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First do no HARM

Last week we mentioned the acronym RICER in reference to treating acute injuries. This week, we thought it might be worthwhile to tackle another popular acronym – HARM. While RICER is all about what you should do when you have an acute injury – HARM is all about what you should not do. H – Heat increases swelling and bleeding in acute injuries as it dilates the blood vessels, bringing more blood to the affected area. Avoid heat packs, hot baths and saunas if you have an acute injury. A – Alcohol will also increase swelling and bleeding – for the same reason; it dilates blood vessels. It can also delay healing by contributing to a build up of toxins such as lactic acid in the injured tissue. The dehydration caused by alcohol can also thicken the blood, increasing problems of swelling and bleeding. R – Running and exercise should be avoided post-acute injury. It can aggravate the injury causing increased swelling, pain and bleeding, and the increase in body temperature caused by exertion can further exacerbate the problem. M – Massage is generally believed to be harmful immediately after acute injury. However, there are two exceptions to this. Massage concentrating on the uninjured parts of the body can be very beneficial. By keeping the rest of the body mobile, post-injury stiffness can be reduced. There are also gentle ‘recovery’ massage techniques used by professional Remedial Massage Therapists that can be used on injuries to help keep the area mobile whilst minimising heat generation. This is why it is vitally important to only see a qualified Remedial Massage Therapist – especially when you have an acute injury. So next time you experience an acute injury, or if you are suffering from chronic injuries that require attention, call or email our Baulkham Hills Clinic to book in with one of our Diploma qualified Remedial and Sports Massage therapists to help get you back on track – without doing any HARM.
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Blowing hot and cold on injuries

Put an icepack on it!  Put a heat pack on it!  Everyone is always full of advice on the best remedy when we have injuries or aches and pains.  So, what is best – hot or cold?  The answer is – it depends… Depends on what, you may well ask.  It depends on the pain. When to use Cold Cold packs should be used on new and acute injuries. When a new injury occurs, the body sends blood to that region – a muscle for instance – in order to facilitate healing.  This causes inflammation and - if you feel the area you may notice this – heat, from the increased blood flow.  A cold pack will reduce the inflammation, pain and heat. The best application of a cold pack is to place the pack – you can buy soft gel cold packs, or a packet of frozen peas/corn will do just as well – inside a pillowcase, or wrap it in a tea-towel.  Apply to the affected area for about 10 minutes every hour for up to 2-3 days, depending on the severity of the injury. A handy acronym if ice is what you need is RICER – Rest, Ice, Compression, Elevation, Repeat. When to use Heat Heat packs are most effective on chronic conditions and old injuries, particularly where stiffness or arthritis are involved.  The heat will warm and relax the muscles and increase blood flow, making them less rigid and thereby reducing stiffness. When muscle stiffness is caused by stress or anxiety – such as neck stiffness often is – heat can have a soothing effect on the nervous system. Heat can be applied via a hot water bottle wrapped in a towel, a wheat-bag heated in the microwave or more gently via a towel taken straight from the hot setting on the dryer.  Heat can also be generated by the application of a heat rub containing menthol. Whether it’s heat or cold you need, the team at our Baulkham Hills clinic can help with advice and treatment that will reduce the severity and length of your injury.
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Fungus

… and not the kind that goes well with pasta… There are all sorts of fungal infections that can take hold of your feet.  As with the Bromodosis that cause funky feet, fungus loves dark, damp, warm places.  Probably the most common fungal problem is Athlete’s Foot. This very common – and very catching – condition causes itching, stinging burning, cracking and peeling.  Yuck. How do you solve the problem? Following the same advice we dished up last week in our Funky Feet blog is a good first approach, but there are some additional things you should bear in mind when dealing with Athlete’s Foot:
  1. Athlete’s foot is extremely catching! If you have it – don’t go barefoot in gyms, locker rooms, pool or shower areas.  You might pass it on.  If you don’t have it – don’t go barefoot in gyms., locker rooms, pool or shower areas.  You might catch it!
  2. Never share socks or shoes.
  3. Avoid tight or enclosed shoes – the more your feet can breathe the better off they will be.
  4. When washing your socks try and include an antibacterial or anti-fungal in the wash with the detergent. And nothing kills off bacteria like good old sunlight – so where possible dry your socks in the sun.
  5. Clean your shower floor thoroughly and regularly with bleach to avoid re-infection.
  6. Invest in some anti-fungal cream, lotion or powder. Whichever one you choose – follow the instructions and use it for as long as indicated – often the fungus can hang around once the symptoms seem to have cleared.
Follow these few simple directions and your feet should be looking dishy again in no time! One final suggestion – visit your podiatrist to ensure whatever treatment you use is working.  Especially if problems persist.  Our podiatrist is in the clinic Monday, Wednesday and Saturday, so call or email the clinic if you would like an appointment.
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Train, compete, recover

