#grange physio

Suffering Sciatica?

Sciatica pain comes from the large sciatic nerve which passes down through the buttocks, down the back of the thigh and then divides into other nerves in the low leg.  There are many reasons as to why this nerve becomes inflamed but it may originate from the lower back.  The sciatic nerve is formed in the mid to lower part of the back and comes out at various levels in the lower back.  If the back has been injured or has undue stress on it then swelling and inflammation may occur and then may then place stress on the sciatic nerve leading to what many people called a pinched nerve.  This can cause severe pain in the back and down the leg/s and pain can be quite debilitating.

It is certainly worth talking to your G.P about your concerns.   Physiotherapists are trained to treat these type of conditions. Ensure that a full history of your back pain is taken as well as an intense assessment of posture, bio-mechanics and movements.  A proper diagnosis cannot be given unless a full history and assessment has been done.   Scans may or may not be needed.  They are usually only needed if treatment has occurred without improvement.   Manipulation should not occur without a full assessment of the spine.

Advice on home management is vital to ensure minimization of pain and enhance recovery.   A regular home exercise regime with advice will encourage normal spinal movement and nerve function.   Grange Physiotherapy therapists treat and given  comprehensive home management.  This is progressed and adjusted with improvement of symptoms.  A written analysis of your diagnosis and treatment plan will be provided with recommendations.  This may include further tests or referral to other specialists.  You will be reassessed at each appointment so your progress is optimal.  Full assessments occur at regular intervals.  Should you need to start a supervised exercise program this will be suggested and implemented with your approval.  Our focus is your recovery to full function in combination with your goals.   While Sciatica may take some time to improve due to the sensitivity and healing ability of nerves, conservative treatment generally provides good results and surgery can usually be avoided.

Chronic Low Back Pain

Chronic low back pain can be both painful and frustrating.  It is also very common.  Research indicates persistent low back pain is due to a range of factors including: poor disc hydration/health, stiff spinal segments, poor muscle control, degeneration of the spine, nerve compression and is influenced by psychosocial issues.  This may lead to not enough or too much movement between the vertebrae segments thus causing pain.  If this is the case then specific exercises aimed at improving normal spinal range and function will improve the back’s function and decrease pain.  These exercises involve both back muscles and abdominal muscles but play an entirely different role to the abdominal muscles we use with exercises such as sit-ups. In fact there is a theory that these type of exercises such as sit ups can actually cause an increase in chronic pain because the wrong type of muscles are being used and they are unable to stabilise and give the support necessary.  The muscles that stabilise the spine are the lower abdominal muscles, which include the transverse abdominus, and the internal oblique muscles.  These muscles can be felt in the lower tummy area just below the front hipbones felt through the lower tummy. The simplest way to exercise them is to try to gently pull in these muscles without tightening the upper abdominal muscles.  This type of exercise then becomes incorporated with activities of daily living so that it becomes an unconscious action involved in posture.

Before you start on an exercise program ensure you get a full assessment of your problem, as instability or weak muscles may not necessarily be the cause of your problem.  Your posture and spinal range needs to be assessed.  The lower abdominal muscles need to be tested  in specific positions to see how strong they are.  Finally you will probably need an individually planned exercise program incorporating both strength exercises and stretches.  On top of all that you need to stick with your exercise program as initially progress can be slow. The longer the problem has been, the slower the rehabilitation can be.  But persist.  With a good physiotherapist your pain can be managed in most cases without surgery.

These injuries can be small but very painful when injured.

