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Injury prevention

“an ounce of prevention is worth a pound of cure”

Benjamin Franklin

 

Injuries sometimes seem an inevitable part of being involved in sports. But they really don’t need to be. Of course, sometimes injuries are just accidents, and can’t be avoided, but often there are things we can do to reduce the likelihood, and severity of an injury, and to avoid recurrence. And that ounce of prevention could make all the difference.

 

 

Risk Factors

There are essentially two types of risk factors for injury – internal and external.

 

Internal – are factors like age, gender, body composition and fitness level. One of the most consistent indicators of risk of injury is previous injury.

 

External – are things like weather conditions, court or field conditions, rules and equipment.

 

Risk factors can be modifiable (such as fitness level or rules) or non-modifiable (age, gender) and increases when internal and external factors combine. Risk changes when training schedules change in type or duration, and throughout a sporting season. It is therefore important to understand the sport and the type of training in order to assess the level, type and severity of risk of injury, and plan prevention measures.

 

 

Injury Prevention Strategies

There are three key phases to injury prevention:

 

Primary Prevention – involves health promotion, rule and regulation changes, education and cognitive training. This phase focuses on understanding how to avoid injury in the broadest sense and is primarily aimed at those who have not yet suffered an injury.

 

Secondary Prevention – is aimed at early diagnosis and intervention in the case of injury, in order to reduce the risk of disability and re-injury. This is the generally the treatment phase.

 

Tertiary Prevention – is focused on reducing or correcting the disability caused by an existing injury. This is what is known as the ‘rehabilitation’ phase.

 

 

Primary Prevention

Most Primary Prevention is undertaken at an educational and team/sporting body management level. Ensuring the rules are in place to avoid serious injury – like the wearing of helmets, or banning high tackles – is an important and ongoing process.

 

However, this doesn’t mean that the individual cannot take responsibility for their own injury prevention. Understanding the potential risks and ensuring you take them seriously is vital to avoiding injury. There are a range of things you can do:

  • ensure you wear the appropriate protective equipment and that your shoes and other equipment are appropriate for the activity and in good order
  • make sure you are fit to participate and that your training schedule is appropriate to the activity
  • warm up before and cool down after all training and participating
  • use bracing or taping to avoid injury in high risk activities
  • make sure you are sufficiently hydrated, this should include the replacement of electrolytes
  • ensure you allow adequate time for recovery in both training and participating
  • ensure your diet is well- balance and contains enough protein, carbs and vitamins and minerals to effectively fuel your body during training and participating
  • Regular Chiropractic treatment and massage therapy ensures your body is in peak condition for training and participating in any sports

 

 

Secondary Prevention

Secondary Prevention for the athlete revolves around the treatment of injury and prevention of re-injury. Since previous injury is the one of the most common indicators of injury risk, this is vitally important.

 

If you do not seek the right treatment in a timely manner after injury you risk creating a weakness that will continue to cause problems throughout your sporting activities.

 

Immediately upon injury follow the Ricer method, which we have talked about before – Rest Ice Compress Elevate Repeat.

 

This should be followed up by consultation with an appropriate health care practitioner, based on the severity and type of injury. Scans or Xrays may be appropriate and treatment should begin as soon as practical.

 

If the injury is musculoskeletal see a qualified Sports Chiropractor for expert advice. They may also recommend Remedial Massage as part of your recovery process. Exercises will almost certainly be prescribed to help get you back to optimum strength and fitness.

 

Diet is an important part of this treatment as the body needs the right fuel to rebuild muscles effectively, particularly protein.

 

 

Tertiary Prevention

Tertiary Prevention, or Rehab, can be an ongoing activity. Some injuries take considerable time to resolve. Where injuries are old and were not treated properly when they happened, or were caused by underlying structural problems, Rehab may be aimed at correcting many months or even years of poor or incorrect movement. Your chiropractor may provide you with exercises aimed at correcting underlying problems to avoid re-injury.

 

 

Chiropractic treatment has a place in all phases of Injury Prevention. The earlier you get your Chiropractor involved in your training and participation schedule, the better able they will be to help you avoid injury and recover when injury does occur.

 

If avoiding injury is important to you, call our Hills District Clinic on 9639 7337 to make an appointment with our qualified Sports Chiropractor today – it could save you a pound of cure.

 

 

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Pain – it’s all in your head

… well, kind of

 

 

We all feel it. We can all describe its many faces – sharp, dull, aching, stinging, burning, throbbing, nagging. You get the idea. But what is pain really? Where does it start and how can we better manage it?

