This is crucial for regaining full mobility after surgery.

Cardiovascular exercise and low-impact activities like swimming or stationary cycling can improve your overall fitness and prepare your body for the demands of surgery and recovery.

Balance Exercises to improve your balance and proprioception (your body’s awareness of its position in space). This helps prevent falls after surgery and promotes stability.

Education and about your surgery, proper pain management techniques, and safe movement patterns post-surgery is crucial for optimal recovery. 

Getting Started with Prehab

The ideal time to begin prehab is several weeks before your surgery, but even a few weeks can make a difference. The majority of knee surgeons now suggest prehabilitation as a crucial part of your overall management. Our physiotherapists all work closely with many of the best surgeons in Western Sydney and are well equipped to work in collaboration with you and your surgeon to get you the best results.

Remember: Prehab is an investment in your future. By taking the time to prepare your body before surgery, you’re setting yourself up for a faster, smoother, and more successful recovery. So, be proactive, embrace prehab, and get ready to conquer your knee surgery with confidence!

Many of us have experienced the dreaded jarred finger at some point in our lives. Whether it’s during a sports game when a ball hits our finger or just in everyday activities, these injuries are often just shaken off. But what actually happens when we jar our finger, and can it be more serious than we realize? This blog aims to clarify and teach you a few things about the dreaded jarred finger.

Mechanism of Injury

A volar plate injury typically occurs due to hyperextension or extreme bending backward of the joint in your finger called the PIP (proximal interphalangeal joint). This joint is the middle joint of your finger, and hyperextension happens when it bends back beyond its normal range of motion. Such injuries are common in sports like basketball, volleyball, and football, but they can also occur during everyday activities like catching a heavy object or even tripping and falling.

Structures Involved

The primary structure involved in a jarred finger injury is the volar plate. The volar plate is a strong ligament located on the palm side of the PIP joint. Its main function is to prevent hyperextension of the joint, thereby protecting it from bending backward too far. When this ligament is overstretched or torn, it can cause significant pain and instability in the finger.

In some cases, the force of the injury can cause an avulsion fracture, where the ligament pulls a small piece of bone away from its attachment point. This is more severe and requires careful management. In the worst-case scenario, the PIP joint can dislocate, meaning the bones are forced out of their normal alignment, causing the finger to look deformed and necessitating immediate medical attention.

Typical Symptoms

Severe Pain: Often immediate and intense, making it difficult to move the finger.

Bruising: Usually appears on the palm side of the finger where the volar plate is located. The bruising may spread to the surrounding areas over time.

Swelling: The finger may swell quickly, sometimes making it difficult to see the natural contours of the finger.

Difficulty Bending and Straightening the Finger: The finger might feel stiff, and any attempt to move it can be painful.

What to Do?

Initially: Rest the finger to prevent further injury. Apply ice to reduce swelling and assist with pain management. Use compression bandages like Coban to provide support and minimise swelling. Elevate the hand above heart level to help drainage of excess fluid if necessary.

X-ray: It’s crucial to get an X-ray to rule out fractures or dislocations. Even if the finger appears to be only mildly injured, an X-ray can reveal underlying issues that aren’t visible to the naked eye.

Seek a Hand Therapist: A hand therapist will assess the extent of the injury and recommend a treatment plan. This could involve:

Taping or Splinting: To immobilize the finger, allowing the volar plate and any fractures to heal properly.

Structured Exercise Program: Once initial healing has occurred, specific exercises will help restore full function, strength, and flexibility to the finger.

Neglecting proper treatment can lead to long-term issues such as chronic pain, stiffness, or even permanent joint deformity.

Here’s how physiotherapy can help

Anterior Cruciate Ligament (ACL) injuries are amongst the most common major injuries in sport with figures from the United States suggesting more than 200,000 ACL surgeries are performed each year. Multidirectional sports in which pivoting, landing and change of direction maneuvers are involved present the greatest risk and account for majority of the injuries. Following an ACL injury, the primary goal for athletes is to return to their sport, typically after ACL reconstruction surgery. To ensure maximum knee function is achieved, high-quality rehabilitation is imperative.

