Loading

Blog Page

02Oct

Wham, bam see you later M’am

Or why Chiropractic has a bad name

 

 

It is easy for some Chiropractors to think that the profession has a bad name because if it’s somewhat strange and, dare we say it, outlandish, beginnings.  But the truth is that many modern Chiropractors are not doing the discipline any good either.  It doesn’t get talked about.  Maybe for fear of triggering the debate, maybe out of misplaced loyalty.  But a practitioner’s loyalty should surely be to his patients, and not having the discussion is only doing them a disservice.  But before we talk about the difficulties faced by today’s practitioners, let’s have a look at the origin of Chiropractic, and why it began as a bit of a black sheep.

 

 

Strange Beginnings

The discipline of Chiropractic has it’s origins in America during the second industrial revolution.  Thanks to groundbreaking work by Louis Pasteur and Charles Darwin, medical practitioners were moving away from ‘Heroic Medicine’ – blood letting, purges and sweating designed to ‘shock’ the body back to heal.  But scientific practices within the community had not yet caught up.  Esoteric disciplines like vitalism, herbalism and magnetisim began to gather popularity.   The sale of tinctures and nostrums with no documented or proven effectiveness abounded.  In other words, quacks were everywhere.

 

It was into this atmosphere that DD Palmer, himself a Magnetic Healer, began to make tentative moves into a type of healing he referred to as “a science, an art and a philosopy”.  In the early days Palmer compared his practices to Osteopathy – founded by Andrew Stills – as an alternative to the unproven drugs being pedaled by unlicenced quacks.  Both Palmer and Stills viewed the body as a ‘machine’.  But in the atmosphere of the day, scientific proof of efficacy was not expected.

 

Perhaps surprisingly, by the 1930’s Chiropractic was the largest alternative healing profession in the US.

 

 

Do you take your Chiropractic Straight or Mixed?

In 1906 DD Palmer’s son BJ took over the School of Chiropractic.  He worked hard at promoting professionalism in the discipline, and overcome resistance to medical technology like X-rays.  However, around this time a divide developed.

 

In simplistic terms, BJ was what is known as a ‘straight’.  That is, he relied solely on spinal adjustments, according to his father’s teachings.  But a growing group of Chiropractors – known as ‘mixers’ began to combine spinal adjustments with other treatments.  Eventually, the two groups parted ways, forming separate professional associations to govern their particular flavor of chiropractic treatment.  The ‘mixers’ began to incorporate alternative treatments, and look for evidence-based treatment objectives.  Dr Solon Langworthy wrote the first scholarly work on Chiropractic “Modernized Chiropractic”, thereby introducing Chiropractic to the scientific arena.  However, it would be years before the science really caught up.

 

 

 

Chiropractic Comes to Australia

Around this time Chiropractic finally made it to Australia, some 10 years after it began in the US, in the form of Henry Otterholt, a student of DD Palmer.  The Sydney College of Chiropractic was founded in 1959 and in 1990 was the absorbed into Macquarie University, making it the first Chiropractic course in a mainstream university in the world.  Chiropractors study a minimum of 5 years to become registered.

 

 

And Now for the Science

Although during the 1980’s Chiropractic had begun to receive mainstream recognition, as recently as 1987 the American Medical Association called Chiropractic ‘an unsafe cult’.  However, a 1975 Conference generated an interest in the discipline, and serious research began.  By the mid 1990’s there was a growing scholarly interest in the relationship of the spine and central nervous system, to overall health.  Today, research continues to support the techniques and modalities taught in Chiropractic degrees and practiced by modern Chiropractors.

 

 

 

Why You Should be Wary

While the concept of ‘mixers’ and straights’ is hugely oversimplified, it still exists today.  As with everything in life, there are no black and white distinctions.  Chiropractors exist on a bell curve with pure straights on one end, and extreme mixers on the other.