 

 

What is pain?

Pain is described in the dictionary as ‘an unpleasant sensory and emotional experience that is felt in the body’.

 

It may seem strange, but pain doesn’t actually exist at the site of the problem. It’s all in your head. Or more specifically, in your brain.

 

All throughout our body our peripheral nervous system contains high-threshold neurons called primary nociceptors. These neurons are found in the skin, muscles, bones, internal organs: in fact everywhere except the brain. They detect danger and transmit this message to the dorsal horn of the spinal cord. Within the spinal cord are secondary nociceptors, which combine the messages from the primary nociceptors with other sensory messages (sight, sound, smell) and act as a relay station, transmitting these signals to the brain. All this happens in fractions of a second.

 

Primary nociceptors detect danger in three forms – mechanical (potentially causing a wound), thermal (potentially causing a burn or freeze) and chemical (potentially causing illness). They are multimodal, so can detect danger from one or more stimuli at once. However, they cannot detect the type of danger. This is done by the additional sensory information received by the secondary nociceptors.

 

Secondary nociceptors filter and prioritise the transmissions received, controlling the speed and strength of the messages going to the brain. So if the danger is perceived as extreme, the messages get through to the brain quickly and strongly, allowing the brain to instruct the body within a split second.

 

 

What the brain does

Once the nociceptor messages are received by the brain, it responds by sending back the appropriate message – for instance, if you have put your hand on a hot stove, your brain instructs the body to pull back immediately. If the brain perceives that the danger is not acute the nociceptor system becomes less sensitive. This is called descending inhibition. If the brain believes the threat is real and present, the system becomes more sensitive – called descending facilitation.

 

The brain also sends messages to the autonomic nervous system. This is the system that controls the automatic functions of the body – breathing, heart beating, digestion, blood flow etc. Your brain will send instructions to increase the white cells and platelets in an injury site, helping to begin the injury repair. It may also release naturally-occurring chemicals which suppress pain, which is why sometimes we don’t feel the pain of major injury immediately that it occurs.

 

This is also why we sometimes feel ‘referred’ pain. The brain doesn’t quite get the message right, and creates a feeling of pain somewhere other than where the damage has occurred.

 

 

Types of Pain

There are essentially three types of pain:

 

Acute – is sudden and often severe. This type of pain is usually explainable and resolves itself within an expected time period. It is generally caused by illness, injury or surgery.

 

Chronic – can last for months, and is sometimes unexplainable. Often it is the result of an initial illness, injury or surgery that has been resolved and left ongoing pain in its wake.

 

Neuropathic – this is caused by damage to the nerves. Damaged nerves can misfire and send spontaneous messages to the brain. It is often a tingling/pins and needles type of pain. This is the type of pain that causes ‘phantom limb’ pain in amputees, as the nerve pathways still exist above where the limb has been lost.

 

 

Pain Influencers

So if the brain has so much control over pain, does it control how much pain we feel? Well, yes it does. And so do many other factors. Which explains why some people seem to have a higher ‘pain threshold’ than others.

 

Factors that can affect your reaction to ‘pain’ include gender, upbringing and social factors, attitude and coping strategies and psychological factors. Genetics also play a part, particularly in the case of neuropathic pain and in how you respond to pain relief medications. One of the most influential factors in how we feel and cope with pain is past experience. Memories, even subconscious ones, can have an enormous impact on how sensitive we are to pain. As pain messages enter our brain they pass through both the frontal and temporal lobes, which means there is a strong cognitive and emotional factor in our experience of pain.

 

 

Managing Pain

In managing pain there is the obvious solution – medication. Both over the counter and prescribed. And this is an essential factor in the management of both acute and chronic pain. However, particularly with prescribed medications, there is the risk of addiction and side effects.

 

There are, however, other ways to help cope with pain.

 

We can slow or stop the messages sent by the nociceptors. This is how local anaesthetic works. It turns off the primary nociceptors in the area where it is applied, so the message of danger does not reach the brain. No brain, no pain.

 

Of course, the reverse can be true. Inflammation increases the sensitivity of nociceptors, so you feel pain long before there is any real risk of damage.

 

Since pain is a direct result of the brain’s evaluation of the level of danger, reducing our perception of the danger can be a key to reducing pain. So, if we ‘distract’ the brain our experience of the pain can be reduced. This is one of the reason past experience plays such a large role in our experience of pain – if we are expecting it to hurt, it will. This might ring true if you have ever had one of those extended low level headaches. If you distract yourself with a conversation, reading or exercise the pain will often subside, only to recur the minute you remember you ‘had a headache’.