Sprained thumbs are fairly common with a range of specific sports such as skiing.  The reason for this is because during a fall the ski pole is between thumb and fingers. (Physiotherapy in Grange)

 Any sport where the hand is stretched out on a fall can create damage to most commonly, the inner ligament of the middle thumb joint.  Like any soft tissue injury the RICE procedure should be followed immediately after injury and for 24 to 48 hours post injury.  This consists of Rest, Ice, Compression and Elevation.  Rockingham Physio

Thumbs or injuries of the hand can be slow healing due to the complexity of the structures and because rest of this area can be difficult.  These injuries may take up to 6 –12 months to heal properly.  However thumbs and fingers respond  well to strapping or bracing which can allow for continuation of activity and sport, while the soft tissue heals.  Strapping or bracing supplies an external ligament support while the real ligament heals.  Grange Physiotherapy and Rehabilitation

 Stretches and mobilisation of the joint may also be appropriate due to the long period of healing which can create joint stiffness. Ultrasound may also be of benefit with these types of injuries as it speeds recovery by decreasing inflammation and increasing blood supply to that area.

Physiotherapists see a lot of painful necks!  It is one of those areas of our body we use all the time and take for granted.  And it can get injured, overused, and wear out with time, excess loading and poor posture. It can then cause pain, headaches, arm pain and a range of other symptoms such as vertigo and weakness.neck and head physiotherapy in grange

 Physiotherapy is important for a full assessment of the problem, to see whether it’s coming from your neck or elsewhere and to ensure a treatment plan is in place.  A home program is vital and may consist of stretch and strength work which will help control neck pain and allow maintenance of chronic pain to minimise flare-ups.  Rockingham Physio

 Chronic neck pain following whiplash injuries is common.  The neck muscles are used every day all day and it is very difficult to rest these injured structures.  Apart from normal movements, they are vitally important in maintaining your posture.  Whiplash can leave a weakness in the neck and sometimes degenerative changes.  Whiplash is quite a complicated injury often causing headaches, face pain, neck pain, pins and needles, weakness, limitations of movements and often depression.

 Physiotherapy at a chronic stage should be twofold.  First, the symptoms should settle down as quickly as possible and then both the physiotherapist and the client must strive to ensure that the problem becomes manageable.  It will probably not go away altogether, so strategies need to be devised in order to live and cope with the condition.  This means regular exercise not only for the neck but also cardiovascular exercise, diet change, loss of weight if appropriate, posture adjustments and flare up strategies. Physio Rockingham

   The aim is to minimise flare-ups to prevent further damage.

The reason that driving or sitting for that matter causes your back to ache is fairly simple. The entire back in standing is very cleverly designed to form an “S” curve when viewed sideways in order to cope with the everyday stresses placed on it. This creates a spring or bounces effect with stresses to the back. The lower back, in particular, has the inward curve of the “S” so that when viewed from the side the curve curves towards the tummy. When sitting, your legs are high in front of you, and this pulls the pelvic bones around so that this inward curve becomes either straight or curves the other way. So often your back takes on the “C” shape instead of the “S”. This places a significant amount of stress on the back which can be enhanced and aggravated by vibration e.g. when travelling. At first, you may only experience stiffness getting out of your seat, then this will progress to stiffness and eventual pain while sitting and sitting to stand. The back can only take so much stress until small degenerative changes start to occur ever so slowly to try to accommodate this stress. We are not designed to sit for long periods in this poor postural positioning. In most cases, the stress builds up slowly until it becomes too much and pain begins.

Despite technology, most seats do not have enough lower back support. There are a variety of supports that can assist to reduce a load of spines in sitting. These are worth trialling. The reality is our bodies are not designed to sit for a long period of time. Stretching and standing activities should be done regularly if sitting for long periods.

Travelling by car? Newer cars are much better than the older cars where there is often little choice between a bucket seat and a straight-backed seat. The newer cars do have adjustable lower back support which while being an improvement on the older cars still need some technology years to refine the perfect sitting position. Let’s face it they are still trying to find the perfect chair for office work and more technology is needed for this. While we are not suggesting you buy a new car, the seat may need replacing if it is considered vintage. However, there are various supports that you can buy which fit into a car seat and will support your back.

Basically, you need to produce an inward curve of your lower back and if you do that you will be able to drive long distances much more comfortably. A quick solution is to invest in a lumbar roll which retails cheaply from most physiotherapy clinics and adds some support. A cushion/pillow may also assist as long as your lower back is in an inward curve position. There are also more fancy expensive options which support both the back and the pelvic area. Mind you in saying all this there are some seats that despite back cushions and modifications etc. need to be put on the trash heap. No matter what you do to them, they stress your back. When travelling if possible, make sure your knees are below your hips as this will help reduce the load on your back by maintaining the normal curves.