Whether you are at the beginning or end of your rehabilitation journey, we are here to help!

What is the ACL?

The ACL is one of four main ligaments of the knee which is responsible for stabilizing the knee joint.

Will I need surgery?

Contrary to typical belief, surgery is not always required for ACL injuries with growing research to support conservative rehabilitation. Choosing to go down a surgical route will likely depend on your future goals, particularly if these are sport related. Fortunately, our  physiotherapists can discuss this with you and provide you with all the details necessary to make an informed decision!

What does the rehab process involve?

Whether you choose surgical or conservative management, the immediate goal of rehab remains the same with emphasis on managing swelling/effusion, restoring full range of motion (ROM) and facilitating sufficient activation of the quadriceps muscles.

Following this initial phase, rehabilitation aims to progress strengthening of the muscles around the knee along with improving balance/proprioception and knee control. It is also important to strengthen all other muscle groups throughout the rehab process to ensure these maintain their strength and are not deconditioned during your recovery.

Most athletes can then return to straight line jogging after 12 weeks along with commencing plyometric exercises such as jumping and hopping. This is a guideline and can vary from person to person. As you progress with your rehab, agility and sport-specific exercises are introduced with emphasis on improving confidence and coordination.

The final stage involves high-level sport-specific strengthening and includes a progressive return to sport. This may include restricted training at first before progressing to full training and finally match play.

It is important to note, the rehabilitation journey is often lengthy, with most athletes returning to sport after 9-12 months.

Sprained ankles are one of the most common injuries that occur in sport and everyday life. Sprains involve ligaments which are a type of connective tissue in the body that attach one bony part to another. A sprain occur when a ligament is stretched beyond its normal capacity. This results in some degree of damage to the ligament that can cause pain, swelling, bruising and often a decreased ability to walk and participate in activities we enjoy.

The most common ligaments in the ankle to be injured (occurring 95% of the time) are those present on the outside of the ankle. There are three ligaments that attach to the large bone on the outside of the ankle and fan outwards. These ligaments are injured when our foot “rolls in”, causing these ligaments to stretch which may cause tearing either microscopically, partially or fully.

So how do we go about managing this injury until we see a doctor or a physio? We all have been taught to use the PRICER principles which include protect, rest, ice, compression, elevation and referral to a medical specialist. However new research has come out which suggests a new way of managing these types of injuries with the acronym PEACE & LOVE.

When we immediately hurt ourselves we should follow the new guidelines of PEACE.

P = Protection: In the first 1-3 days we should avoid movements that increase pain and offload the injured ankle where possible to prevent the risk of further damage. This may include using crutches to help us get around. Although it’s important to note we should avoid prolonged rest as this delays healing.

E= Elevation: It is important to elevate the injured ankle above the level of the heart where possible. This prevents excessive swelling build up around the injured site.

A = Avoid Anti-inflammatories for 72 hours: Inflammation is an integral phase of the body’s natural healing process. Inflammation allows for nutrient rich blood to reach the injured body part to removed damaged tissue and repair. If we use anti-inflammatory medications like Ibuprofen we will disrupt this natural process and negatively impact healing. Although ice is important for pain and swelling management, we shouldn’t overuse it. We should limit the use of ice as this can also impacts the inflammatory process and may limit healing.

C = Compression: Appling external compression through the use of crape bandaging or tubigrip may help limit excessive swelling building up around the ankle.

E = Education: It is essential that health professionals including physiotherapists and GPs educate the injured individual on the benefits of active approaches to recovery and the negatives of passive approaches such as acupuncture and electrotherapy modalities. You as the patient should be empowered with the knowledge of the injury to be able to manage this condition and be able to seek out advice from qualified and reputable health practitioners.