 

Recent studies suggest that using Cognitive Behaviour Therapy (CBT) can help with management of chronic pain, which can often prove to be the most difficult to relieve. Long term chronic pain can increase the brain’s perception of danger, increasing our sensitivity. CBT aims to change the way we think and talk to ourselves about pain. Using the right thoughts and words can not only reduce the brain’s perception of danger, but can activate dopamine production, which is one of a number of ‘feel good’ chemicals in our body.

 

 

If you are suffering from acute or chronic pain, understanding how the body processes it can be the first step to managing it and feeling well again. For more information call our Hills District Clinic on 9639 7337.

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Live long!

Once upon a time living to 100 was a rare thing. These days, however, it is becoming more and more common. In 1976 there were 300 Australians over 100. Last year there were nearly 5000! It’s easy to put this amazing increase down to the wonders of modern medicine. After all, we keep inventing cures for anything that ails you. But actually, there is a lot more to it than that.

 

So, since estimates suggest there will be 2 million centenarians worldwide by 2050,  what characteristic do you need to have to be in the fastest growing age bracket in the world?

 

Research suggests that up to 30% of your likelihood of living long is down to genetics – if your parents and grandparents did it, you may well do it too. So that leaves 70% up for grabs. Of course, there are the advances in medical science – both preventions and cures - that are not only prolonging our lives, but keeping us healthier for much longer. That accounts for some of it.

 

However, recent studies have shown something that you might not consider. Your personality has a lot to do with it! I remember as a kid my mum saying of a particularly grouchy old relative “he’s too cranky to die”. In actual fact, it seems, the reverse is true.

 

Studies by Keio University in Japan and UNSW’s Centre for Healthy Brain Aging suggest that your personality has a lot to do with your chances of living to a ripe old age. Traits that many Centenarians have in common are friendliness, happiness, kindness and compassion, making them people who are generally good to be around. Perhaps the most important trait, however, is resilience. It seems we keep coming back to this one – remember our blog from August – Resilience? In that blog we talked about the importance of resilience in our communities. But resilience as a personal trait, it turns out, is an important indicator in our ability to ‘live long’.

 

So, is resilience an inherent trait, or can we learn to develop it? Well, yes. To both. Some people are born with naturally positive, resilient characters. Others have to work on it. So, if you need to work on your resilience, how do you actually go about doing that?

 

There are a few key things that you can do to help build your resilience:

 

  • Focus on what you can control, not what you can’t. This will help you feel more confident and empowered. There will always be aspects of life that we just can’t control, so let that go and focus on what you can control.
  • Learn from your mistakes. We all make them. So look at them as opportunities for growth, not a negative reflection of your worth.
  • Have goals. And commit to them. Not just at work but personally – in your family life, friendships and personal interests.
  • Maintain a positive attitude towards the future – think about the good things ahead.
  • Work on your relationships. Solid support networks in both your personal and professional life are very important in maintaining resilience.
  • Avoid thinking of yourself as a victim. Take responsibility if you need to, then move on. And as we said earlier, if you can’t control it, don’t let it control you.

 

If that’s what you should do, are there things that you shouldn’t do? Of course!

 

  • Try not to see setbacks or mistakes as permanent. Everything is temporary, even the worst mistakes.
  • Don’t let problems in one area of your life ‘bleed’ into another. If things aren’t great at home, don’t take it to work with you. And vice versa. Try and compartmentalize problems.
  • Don’t take it personally. Easier said than done, but try and recognize the circumstances, rather than always blaming yourself when things don’t work out.
  • Don’t worry about what other people think. This can be a fine line. Strong relationships are important, but always remain true to yourself.

 

All this has a cumulative effect. If you develop your resilience, you will be happier. If you are happier, you will be more friendly, kind and compassionate. So you can see how it works….

 

Now, we wouldn’t be an allied health clinic if we didn’t mention that keeping yourself fit and active and aiming for a healthy diet is important too. So remember the regular exercise, plenty of sleep and healthy diet mantra while developing all these wonderful personality traits.

 

Before you know it, you’ll be getting your letter from the Queen and attempting to blow out 100 blazing candles!

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Are Chilblains the bane of your existence?

 

What are chilblains?

Chilblains are small, itchy reddish purple patches, like blisters, on the skin, which can be very painful. Generally, they occur on the extremities – toes, fingers, even ears and noses. When more severe, these patches can swell and sometimes cause splitting and cracking of the skin, leading to infection. If left untreated, these infections can become ulcerated. This condition is sometimes called Pernio, Perniosis or Cold-Induced Vascular Disorder.