AEROBIC EXERCISE: Physiotherapy in GrangeANAEROBIC EXERCISE:

Our Physiotherapists in Rockingham and Mandurah believe exercise is important.  Previously it was thought that once you retired inactivity was acceptable.  It’s now recognised that activity is beneficial throughout our journey. Our bodies are designed to exercise every day.  In fact if we don’t exercise, just as if we don’t eat, our body literally starts to break down and all sorts of problems emerge e.g. heart, bone/osteoporosis, depression, balance. mobility and lots more.

It is a well-known fact that the way to fitness and good health is a well balanced diet and regular physical activity. This is especially true and important for the elderly.

 Recent studies have shown that physical exercise in the twilight years adds quality and vitality to life. One mayor concern among a lot of people who don’t exercise is the fear of overdoing it and risking injury, especially as we get older.  This concern is valid but should not hinder from reaping the benefits of what a carefully planned and professionally assessed program has to offer. It is important to remember that young or old – we are supposed to exercise within the boundaries of the body’s current level of tolerance.

 What should we be doing?  Most research shows that we should be exercising 2-3 times weekly for a minimum of 20 – 30 minutes.  This will vary depending on what type of exercise and what intensity it is.  For example with moderate walking then a reasonable goal could be 40-50 minutes per session.  If high intensity cycling is the activity then 20 minutes may be sufficient.  There are 2 types of systems that the body uses to create energy:

Exercise with the use of Oxygen

This type of exercise makes you puff

It trains the cardio/vascular system

Examples: brisk walking, cycling

Exercise must be for a minimum of 15 minutes to be aerobic

  Exercising without Oxygen

Gives you short bursts of energy before the aerobic system comes in

E.g. squash (stop-start), gym work, weightlifting etc.

Whenever we start to walk we use our anaerobic system until the aerobic system starts to kick in.  Anaerobic training is often used for specific functions e.g. muscle strength, osteoporosis bone building etc. Both types of exercise are beneficial although aerobic exercise is very important for full health i.e. cardiovascular health. Physio Rockingham 

How to get motivated?  Join a class or train with others.  Make sure the class is appropriate for what is needed and caters for specific needs.  If there are medical issues, assessment by a qualified professional such as a physiotherapist is recommended.   There are various classes available e.g. aqua-aerobics, prime movers, hash house harriers (runners).  Classes need to be specific for the needs of each individual. A client who has degeneration of the knees and a total hip replacement needs a specific program to incorporate all the areas of concern.  Physiotherapists often have clients who haven’t exercised for a while and just want a general fitness program.  They can be given guidelines on what to avoid and what to focus on.  It can be a lot easier to exercise with others when there is the social aspect of meeting other people while doing the task.

With gym training, there are many gyms and clubs around currently offering competitive fitness deals.  Find someone who understands specific medical history so damage is not done.  It may be worth getting knowledgeable advice from your physiotherapist on this.  Our clinics run small strength training groups for the older person or those suffering specific medical conditions such as osteoporosis, arthritis etc.  Exercise programs are written by a qualified physiotherapist so that they are specific to the client’s needs, and training occurs for a one-hour period.  The classes are small so that the instructor can give individual attention to everybody whilst still being able to keep the price low. physiotherapy for back pain relief in grange

 The advantage in a small class is that you are guided throughout the entire training session and supervised.  There are also social aspects as well, which include encouragement, friendship and stamina.  It is always easiest to train with someone than to try to train independently especially when you’re in pain.  This type of class is very appropriate for the older person even if there is no gym experience at all.  Other options involve just getting specific advice on an appropriate program and train independently.  Regularity with a training regime is important to obtain best results.  At least 2-3 times a week is a general guideline.

Too much exercise can decrease hormones needed for good bone health. Moderate controlled exercise is the key.