After a few days our ankle sprain, when should follow the LOVE guidelines to rehab our ankle.

L = Load: We need to take an active approach with our injury rehab which includes exercise or “load.” Loading our ankle within tolerable ranges will actually promote healing and remodelling of the ligaments and insure our ankle is able to be as strong as possible. The right exercise program can reduced the risk of re-injury.

O = Optimism: After an injury we need to be optimistic about our situation. Negative attitudes and beliefs including fear and catastrophizing are actually associated with worse outcomes.

V = Vascularisation: Pain free aerobic exercise that you enjoy is important in the rehab process. Cardiovasulauar exercise increases nutrient rich blood flow to the injured ankle promoting healing and improves function.

E = Exercise: Finally after we injure our ankle we must exercise. Exercise is extremely important and the cornerstone of rehab from injury to improve mobility, strength and balance of the joint. Your physiotherapist will play a critical role providing these exercises that are tailored to you.

We hope this helps the next time your sprain your ankle. If you found this interesting and would like more information follow the link below or contact us.

Happy healing!

Many people have either heard the term hip bursitis or unfortunately experienced this condition. It is often believed that the bursa or fluid filled sac is the primary cause of pain and irritability. However, we now know that it is often the gluteal tendons that are the primary cause of pain and that physiotherapy can be extremely beneficial for this condition. To find out more about this please refer to the previous blog by myself called “Is my bursitis causing hip pain?” In that blog the anatomy and causes and treatment options of this hip pain, AKA Greater Trochanteric Pain Syndrome (GTPS) are explored in greater depth.

So what about corticosteroid injections?

Corticosteroid injections are commonly used not only for GTPS but many other conditions as a way of alleviating pain. They do this because they are extremely potent anti-inflammatory medications that reduce pain on average by 55%. Research has suggested that although 72–75% of people have positive response at 4 weeks, these symptom changes are short lived and by 12 months there are no difference in outcomes between subjects receiving corticosteroid injection and those receiving usual care (analgesics as required).

In addition the safety and benefit of repeated use remains unclear. When we consider GTPS often presents with limited inflammation, rather degenerative, thus the benefit of potent anti-inflammatory drugs may be unlikely. Furthermore these drugs often hinder the healing capacity of tendons. Due to these reasons although injections may help with pain in the short term, it is not a fix for the underlying issues and it is likely the pain will return if the tendon itself isn’t treated.

So if you or anyone you know has “trochanteric bursitis”, before asking the doctor for an injection, have a try at some physiotherapy to try and address the underlying issues.

If you have enjoyed this blog and wish to know more below is a detailed article.

Sydney West Physio is Sponsoring the Inaugural Raging Waters Running Festival

Sydney West Physio is thrilled to announce our official sponsorship of the Raging Waters Running Festival, an exciting and unique race event set to take place at Raging Waters, NSW’s biggest water park! This festival promises to be a day of thrilling challenges, fun-filled moments, and an unforgettable experience for all participants and spectators.

Organised by Race Hub Australia, the Raging Waters Running Festival is not just your typical running event – it’s an adventure! Start with a 10km, 5km, or 2km race, and then cool off with unlimited water slide fun as soon as you cross the finish line! Set against the backdrop of Raging Waters, the largest water park in New South Wales, this festival combines the excitement of running with the fun of water-based activities.

At Sydney West Physio, we’ve always been passionate about supporting health, wellness, and an active lifestyle in our community. We are dedicated to helping individuals stay healthy and achieve their fitness goals, whether they’re running a marathon or simply taking part in a fun, family-friendly event.

By sponsoring the Raging Waters Running Festival, we are reinforcing our commitment to promoting physical health and supporting local events that encourage people to lead active, healthy lives. We believe in the power of movement, and we’re excited to see our community come together for this amazing event.