 

A condition related to chilblains is Raynauds Phenomena, which has many similarities to chilblains.

 

Causes

The main cause for chilblains is cold weather. When we become cold the blood vessels close to the skin constrict to concentrate blood and body heat in the areas of the vital organs. This constriction starves the extremities of blood. When the extremities are later warmed – for instance if we come inside from the cold – the constricted blood vessels expand too quickly. This can cause blood to leak into nearby tissue, creating a chilblain.

 

Less common causes for chilblains are:

  • Poor circulation. If your circulation is already sluggish or compromised by an underlying condition such as diabetes or lupus, chilblains will commonly arise.

 

  • Tight or ill fitting shoes. Shoes which constrict the flow of blood to the foot because they are too tight, or pinch in specific places, can cause chilblains to develop.

 

Anyone can suffer from chilblains, however the people most at risk of chilblains are the elderly, people with underlying medical conditions, smokers, people who are underweight, and those with a sedentary lifestyle. Women are also more prone to the problem than men.

 

Symptoms

As we said earlier, chilblains are red/purple, itch, painful and sometimes swollen patches on the skin. There is usually itching, and often a burning sensation. Blisters often develop and the skin splits and cracks.

 

Most often, chilblains occur on the toes and feet. However, your hands, ears and nose may also be affected.

 

Treatment

  • If you regularly suffer from chilblains, or if the skin has split or cracked, it is important to see a Podiatrist for assessment. They will be able to make recommendations on treatment and prevention, and to manage any underlying or secondary conditions related to the chilblains, like ulcerations. This is especially important if you suffer from diabetes.
  • Soothing lotions will reduce the itch. It is important not to scratch as this will increase the likelihood of the skin cracking. Witch hazel or calamine lotion are often good
  • Keep the affected skin supple with rich lotions like lanolin to avoid cracking
  • Vicks or Antiflamme will increase the circulation in the area
  • Look for wool or cotton socks as the natural fibers will not irritate the skin

 

 

Prevention

  • When you are outdoors in very cold weather, make sure both your body and your extremities are kept warm. Warm shoes and socks and gloves are essential as well as hats, coats and scarves. Aim for layers, which will trap the warmth, rather than one bulky layer
  • When you come in from the cold, don’t be tempted to reheat your extremities too quickly. There may be no better feeling than warming your hands over a roaring fire, but aim for a slower warming. Run your hands and feet under warm - not hot – water and allow them to warm slowly. Sudden, extreme changes in temperature will exacerbate the problem
  • Make sure your shoes are comfortable and well fitted to avoid pinching
  • Keep up a routine of exercise to ensure your circulation is good

 

 

Raynauds Phenomena

This condition has some similarities to Chilblains in that it is related to restricted blood flow to the extremities. In the case of Raynauds, blood flow to the extremities is restricted or interrupted by a constriction of the blood vessels called a vasospasm. Triggers for this can be cold or emotional stress.

 

Unlike the red/purple patches of chilblains, when blood flow is constricted in Raynauds Phenomena, the skin turns white, feels icy cold and sometimes even develops a blue tinge.

 

There are two types of Raynauds:

- Primary, where there is generally little pain. Primary Raynauds exists on its own and has no underlying condition

- Secondary, where the sufferer may experience pain, tingling and numbness for minutes or hours. Secondary Raynauds is related to underlying conditions such as arthritis or an auto-immune disease

 

When a Raynauds vasospasm is over it may take some time for circulation to be restored, and you may experience throbbing and redness in the area.

 

Raynauds is caused by a range of conditions and environmental factors such as arthritis, atherosclerosis, lupus, smoking and some medications, such as beta blockers.

 

Prevention and treatment for Raynauds is much the same as with chilblains. However, if you suffer from Raynauds it is important to keep warm as much as possible and avoid triggers like nicotine and caffeine. It is also important to try and manage emotional stress.

 

 

If you are suffering from chilblains, or think you may have Raynauds Phenomena, call our Hills district clinic on 9639 7337 to make an appointment for an assessment and treatment to with our Podiatrist.

 

 

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Have you lost your groove?

Patellofemoral Pain Syndrome

 

Patellofemoral Pain Syndrome sounds pretty scary. In fact, it is one of the most common knee complaints – up to 25% of the population will suffer from it at onetime or another. Sometimes called Runners Knee, and even Theatre Knee, you don’t need to be a runner or a theatre-goer to suffer from it.