Repeat Training and competing is the focus – right?  Well, maybe not.  Without an effective recovery plan, your training and competing in the next event can, at best, be less than effective.  At worst, it can put you at serious risk of injury and jeopardise future events. So, why is recovery so important?  And what should it incorporate? Why you Need Recovery When we exercise, our muscles can become overstretched, causing tiny micro tears.  This causes mildly to moderately painful an inflammatory response, and can result in restricted movement or reduced power in the muscle.  Pain can also be the result of adhesions, lack of oxygen, build up of toxins and nerve irritation. The stress created by training and competing also triggers your fight or flight response, which releases adrenaline and cortisone.  When released in large amounts, or too regularly, these hormones can have a negative effect on the immune system.  This in turn makes it harder for the body to recover. What should Recovery Include? Ideally, recovery should incorporate long periods of rest.  Unfortunately, this is not always possible for busy athletes – even for weekend warriors.  Fortunately for us, Recovery Massage can provide many of the benefits of rest – and many more besides - in a short period of time. What is Recovery Massage? There are essentially two different forms of Recovery Massage
  1. Immediately after the event (within 24 hours) – this massage will use Swedish massage techniques such as effleurage and petrissage.  Light, flowing strokes are used to gently encourage blood flow to the affected muscles, lengthen tightened muscles, reduce tension, remove lactic acid and reduce the risk of delayed onset muscle soreness.  This style of massage will also provide optimum Central Nervous System stimulation and relax the entire body.
  2. 24-72 hours after the event – your massage will be a more remedial style massage, using a combination of Swedish techniques for increasing blood flow and clear toxins and deep tissue techniques to increase flexibility and release deep tensions.
When should you have your recovery massage? The sooner the better!  A light recovery massage – usually 30 minutes in length – within 24 hours, followed by a longer, remedial massage style massage 2-3 days later. So if you are serious about your sport – no matter what sport or what level you are at – make sure you incorporate a Recovery Massage in your train, compete, recovery regime.  You will notice the difference in your performance! Our massage therapists are available at the Baulkham Hills Clinic Monday to Saturday during normal clinic hours.  Call or email for an appointment to make sure your recovery keeps you performing at your best.  
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Funky Feet

And how to get them smelling sweet. In essence, smelly feet are caused by sweat.  Nothing earth shattering about that news.  But what actually causes the smell is not the sweat itself, but the bacteria that feed on the sweat – called Bromodosis.  Since feet are locked up tight in shoes most of the day, the sweat is not able to dry, hence creating the perfect environment for those Bromodosis to gorge themselves.  Dark and damp.  Not only that, but feet have more sweat glands than anywhere else on the body.  Is it any wonder some of us have a problem? Some people sweat more than others naturally.  And sometimes other conditions – such as adolescence, pregnancy, menopause or stress – cause an increase in sweating, and thereby smelling. How do you solve the problem? There are a number of things you can do to reduce the funkiness of your feet:
  1. Aim for shoes that are made from natural fibres, which breathe more than synthetics. Leather or canvas are good options.
  2. The same goes for socks – cotton and bamboo are the best options, although you can now get socks that are specially treated (for instance some contain copper, charcoal or silver) which will reduce the funk.
  3. Cleanliness is next to… well, sweetness. Make sure you wash your feet with soap (try for an antibacterial soap) at least once a day, and make sure you wear fresh socks every day.  And make sure you dry your feet properly before putting on shoes and socks – especially between the toes.
  4. Rotate your shoes. If you can avoid it, don’t wear shoes two days in a row.  Give them time to dry out between wears.  And whilst keeping things neat by putting them in the wardrobe at night might be your preference, it is good to leave them out in a bright, ventilated spot to aid with drying them out.  A quick spritz with tea tree oil can also improve the smell.
  5. Specialist products – like foot soap, foot deodorant and foot powders can help. A little surgical spirit or tea tree oil between the toes can help.
Follow these few simple directions and your feet should be smelling if not rosy, then at least not like your shoes could get up and walk off on their own. And if the problem persists – visit your podiatrist to ensure nothing more serious is going on.  Our podiatrist is in the Baulkham Hills clinic Monday, Wednesday and Saturday, so call or email the clinic if you would like an appointment.
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Steptember at Precision Health Spine & Sports Clinic