Special Offers for Participants

We want to make your Raging Waters Running Festival experience even more unforgettable with a special range of offers available exclusively to participants:

30% Discount on your Initial Appointment*: Take advantage of a 30% discount on your first physiotherapy appointment at one of our clinics to help you recover from any niggles after the race, or help you reach peak performance for the next event.

Complimentary Post-Race Massage: After crossing the finish line, let us help you unwind and recover with a complimentary post-race massage.

Entry to have a chance to win a Recovery Prize Pack

On-the-Spot Giveaways

Sydney West Physio is proud to support such an event, and we can’t wait to see you all there. If you’re ready to get your heart pumping and your feet wet, sign up for the Raging Waters Running Festival today! You can even use our code SWP20 for 20% off your entry fee.

Back to School – Fibre Rich foods for the School Lunch Box. Fibre is a type of carbohydrate found in plant-based foods that cannot be fully digested by the body. It passes through the digestive system largely intact, acting as fuel for beneficial bacteria in the gut.

Fibre helps to promote regular bowel movements, prevents constipation, supports overall digestive health and can also sustain our energy levels.

Many children do not consume enough fibre in their diets, which can lead to issues such as constipation and poor gut health. A low fibre intake may also increase risks of other health conditions such as being above a healthy weight and heart disease later in life.

It is important to include fibre rich foods in a child’s diet from an early age. Children also need to drink plenty of water throughout the day to keep bowels healthy and regular.

How much fibre does my child need?

Source: Eat for Health (https://www.eatforhealth.gov.au/nutrient-reference-values/nutrients/dietary-fibre)

Sources of Fibre

Parents can help ensure their children get enough fibre by offering a variety of fibre-rich foods as part of their daily meals and snacks. Good sources of fibre include fruits, vegetables, whole grains, legumes, nuts, and seeds. Incorporating these foods into meals and snacks can provide children with the fibre they need to support a healthy gut microbiome.

Practical tips for increasing fibre intake

Include a variety of fruits and vegetables in meals and snacks. Offer fresh, frozen, or canned options, and encourage children to try new varieties.

Choose whole grain bread, pasta, and cereal options over refined grains to boost fibre intake.

Incorporate legumes such as beans, lentils, and chickpeas into soups, stews, salads, and casseroles.

Snack on nuts, seeds, and popcorn for a fibre-rich crunch.

Offer fibre-rich desserts like fruit salad, fruit smoothies, or yogurt parfaits with granola.

Fibre Rich Meals & Snacks

For more information on Nutrition, talk to one of our specialists today.

References: 

Department of Health & Human Services. (n.d.). Gut health (online). Retrieved from https://www.betterhealth.vic.gov.au/health/healthyliving/gut-health. Last accessed 05/02/24.

Overactive bladder! – A strong, immediate need to urinate?

Are you constantly searching for the toilet? Are you not confident that you will make it in time? Is this impacting your work or social life? You may have symptoms of overactive bladder.

Overactive bladder (OAB) is a condition characterised by a sudden, uncontrollable urge to urinate, often accompanied by frequent urination and sometimes urinary incontinence (leaking). It affects many women and can significantly impact daily life. Here are some key points regarding OAB:

Symptoms

– Urgency: A strong, immediate need to urinate. – Frequency: Needing to urinate more than eight times in a 24-hour period. – Nocturia: Waking up at night to urinate. – Incontinence: Involuntary leakage of urine.

Causes

OAB can be caused by a variety of factors, including:

– Weak pelvic floor muscles. – Neurological disorders (e.g., multiple sclerosis, Parkinson’s disease). – Bladder irritants (e.g., caffeine, alcohol). – Certain medications. – Hormonal changes, especially during menopause.

Diagnosis

Diagnosis typically involves:

– Medical history review. – Physical examination. – Urinalysis to rule out infections or other conditions. – Bladder diary to track urination patterns.

 Treatment Options

1. Lifestyle Modifications:

– Dietary changes (reducing caffeine and alcohol). – Bladder training and physiotherapist lead pelvic floor exercises.