 

These days only about 15% of Chiropractors can be classified as pure ‘straights’.  Many (though not all) can be identified by their unwillingness to incorporate additional therapies into their practice, and by their claims to be able to cure conditions such as asthma with Chiropractic.  A great many of them are anti-vaccination.  They generally do not utilize medical technology such as MRIs and CTs and an appointment with them will involve adjustment only, and usually take only a few minutes.  This type of treatment does not take into account any muscular skeletal issues, and so does not incorporate any soft tissue work on muscles that may have been damaged through activity.  Neither does it allow for the potential that the nerves of the peripheral nervous system can be impinged in any of the joints through which they travel – not just those of the central nervous system in the spinal column.  This concentration on adjustment of the spine means appointments are very brief – often you will spend as little as 5 minutes with the practitioner.  Wham, bam, see you later m’am.

 

It is not uncommon for patients of these practitioners to never get ‘better’.  The objective is for them to see their practitioner every week or month for the rest of their lives.  These are often the practitioners who generate the media hype about the unsafe nature of Chiropractic treatment.  It is these practitioners who ensure the discipline is still having trouble getting out from under the shadow of its somewhat murky inception.

 

At the other end of the spectrum we have the extreme mixers – some of whom no longer even attempt adjustments of the spine.  These Chiropractors are more like physiotherapists than anything else in their approach to health care.

 

And in the middle we have the sweet spot.  Most Chiropractors educated in Australia today would be classified as ‘mixers’, and the greater proportion of them sit somewhere in the middle of the bell curve.  These practitioners have been highly trained – with a minimum of 5 years at university.

 

Mixers – today more correctly known as Musculoskeletal Chiropractors - will utilize the current medical diagnostic technology available to them to help identify the problem being presented.  Treatment will be drawn from a range of modalities to best suit a patient’s needs, from standard adjustments to soft tissue work, IASTM, dry needling, laser and shockwave therapy and exercise prescriptions.  All treatments are evidence-based and specifically ‘prescribed’ for the individual patient.  Appointments may take anywhere from 20-40 minutes, and care is taken to treat the whole patient, not just the spine.  The focus is correcting the problem so the patient can get on with their daily activities, pain and restriction free.

 

At the end of the day, what Chiropractic should be about is treating the patient.  If you are looking for a Chiropractor, take a good long look at their website.  Are they focused only on adjustments, or will they use a range of modalities?  How long are the appointments?  What additional services are offered?  If you are still in doubt, call their clinic and have a chat to the staff.  They will soon tell you what the philosophy of the clinic is.  Look at Google reviews, ask your friends for recommendations.  Then weigh up all the evidence and decide for yourself.

 

 

If you think you might need Chiropractic treatment, don’t be put off by the small minority of ‘Wham Bam’ practitioners or the sensationalist hype.  A visit to a good Chiropractor might just leave you feeling pain and restriction free.

By chiro0 Comments
Read more...
27Sep

Growing old gracefully

it's not just a state of mind

In the past we have talked about the benefits of massage in general, as well as the benefits related to sports performance and recovery, pregnancy and mental health. But with a rapidly ageing population in Australia – and around the world – are there benefits in massage for the more mature members of our community?

 

The answer, of course, is yes there are! Australian Bureau of Statistics figures have tracked a steadily increasing age profile in Australia in the last 100 years. In 1911 one in every 25 people were over 65. By 2016 it was one in six. That’s a whopping 16%! And what’s more – those people over 65 are getting older. That is to say, there is a higher percentage of people 75-84 and over 85 than ever before.

 

 

The old prevention is better than cure routine

One of the most important things we can do as we age is retain our health. As we age, it is more difficult to recover from illness, so to avoid getting ill is the best way to ensure we get that letter from the Queen congratulating us on our 100th birthday.

 

Massage can play a key role in helping us remain fit and healthy as we age. The American Medical Association has stated “it has been verified through scientific exploration that more than 80 percent of all diseases are due to stress and strain that originate in the mind and reflect on the body”. If we consider stress has a cumulative effect on the body, then as we age we are likely to be more and more prone to stress related illnesses. It is also worth noting that illness, in and of itself, can create stress. So as we age, and become more prone to diseases like arthritis, diabetes, stroke, Parkinson’s disease and heart problems, our stress levels can increase.