 

 

What is it?

As we bend our knee, the kneecap glides up and down the ‘femoral groove’, which is an indentation on the femur (thigh bone). This movement creates pressure between the kneecap and the groove. If your kneecap jumps out of this track, or misaligns, it rubs against the femur and the pressure is increased even further.

 

Misalignment can be caused by trauma, muscle imbalance or biomechanical problems.

 

Patellofemoral Pain Syndrome (PPS) often occurs in adolescence as the long bones of the thigh grow faster that the muscles, causing the muscles to tighten and pull the kneecap out of alignment.

 

 

Causes

The most common causes of PPS are muscular imbalance and biomechanical:

 

Muscular Imbalance – weakness in your Vastus Medialis Oblique (VMO) muscle, which pulls your kneecap up and inwards creates an imbalance with the Vastus Lateralis, which pulls up and outwards

Biomechanical – poor foot posture and poor control of hip and buttock muscles

 

Trauma such as a direct fall on the knee can also cause PPS.

 

Sports that require running and jumping can exacerbate this condition – netball, tennis, volleyball and basketball to name just a few.

 

 

 

Symptoms

Generally with PPS there will be a gradual onset of pain, starting with pain on weight bearing activity, like jumping or squatting, and developing through pain on walking until there is even pain when resting.

 

The pain can be sharp and sudden or dull and continuous. You may feel or hear grinding or popping and there may be swelling.

 

And if you were wondering where the term “Theatre Knee” came from here it is. It can be painful to sit with the knee bent for extended periods – as you do at the theatre.

 

 

Treatment

As with many conditions, the first port of call is to reduce pain and inflammation – so back to the RICER (link) principles that we mentioned in an earlier blog. Light massage and chiropractic treatment including taping and dry needling will help with the pain an inflammation, as will anti-inflammatories.

 

Once the pain and inflammation has settled, a structured approach to Rehabilitation is required. It is likely this will include both a Chiropractor and a Podiatrist. The aim will be to normalize the movement of your kneecap within the femoral groove.

 

Your chiropractor will assess the strength and balance of your hip, thigh and quad muscles and develop a treatment plan that includes:

  1. Exercises that stretch the thigh, hamstring and calf muscles to reduce tension on the joint
  2. Exercises to strengthen and balance the muscles, particularly the quads
  3. Specific exercises that address speed, power and agility depending upon the needs of your activities or sports

 

Your Podiatrist will review your foot posture and gait to determine whether orthotics are required. Shoe selection will also be considered, based on your foot posture and activities.

 

Return to sporting activities should begin slowly, with low impact sports like swimming and cycling. Your Chiropractor will let you know when you can return to your normal sports.

 

 

If you are suffering from knee pain, contact our clinic on 9639 7337 to make an appointment for an assessment. The sooner you get treatment, the sooner you will be back in the groove!

 

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Give me 1 Good Reason

 

It’s hard to believe, but this is our 100th blog post! We originally started the blog posts to provide our patients and the wider community with information and knowledge on conditions and treatments related to the services we offer. Sometimes we stray into lifestyle and general interest topics, just to keep ourselves and our readers on our toes, but generally, we stick to Chiropractic, Podiatric, Massage and Traditional Chinese Medicine related topics.

 

When I sat down to write this post I thought about all the posts that had gone before. What would be a good way to mark our 100th blog? Do I review our best and worst? Most popular? Most controversial? It seemed important to mark the occasion somehow.

 

What about 100 reasons to visit Precision Health Spine & Sports Clinic? What a great idea! I sat down and thought about it. Came up with loads of reasons why you should visit our Clinic. But the more reasons I came up with, the more I realized there is really only one reason you should come to Precision Health Spine & Sports Clinic – we are very, very good at what we do. So, here is the Top 100 Reasons to visit us:

 

  1. We are very good at what we do

2-100. See Above

 

Since this turned out to be a very short blog – I thought I might as well have a look at our Top 5 blog posts anyway. We have covered everything from the very serious, in blogs like Performance Enhancement – Worth the Risk?, to the fun of the Secret Life of Coffee, and the important issues like Putting your High Heels On. But our Top 5 most popular topics have been:

 

  1. The Do’s and Don’ts of Wearing a Great Aussie Tradition – Thongs
  2. Tight Muscles?
  3. Sciatica – What a Pain in the Butt
  4. Scoliosis – a Matter of Degrees
  5. A Smart Tradesman Blames His Tools

 

You might like to take this opportunity to delve back into the depths of history if you missed them. Or catch up on any others that might interest you.