2. Medications:

– Anticholinergics (e.g., oxybutynin, tolterodine). – Beta-3 adrenergic agonists (e.g., mirabegron).

3. Non-Pharmacological Therapies:

– Neuromodulation techniques (e.g., sacral nerve stimulation). – Botox injections into the bladder muscle.

4. Surgery:

– Considered in severe cases when other treatments have failed.

Managing OAB

– Maintaining a healthy weight. – Staying hydrated but managing fluid intake. – Regular pelvic floor exercises. – Seeking support from healthcare professionals.

Oh Baby! Achieving a healthy pregnancy after bariatric surgery

Finding out you’re pregnant is a big moment. For some it will spark excitement and joy; for others it will bring anxiety and fear; for most, it will be somewhere in between.

Whatever you’re feeling, one thing is for sure – pregnancy adds a pile of new things to the to-do list.

While booking an appointment with your GP, finding yourself a team of midwives and doctors and perhaps a doula to support you through pregnancy and birth feels like a no-brainer, going to see a dietitian might not even be on your radar.

Research shows that mum’s nutritional status prior to conception and what she eats during pregnancy has a huge impact on a baby’s growth and development, yet it is not common practice to get expert advice from a pre-natal dietitian when planning a family.  Optimising mum’s nutritional status before conceiving is especially important if she has had bariatric surgery, as surgery has significant implications for her nutritional requirements and ability to meet them.

It is advised that women wait 12 – 18 months to fall pregnant following bariatric surgery to allow their weight to stabilise. However, the hormonal shifts that occur with significant weight loss often mean women find themselves more fertile than they were before surgery.

While there are many benefits to achieving a healthy weight prior to pregnancy, bariatric surgery comes with the risk of nutritional deficiencies on its own without the added nutritional demands of pregnancy. What’s more, babies born to mothers post bariatric surgery are at increased risk of fetal growth restriction, being small for gestational age, pre-term birth, still birth, congenital abnormalities and NICU admission. To help avoid these complications, it makes sense to get expert nutritional support which has benefits for both mum and baby.

If you are a woman who has had bariatric surgery and are hoping to start a family, there is great benefit in adding a pre-natal dietitian to your pregnancy care team. Pregnancy is perhaps the most important time in a woman’s life to eat well, so get in touch and find out how we can help you and your baby have the best possible start with tailored nutrition advice that works for you.

Have you ever experienced a sudden bout of dizziness or sensation that the room is spinning? Does this happen when you lay down in bed at night or roll over in your sleep? These are common signs and symptoms of people that suffer from BPPV. Luckily, most cases can be fixed very quickly with the correct treatment provided by vestibular physiotherapists.

What is BPPV?

BPPV stands for benign paroxysmal positional vertigo and is the most common causes of vertigo worldwide. More than 1 in 50 people will experience BPPV at some point in their lifetime and it accounts for nearly one quarter of all dizziness related hospital visits.

BPPV occurs when small crystals (otoconia) in your inner ear become dislodged and enter a semicircular canal. These crystals are responsible for detecting postural changes when we move our head. If these crystals get stuck in the wrong area, they can move in different directions causing incorrect messages to be sent to the brain. This results in the spinning sensation of vertigo.

How do I know if I have BPPV?

BPPV generally occurs without any warning and most people will wake up feeling like the room is spinning. This lasts for 5-20 seconds and will resolve if you keep your head still. Following onset, most people will continue to experience the same symptoms each time then perform a particular postural movement. Most commonly:

Lying down in bed at night

Rolling to the left or right when in bed

Bending forwards

Or looking to the ceiling

Depending on each individual, these symptoms may be accompanied by imbalance, nausea, vomiting or other vestibular symptoms.

How can physiotherapy help?