For Cerebral Palsy Every 15 hours an Australian child is born with Cerebral Palsy.  It is the most common childhood physical disability.  There is no cure. Cerebral Palsy is an umbrella term referring to a group of disorders affecting a person’s ability to move.  It is the result of damage to the brain during pregnancy, birth or shortly after. This September the team at Precision Health Spine & Sports Clinic are stepping up to help Australians with Cerebral Palsy by joining Steptember for The Cerebral Palsy Alliance. The Cerebral Palsy Alliance provides training and professional development for therapy teams working in the disability sector, family-centered therapies, life skills programmes, equipment and support for patients, and funds research in both Australia and overseas Our aim is to raise $1,000 by walking 10,000 steps a day for 28 days.  Each.  Yes, that’s a lot of steps.  We might need to take a walk at lunchtimes.  If we do – we’ll let you know.  We would love for you to join us! If you would like to sponsor our team, click on this link - https://event.steptember.org.au/donate - to help us meet our goal.  Or, you can set up your own team – and even link it to ours through the Steptember website – just click Register. So get involved and help people with Cerebral Palsy to lead the most comfortable, independent and inclusive lives possible!  
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Stepping out..

..into Spring! Well, we haven’t had much of a winter this year.  But that doesn’t mean Spring isn’t just around the corner.  And we all know what that means.  Feet that have been covered up in boots and shoes for months will soon be making an appearance in sandals and thongs.  And all those months out of sight – and mind – can mean your feet are less than beautiful.  Are your feet fit for viewing? The skin is the largest organ of the body – responsible for protecting everything within.  And sometimes, the wear and tear shows! Feet can be particularly vulnerable to wear and tear.  They carry the weight of the entire body, and they spend a great deal of the day enclosed in shoes and boots that can rub and irritate. Callouses are created by pressure and friction.  The skin contains Keratin, which is a protective protein.  When pressure and friction combine in a specific area, the skin produced too much keratin, causing a callous. Corns develop in a similar way to callouses, but form in a small, concentrated area.  Often bone pressure against the skin is the cause – so they often form on toes. Cracked Heels are caused by a combination of dryness, thickening of the skin and tensile stress to the skin, or epidermis.  The skin around the heel loses it’s suppleness and elasticity and cracks form.  Sometimes these cracks are deep, painful, and can even bleed.  Prolonged standing, increased weight and even hormonal changes can affect the heels. Nobody wants to see corns, callouses and cracked heels in a nice pair of sandals or even a casual pair of thongs. So, what do you do if you have any of these problems?  Simple, call Precision Health Spine & Sports Clinic on 9639 7337 for an appointment with our podiatrist and your feet will be ready for stepping into Spring in no time.
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Bend the knee…

Reasons why Jon Snow might not be the only one having problems. Let’s be honest, we’ve all been waiting for it.  For Jon Snow to bend the knee to Daenerys.  He took his time.  He was reluctant.  But was loyalty to the northern lords the only reason he hesitated?  For a lord with as many scars (and one actual death) as Jon, maybe bending the knee is painful.  He wouldn’t be alone.  But what causes knee pain?  And what can be done about it? You may not know, but up to seven times your body weight goes through the knee when it bends!  No wonder knee pain is such a common complaint. Generally, knee pain stems from how the knee moves.  As you bend the knee a number of things happen – muscles contract and relax; the patella slides up and down through a groove in the thigh bone; the cartilage moves out of the way and ligaments tighten to provide stability.  All these things have to happen together for pain-free movement.  So, if any one of these areas does not operate properly, destabilization and pain can occur. Although knee pain can occur even when non-weight-bearing, but it comes as no surprise that weight-bearing bending – squatting, stairs, jumping – causes the most pain due to the force moving through the knee. The most common forms of knee pain relate to four key areas: Friction If the movement of the kneecap is not smooth, it can place extra friction on the cartilage as it moves.  This causes pain in the front of the knee, below the kneecap.  This may be accompanied by a disturbing grinding or grating noise.  Causes for this type of pain often include muscle weakness and biomechanics of the foot arch and hip. Bursitis The bursae are small fluid sacs between the bone and soft tissue that act to reduce friction.  These sacs can become inflamed and painful, and irritate the surrounding structures – causing more pain.  The pain will be accompanied by swelling, both at the front of the knee. Sprain If one of the four ligaments of the knee is overstretched or tears, instability, pain and swelling will occur.  The meniscus can also tear, which results in a decreased cushioning in the joint. Arthritis There are over 200 different types of arthritis, but most common in the knee is osteoarthritis.  This causes thinning and wear and tear on the cartilage, creating bony lumps, which in turn cause friction and pain in the joint.  General stiffness and pain are the result. Treatment for knee pain depends on the specific cause of the pain, but often includes massage, acupuncture, taping, biomechanical movement correction and Smart Tools to name just a few. So, if Jon Snow had access to a Chiropractor, perhaps he might have bent the knee a little sooner… If you, like Jon Snow, are having trouble bending the knee, call us on 9639 7337 to make and appointment so we can get you on board with team Jon and Daenerys!
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Modern science is amazing. Right?