 

Finally, we would like to take this opportunity to thank our patients and friends for their support over the past 100 blogs. Since we began writing the clinic has changed a great deal. Some staff have moved on, and some new staff have come on board. What has not changed is our commitment to being the best allied health clinic in the Hills District. Whether it’s Chiropractic, Remedial or Sports Massage, Podiatry or Traditional Chinese Medicine you are looking for, Precision Health Spine & Sports Clinic has a highly qualified, experienced professional to help you. Call our Baulkham Hills Clinic on 9639 7337 to make an appointment.

 

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Peripheral Neuropathy

 

We have talked in the past about the the central nervous system in  “You’ve got a Nerve”. In that blog we touched briefly on the Autonomic and Peripheral Nervous Systems. Sometimes, one or more of the nerves in the Peripheral Nervous System are damaged, and this condition is known as Peripheral Neuropathy. There are many potential causes, and the symptoms vary depending on the location and number of nerves affected.

 

Peripheral Neuropathy is the result of damage to your peripheral nerves and can affect one nerve (mononeuropathy), multiple nerves in more than one location (multiple mononeuropathy) or many nerves (polyneuropathy). Generally, it is the hands and feet that are affected by this condition.

 

 

Causes

There are a wide range of possible causes for Peripheral Neuropathy. Damage to the nerves may be caused by trauma such as an accident or injury, by pressure such as wearing a cast or brace, or by repetitive activities such as typing.

 

Environmental factors may include exposure to toxic substances like heavy metals, alcoholism, and vitamin deficiencies, particularly vitamins B, E and Niacin. Some medications – like chemotherapy – can also cause peripheral neuropathy.

 

Infections, tumors, bone marrow disorders and a range of auto-immune diseases like lupus and rheumatoid arthritis can also be responsible. Inherited disorders such as Charcot-Marie-Tooth disease are also linked to peripheral neuropathy Perhaps the single most common cause of peripheral neuropathy is Diabetes.

 

 

 

Symptoms

Every nerve in your body has a specific function, so symptoms will be dependent upon which nerves are affected. In the hands and feet, these are likely to be the sensor nerves (feeling temperature, pain and touch) and the motor nerves (controlling muscle movement). Symptoms might include:

 

  • numbness or tingling in your hands and feet, even spreading up your arms and legs
  • Extreme sensitivity to touch
  • Pain – which may be burning, freezing, sharp, throbbing or jabbing
  • Lack of co-ordination – falling, difficulty in picking things up
  • Weakness – lack of strength in feet and hands

 

When Peripheral Neuropathy is present, complications can arise from the lack of strength and sensation in your hands and feet:

 

  • You may not feel injuries like burns or cuts. This can lead to infections, particularly in your feet where you may not see them.
  • You may have trouble with your balance if you do not have good feeling in your feet, particularly on uneven ground. You may even have trouble driving, as your sensitivity to the accelerator and the brake may be limited.
  • Weakness in your hands may cause clumsiness, affecting your fine motor skills and reducing your ability to lift anything with weight, like a kettle or saucepan.

 

 

Treatment

Initially, it is important to address the underlying cause of potential Peripheral Neuropathy before it begins to affect your nerves if at all possible. Managing conditions like Diabetes will help reduce the likelihood of developing this condition.

 

Maintaining a healthy diet, avoiding smoking and alcohol and getting sufficient exercise will all help in both managing the underlying condition and reducing the impact of Peripheral Neuropathy.

 

Treatment options to manage the symptoms may include using a TENS Machine (Transcutaneous Nerve Stimulation), casts, splints or orthotics, acupuncture, massage and chiropractic treatment.

 

If Peripheral Neuropathy is affecting your feet and legs, it is vital to make regular visits to a Podiatrist who will help you manage any motor issues and ensure your feet are free of secondary injuries and infections.

 

 

If you have been experiencing any numbness, tingling, pain or weakness and your hands, feet, arms or legs call our Baulkham Hills Clinic today on 9639 7337 to make an appointment to discuss your symptoms and treatment.

 

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Make the most of your Massage

When our patients come out of a massage we often hear “I wish I could have one every week!”. Whilst we are more than happy to see out patients every week for a massage, it does get difficult for them to find in the time – not to mention it would get pretty expensive.

 

So how do you feel like you have had a massage when you haven’t? Well, you can’t really. But there are some things you can do to extend the therapeutic benefits of your massage, which is almost the next best thing.