Vestibular physiotherapists are trained to identify if any of these crystals are dislodged with specific tests and equipment. They will use a camera to identify involuntary eye movement which confirm the areas the crystals have settled. Once this is confirmed, specific repositioning manoeuvres are preformed to relocate the crystals. Generally the treatment is successful in 1-2 sessions and patients make a full recovery.

Contact one of our clinics to discuss your needs

References

Weight loss is a multifaceted journey that involves a combination of healthy eating, regular physical activity, and behavioural changes. As dietitians, we often get asked about the role of weight loss medications in this process. While these medications can be beneficial for some individuals, it’s essential to understand their role, effectiveness, and potential side effects.

Understanding Weight Loss Medications

Weight loss medications are prescribed to help individuals lose weight when lifestyle changes alone are not enough. These medications work in various ways, such as reducing appetite, increasing feelings of fullness, or decreasing the absorption of fat.

Who Should Consider Weight Loss Medication?

Weight loss medications are typically recommended for individuals who:

Have a Body Mass Index (BMI) of 30 or higher.

Have a BMI of 27 or higher with obesity-related health conditions like type 2 diabetes, high blood pressure, or sleep apnoea.

Have tried to lose weight through diet and exercise without significant success.

Types of Weight Loss Medications

Several weight loss medications have been approved in Australia.

Some of the commonly prescribed ones include:

Contrave (Naltrexone-Bupropion): Combines two medications that affect the appetite and reward centres of the brain.

Duromine (Phentermine): Suppresses appetite by stimulating the central nervous system

Saxenda (Liraglutide): A daily injection that mimics a hormone to help regulate appetite.

Ozempic (Semaglutide): A weekly injection that mimics a hormone to regulate appetite and food intake.

Mounjaro (Tirzepatide): A weekly injection that targets two different hormones involved in blood sugar control and appetite regulation.

Benefits of Weight Loss Medication

When combined with lifestyle changes, weight loss medications can help individuals achieve significant weight loss, which can lead to improvements in obesity-related health conditions, such as diabetes, high blood pressure, and sleep apnoea. Additionally, these medications can provide the extra boost some individuals need to stay motivated and committed to their weight loss goals.

Potential Risks and Side Effects

It’s important to be aware of the potential side effects and risks associated with weight loss medications. Common side effects vary & can include gastrointestinal issues e.g. nausea, diarrhoea, constipation, increased heart rate, dizziness, and insomnia. More severe risks include potential cardiovascular problems and interactions with other medications.

The Importance of a Comprehensive Approach

While weight loss medications can be an effective tool, they are not a standalone solution. A comprehensive weight loss plan should include:

Healthy Eating: Focus on a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats.

Physical Activity: Aim for at least 150 minutes of moderate-intensity exercise per week.

Behavioural Changes: Develop healthy habits, manage stress, and seek support from a dietitian.

As dietitians, our goal is to work with you to achieve sustainable weight loss through personalised nutrition & tailored advice.

Maintaining a good diet while on weight loss medications is important & key points to consider include:

Protein intake & preserving muscle mass: having ensure protein is important to minimise muscle loss, which can lead to a loss in strength instead of body fat.

Adequate protein intake can also help you to feel fuller for longer and therefore less reliant on foods that are nutrient poor, energy dense.

Adequate nutrition: prioritising nutrient rich foods is important to make sure that you are fuelling your body properly. Our bodies are complex & requires enough energy, fats, vitamins, minerals to keep us healthy. Weight loss through unhealthy restrictive eating behaviours do not lead to sustained weight loss and often is at the detriment of our physical & mental health.

Mindful eating: a change in our eating behaviours is important for sustained weight loss. We discuss various strategies to support you to implement healthier & happier habits to understand how your body’s needs and wants.

Metabolic function: Eating is a behaviour & food is a science. For long term health, we need to eat food that supports our metabolic health & to prevent risks of associated chronic conditions.

Conclusion:

Before starting any weight loss medication, it’s crucial to consult with a doctor.

They can evaluate your health status, discuss potential benefits and risks, and determine the most appropriate treatment plan for your individual needs.