 

 

How Seniors Massage is Different

Many massage clients love nothing more than a good, deep remedial massage, often commenting that it ‘hurt in a good way’. As we age, this is not necessarily the best approach. The older we get, the style of massage we need changes:

 

  • shorter more frequent sessions often work better – a half hour massage weekly or fortnightly is better than an hour once a month. This is because massage keeps muscles supple and blood moving. A month in between is just too long.
  • Swedish – rather than the pressure of a Remedial or Sports Massage, Swedish style is more appropriate as the body ages. Long sweeping movements to encourage blood flow and lymphatic drainage are best.
  • Hands and Feet – as we age arthritis can make our hands and feet less flexible. If they are not too inflamed massaging hands and feet can keep them moving.

 

The key is being clear with your therapist about where your aches and pains are, and what level of pressure you would like. Don’t ever be reluctant to speak up. Your massage therapist wants you to leave feeling fabulous – not like you’ve been through the wringer.

 

 

Benefits of Massage as we Age

All the benefits of massage that we have talked about in previous blogs apply here. However, there are some aspects that are worth mentioning specifically, as they are particularly pertinent as we age:

 

  • the stimulation of the lymphatic system offered by massage (even when not specifically a lymphatic drainage) is important as it helps drain the body of toxins. As we become less active, the lymphatic system becomes more sluggish, and the resulting build up of toxins can impact our overall health.
  • Restoration of mobility – conditions like Parkinson’s Disease and Arthritis can reduce our mobility, causing muscles to become stiff and to shorten. Massage will help lengthen and keep these muscles supple.
  • Sleep - many older people have problems sleeping. Regular massage can help you get a better night’s sleep
  • Faster healing – as we age it takes longer and longer for us to heal as the body’s repair systems slow down. The blood-flow and general health benefits of massage mean you will heal faster, reducing the risk of secondary infections and prolonged illness.
  • Many, many studies have confirmed the healing power of touch. This seemingly simple human interaction can have an enormously powerful effect on people who are older, particularly if they have lost their partner and their social circle is limited.
  • Increase production of serotonin and dopamine improves your frame of mind – no more stereotyped Cranky Old Men/Women!
  • Non-invasive and drug free. As we age, the number of pills we take can increase alarmingly. To be able to improve our health or reduce pain without another pill to take can be hugely important.
  • Improved energy – the increased blood flow, improved lymphatic drainage, increased production of serotonin and dopamine, and better sleep all contribute to an elevated level of energy.
  • Reduced risk of falls. It has been well documented that a fall as we age can have extraordinarily negative impact on our overall health and well-being, far beyond the specific damage of the fall. So much so that it is one of the primary concerns of many older Australians. Massage has been proven to help proprioception – that is, our sense of the relative position of our body parts, thereby reducing the risk of falls.

 

That’s quite a list!

 

So, if you or someone you know could benefit from a regular massage routine, call our Baulkham Hills Clinic on 9639 7337 to make an appointment.

 

 

 

By massage0 Comments
Read more...
25Sep

Orthotics

Custom Made vs Off the Shelf

 

 

Lots of our patients ask us about the need for custom made orthotics. Are they really necessary? What about the off the shelf version – aren’t they just as good? The custom made ones are so expensive. We get it. Custom made orthotics can put a bit of a dent in your budget. But when you consider you are walking around on them all day, every day, the cost really is worth it. Let’s have a look at the differences between custom made and off the shelf.

 

What they are, and what they aren’t

Firstly, not everything you put in a shoe (other than your feet) is an orthotic. Gel insert style products, which you can buy off the shelf in the supermarket or shoe shop for around $30, are not orthotics. These are little more than cushioning, and are really just designed to make your shoes more comfortable. They offer nothing by way of support, and should really only be worn by people who don’t actually need orthotics.

 

Orthotics aim to provide support and adjustment for feet that have, for many and varied reasons, biomechanical problems. They should provide proper alignment, balance, support and motion-control for your feet, adjusting your gait and the way your foot strikes the ground. This is quite a tall order.