 

 

Drinking

No, sorry. Not wine or beer. Or even coffee. WATER. Drink plenty of water before and after your massage. Massaging helps release toxins from your muscles, which then move into the lymphatic system. The best way to keep them moving all the way through is with water. 8 glasses if you can.

 

 

Stretching

Massage heats up your muscles much as a warm-up would. So right after a massage is a good time to do some stretching exercises. You will achieve a nice deep, effective stretch, and help continue that relaxed feel a massage provides.

 

 

Moving

Sometimes muscles feel stiff and sore after a massage. Light exercise, like walking, can help alleviate both by keeping the joints mobile and the blood flowing.

 

 

Soaking

A good old-fashioned Epsom Salts bath can do wonders after a deep tissue massage! Watch the temperature (not too hot), especially if you have a specific injury with swelling or inflammation. And whilst I would love to be able to say try a nice glass of wine – no. Stick to water!

 

 

 

 

Rolling

If you have a particular area or muscle that gives you trouble, talk to your therapist about whether a foam roller, or even a tennis ball, could help keep the area loose between appointments.

 

 

Sitting

Many of our aches and pains come from poor posture, or poor movement practice during work or sport. The days following a massage are a good time to try and change some of these bad habits. Talk to your therapist about what you might be doing wrong, and how you can improve it.

 

 

Scheduling

Here’s the good news! Put another massage on the horizon. Something to look forward to. Talk to your therapist about how often you should have a massage, and book a few up in advance. Not only will it help you get the time and day that’s most convenient for you, but it will make sure you don’t let important self-care slip through the cracks.

 

 

At Precision Health Spine & Sports Clinic we have three highly qualified Remedial Massage Therapists who provide Sports, Remedial, Swedish, Pregnancy and Injury massage. We service the Baulkham Hills, Castle Hill and the wider Hills District. If you would like to book a massage, call the clinic on 9639 7337.

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How long is this going to take?

 

King Julian might not have been talking about healing when he uttered the immortal line “How long is this going to take?” in Madagascar, but anyone who has had a soft tissue injury will surely have wondered the very same thing. Not to mention wondering why their Chiropractor wants them to keep coming back, even when they ‘feel better’.

 

The answer is both simple and complicated. Not all soft tissue injuries are created equal. Different tissues in the body heal at different rates. And those rates differ for every person, depending on the severity of the injury, your level of fitness, age, your individual body chemistry and the presence of other health conditions. So, the answer to the question is – as long as it takes.

 

 

What Happens During Healing?
The process of healing happens broadly in three phases:

 

  • Acute Inflammation – at the onset of the injury there is pain, swelling, heat and redness. This is caused by the release of chemicals required for the healing process. During this process damaged cells are broken down ready to be replaced with new ones. Collagen synthesis decreases, and the number of inflammatory cells increases.
  • Repair – As the number of inflammatory cells decreases, collagen fiber production increases. New collagen fibers are laid down in an unstructured pattern, which is not as strong or flexible as normal tissue.
  • Remodeling – in the final stage of healing, the collagen fibers begin to align more normally and tissues begin to regain their original strength, allowing the tissues to accommodate increased loads until eventually normal function is restored.

 

 

Muscles

Muscles are made up of soft, elastic tissue containing protein filaments of actin and mosin. Muscles generally have a good blood supply, which is essential for healing.

 

Muscle strains can be divided into three categories:

Grade 1 – is a mild strain and will usually heal within 3-6 weeks

Grade 2 – is more severe and will take weeks to months to heal

Grade 3 – is a full thickness tear or rupture, and will often require surgery. Healing time for this type of injury can be many months

 

Tendons & Ligaments

Tendons attach muscles to bones, whereas ligaments attach bone to bone. Tendons and ligaments have a much lower blood supply than muscles, which is one of the reasons they heal much slower. They are also much denser tissue, made up mostly of collagen fibers and fibroblasts, which synthesise extracellular matrix and collagen. Ligaments are generally more elastic than tendons. Consequently, damage to a tendon or ligament will heal much more slowly than damage to a muscle.

 

Grade 1 – should heal in 2-8 weeks

Grade 2 - healing may take between 2 and 6 months

Grade 3 – 6-12 months healing likely

Tear/Rupture – will require surgery and take a minimum of 4 months, up to over 12 months to fully repair

 

Of course, this is assuming the appropriate treatment for the injury is being received.

 

 

What can you do to speed things up?