Work with a Dietitian and Exercise specialist with design a program that considers your current health, lifestyle, home situation and eating and exercise habits.

Finally, remember the path to a healthier you is a marathon, not a sprint.

If you are like many people who have experienced pin point pain on the outside of your hip, the bursa is often to blame. This condition is called trochanteric bursitis and it is the result of inflammation of the bursa on the side of your hip bone.

Bursa are fluid filled sacs which lay beneath tendons to reduce friction and stress during contraction of muscles. It has long been thought that the bursa were the painful culprit and cause of this condition that effects 23.5 % of women and 8.5 % of men between the ages of 50 and 79 years. However this notion has now been challenged for some time in scientific research.

Imaging and surgical studies now have identified that the tendons of smaller gluteal muscles (gluteus medius/minimus) are the primary cause of people’s painful hips. Although the bursa may become distended, this is believed to be secondary and is often not due to an inflammatory process. As such the condition is now often referred to as Greater Trochanteric Pain Syndrome (GTPS).

The tendon condition is called a “tendinopathy” which refers to an overuse and degenerative injury to tendons that occurs over time. Essentially it is an imbalance between the rate of wear and repair of a tendon and this leads to degenerative changes causing pain. Furthermore these negative changes can occur if a tendon is continually compressed.

Therefore the two major causes of GTPS are overuse and/or compression of the tendons.

So why does all that matter?

Well what that means is if we are able to treat the gluteal tendons, we can help decrease pain and improve your everyday life. That is where physiotherapy can help.

To treat GTPS specific and tailored gluteal tendon exercises can be utilised to increase the strength and endurance allowing for the tendon to heal. Also physio can help reduce compression of the tendon through changing a person’s positions and postures especially where a person’s leg crosses the midline of their body. This can occur when we sleep on our side or when we sit cross legged.

If you believe you have symptoms or would like treatment from physiotherapy follow the prompts on our website for more information or click here to make an appointment at one of our clinics. If you have enjoyed this blog and wish to know more below is a detailed article.

Strength, Stamina, and Steph: Helping the Australian Rowing Team Prep for the Olympics

Earlier this month I was lucky enough to head to the Australian Institute of Sports’ European Training Centre (AIS ETC) in Gavirate, Italy to work with the Australian Rowing team in the lead up to the Olympic Games. This follows from my involvement with the Australian Women’s Rowing Team at their National training Centre right here in Penrith on the Nepean River since mid-2023. Working with both the men’s and women’s teams whilst in Italy, I was part of a multi-disciplinary team including our Sports Doctor Dr Kath Gaffney, as well as dietician, soft tissue therapy and exercise science.

What a great experience!

From getting up very early to perform athlete checks before they went out on water to row, to completing individual (physiotherapy) assessments or (physiotherapy) treatments with athletes each day. My role was to ensure the athletes were able to perform at their best both on water and in the gym in the lead up to the Paris 2024 Olympic Games. I went out in coaches boats to watch the athletes training on the water, which added invaluable information when it came to treating these athletes. It was hard work, 11-hour days, non-stop for just over two weeks.

Fortunately, I did make use of the (little) down time we had in the beautiful Lake District of Northern Italy. I was able to have a truly authentic Italian experience as I enjoyed eating plenty of the local food – from a caffe crema with brioche in the mornings, to finishing off a hard days work with an aperol spritz and an aperitivo, before moving onto pizza, pasta, gnocchi or gelato afterwards! I enjoyed some truly unique scenery – from the view of the swiss alps when on the lake, to exploring the city of Milan briefly before heading home to be reunited with my family whom I missed while I was away. This was a great opportunity to work with an amazing bunch of athletes and a great group of support staff. I thoroughly enjoyed my time at the AIS ETC working as a physiotherapist. As the Australian Rowing Team continue their Olympic campaign, I wish them all the very best of luck for their respective events!

Go Rowsellas!