Well, maybe ancient science was too! If you, or someone you know, has ever broken a bone, you might have had that bone pinned.  Amazing modern science, huh?  Actually, it turns out the Ancient Egyptians knew a bit about bone pinning nearly 3,000 years ago! We have talked before about how the Ancient Egyptians understood the importance of podiatry (Walk like an Egyptian), but this is taking things to a whole other level. During routine x-raying of mummies held by an Amercian museum, a metal implant was found in the left leg of one mummy from the New Kingdom (16th-11th Century BC).  Professors were curious, but assumed this must have been attached in modern times to keep the mummy together.  Not so!  Tests showed the pin had been put in the leg in ancient times. What was truly amazing was that this 9 inch pin was of the same design as pins used today to stabilize bones.  Right down to the three flanges on the top to stop the pin from rotating inside the bone.  And the organic resin around the pin is very similar to modern bone cement. Interestingly, tests show this pin was put in after death.  Many people think the Egyptians were obsessed with death.  In actual fact, they were obsessed with life.  Specifically, the afterlife.  They believed bodies needed to be preserved for souls to inhabit in the afterlife.  So, presumably during the mummification process, someone took the time and effort to insert a complicated pin to ensure a successful afterlife for this obviously much loved deceased. While this is the most spectacular case of post-mortem rehabilitation, there are documented cases of dental repair, wound repair and prosthetics in other mummies.  Proving how important the integrity of the body in the afterlife was to the Egyptians. These days we think about how amazing all the modern medicine we have is.  But that very modern science has proved one thing to us.  There is a whole lot we don’t know, or have forgotten, about ancient science!
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The knee bone’s connected….

It’s all about those connections.  You might not think an ankle injury can cause problems with your lumbar spine, but you would be wrong.  Studies show that our bodies are ‘regionally interdependent’ – which means that injuries in one area of the body can and do impact on seemingly unrelated areas. Selective Functional Movement Assessment (SFMA) is a new way of assessing a patient and developing treatment and exercise plans that take this ‘regional interdependence’ into account. Because we are all about giving our patients the best treatment we can provide, Charbel recently undertook some SFMA training.   So, what does dem bones connecting mean? What is SFMA? Selective Functional Movement Assessment is a comprehensive assessment that can be used by Chiropractors to classify movement patterns to determine treatment and exercise plans. SFMA works on two key principles.  Firstly, every body is different, and movement patterns are subtly unique. - no two bodies move the same.  Secondly, the body is regionally interdependent.  In other words, each moving part of the body affects the others, even when they are not directly connected. It then follows that when an injury occurs, movement of the entire musculoskeletal system is affected.  Natural patterns are altered to compensate for pain and immobility, creating dysfunction and compensation.  In many cases, even when the injury is healed, the body continues to ‘compensate’, creating an ongoing change in the pattern of movement.  This change can cause problems in other parts of the musculoskeletal system. How Does it Work? Using the principles of SFMA Chiropractors assess the movement of the whole body, and develop treatment and exercise plans that specifically respond to the individual patterns of each patient.  The movement of the patient is used to determine the most efficient effective path to resolution of pain and reduced mobility. Who Can It Help? Anyone who has had an injury can be helped by SFMA.  Previous injury is the single most powerful factor in prediction of future injury, so resolving any issues relating to injuries is vitally important.  Even if the injury has healed, the body may still be compensating, putting the injured area at increased risk.  Many studies have shown that injuries in one area – the ankle for example – impact on the activation and function of muscles not directly attached, such as the gluteus.  This can cause a muscular or skeletal imbalance, contributing to a likelihood of future injury. By using SFMA our practitioners can assist in restoring the natural movement of patients and reduce the risk of future injury due to changes in musculoskeletal movement and ensure those thigh bones connected to the knee bones are in good working order. If you have had an injury and would like to know more about how SFMA might help you get dem bones connecting better, call Precision Health Spine & Sports Clinic on 9639 7337 for an appointment.
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