There are a few key things you can do to speed up your recovery:

 

  1. Seek immediate first aid treatment when you are injured – proper management of an injury can make a big difference to your recovery.
  2. Ensure you seek treatment as soon as possible. The sooner your rehab starts, the sooner you will be back to normal.
  3. Follow orders! Your Chiropractor will provide you with advice, a treatment plan, and possibly exercises. Stick to them! The advice you are given is designed to get you back to normal in the optimum time, so listen to the experts. And if this means sitting out a few games or races – just do it. You will be happy you did in the end.
  4. Eat well. In the early stages Turmeric and Curcumin will help with inflammation. Vitamin C will help with collagen production, flush lactic acid from your muscles, and zinc helps with wound healing.
  5. Be patient. It will take as long as it takes.

 

 

So, next time you injure yourself and your Chiropractor suggests a treatment, rehab and exercise approach, try and stick to it. Otherwise how long it will take will be much, much longer than you might like.

 

If you have an injury, call our Baulkham Hills Clinic on 9639 7337 to make an appointment for assessment and treatment by our experienced Sports Chiropractor.

 

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Joint Hypermobility Syndrome

 

We’ve all seen those people who can touch their forearm with their thumb, or bend their fingers right back. People often call this ‘double jointed’. But what it is, in fact, is hypermobility.

 

What is Hypermobility?

Hypermobility can affect any joint in the body, and is caused by abnormal collagen content in the fibres of the ligaments, causing an increase in elasticity. It is generally an inherited trait, and is more frequent in women than men. Where there is hypermobility in multiple joints, accompanied by joint and muscle pain, and sometimes fatigue, the condition is referred to as Joint Hypermobility Syndrome.

 

There is no prevention or cure available, although generally as we age joints and ligaments become less flexible and mobile, so the condition can reduce. Knee, ankle and shoulder joints are most likely to be affected, and osteoarthritis can develop as a result of weakened joints.

 

Joint Hypermobility Syndrome is often present with other syndromes such as Down or Marfan Syndromes.

 

 

The Beighton Score

Hypermobility is diagnosed using the Beighton Score. Here’s how to check if you might have the condition

For every on of the things below you can do, give yourself one point.  Can you:

  • Bend your knee backwards
  • Bend an elbow backwards
  • Bend a thumb backwards onto your forearm
  • Bend a little finger back more than 90 degrees
  • Put your hands flat on the floor with your knees straight

If you scored 4 points, you are likely to be hypermobile. If you scored 4 points, and experience joint or muscle pain regularly, you could have Joint Hypermobility Syndrome

 

 

Symptoms

Often there are no symptoms – other than your ability to move your body in ways others can’t. However, people with Hypermobility are at much higher risk of injury of sprains, strains, subluxation (where a joint slips out slightly) and dislocation (where a joint slips out completely). Recovery from injury can also take longer where Hypermobility is present due to the reduced amount of collagen in the ligament fibres.

 

Sufferers of generalized Hypermobility might also find they have trouble with balance and co-ordination. And of course, this compounds the tendency towards sprains and strains.

 

Hypermobility can also affect the arches of your feet, causing them to flatten.

 

 

Treatment

Possibly the most important aspect of managing and treating Hypermobility is preventative. Maintaining strength in the muscles around the joints will reduce the likelihood of injury.

 

If pain is present, there are a number of things that can be done:

  • Take anti-inflammatories to ensure the tissues around the joints remain healthy
  • Warm baths and heat packs will reduce pain
  • Use heat-rub creams like arnica to reduce any pain and swelling
  • Regular chiropractic treatment to ensure proper alignment, and keep the muscles strong
  • Visit a Podiatrist to ensure your foot arches are supported correctly
  • Regular massage to improve blood flow in the muscles
  • Strengthening and balancing exercises – it is very important to keep the muscles strong, particularly the core, and those around the affected joint. This will help avoid injury.

 

 

Do’s and Don’ts

Do

  • Low impact exercise – yoga is great, but care should be taken not to overextend joints
  • Maintain a healthy weight
  • Take care choosing shoes – if you have flat feet consider orthotics
  • Make regular visits to the Chiropractor to ensure your joints are as healthy as possible
  • Have a Podiatrist check out your feet to ensure your arches are up tot the task, and consider orthotics if they are not

 

Don’t

  • Do high impact exercise
  • Overexercise
  • Be tempted to overextend your joints as a party trick or whilst doing yoga

 

 

If you think you may have Hypermobile joints or Joint Hypermobility Syndrome, call our Baulkham Hills clinic on 9639 7337 to have a full assessment and treatment plan developed by our experienced Chiropractor.

 

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