 

 

Off the Shelf

Sports shoe stores and clinics often sell off the shelf, or pre-fabricated, orthotics, which can be trimmed to fit a particular shoe. In most cases these orthotics provide little more than support for the arch of your foot, or padding.

 

For patients with very minor biomechanical problems, or short-term conditions, it may be that off the shelf orthotics are sufficient. However, since they are not constructed based on the wearer’s actual foot, they only provide generic correction that may not be enough for some biomechanical problems. In fact, sometimes, although they may provide short term relief, off the shelf orthotics can often cause longer term problems, especially when not sized and fitted correctly to the shape of the foot and the arch.

 

 

Custom Made Orthotics

A full biomechanical assessment is required for custom fit orthotics.   Your podiatrist will examine and evaluate:

 

  • your feet, looking at things like your foot arch, visible bunions, toe problems and other structural concerns
  • your gait, looking at how you walk, whether your feet roll in or out and watching your leg movement from the hip down through the ankles and feet
  • your shoes, looking for wear patterns that show how you stand and walk

 

Once the full assessment is complete a cast will be taken of you feet. This cast will be used to design and make orthotics to specifically fit your feet, and address the biomechanical issues causing your problems. Because of this the orthotic for the right and left foot may be different – and sometimes by quite a lot.

 

It is important to bring your most commonly worn shoes with you for a Biomechanical Assessment, as the shoe you wear most of the time is the one the orthotics should be fitted to. If you already wear orthotics, it is important to bring those too – whether they are custom fit or off the shelf.

 

There are is enormous range of conditions that can be treated and managed with custom fitted orthotics, including:

 

  • Flat feet – improving foot and leg position
  • High arches – increasing shock absorption and redistributing pressure
  • Bunions – development of bunions can be slowed
  • Knee, hip and lower back pain – when the feet are not properly aligned knee and hip pain can become a problem
  • Arthritis – joint degeneration can be slowed and pain reduced
  • Plantar Fasciitis – pain can be reduced and a recurrence avoided
  • Pronation (rolling inwards) of the foot whilst standing or walking
  • Supination (rolling outwards) of the foot whilst standing or walking
  • Tendonitis
  • Recurrent stress fractures

 

It is important to note with orthotics that they may be slightly uncomfortable at first. It is best to wear them in for brief periods – start out with an hour a day and build up over a week or two. This is because the orthotics are designed to realign your foot. For instance, people with very flat feet sometimes comment it feels like there is a pebble in their shoe at first. But you will find that very quickly your foot will adjust and the orthotics will start making a positive impact on any pain or difficulty you have been having.

 

When your orthotics are ready your Podiatrist will fit them in the shoe and check they are correct and achieving the goals you set out to achieve. On rare occasions, some small adjustments may need to be made. A review of how you are going should be scheduled for a two weeks later to assess how your joints and muscles have adapted to the orthotics.

 

You should then visit your Podiatrist every 6-12 months to have your orthotics checked. Sometimes you may need new ones, or your existing orthotics may need ‘refurbishing’, depending on the response of your feet and the wear and tear on the orthotics.

 

 

If you are experiencing lower back, hip, knee or foot pain, or if you know you have flat feet you might like to make an appointment to see our expert Podiatrist for a Biomechanical Assessment. It could be that some orthotics are just what you need. Call our Hills District Clinic on 9639 7337 to make an appointment.

 

 

 

By podiatry0 Comments
Read more...
20Sep

Travel Tips

how to leave healthy and stay that way

For most people there is not much more exciting than an overseas holiday.  And there is not much that can spoil that holiday faster than getting sick or being in pain.  Let’s have a look at some of the things you can do to stay well and pain-free on your overseas holidays.

 

 

Make like a Scout and Be Prepared

Being prepared will not only help avert any health problems when you are travelling, it will also give you peace of mind so you can enjoy your trip.  Here are a few suggestions:

  • make sure you are fit and well, and have had any appropriate shots in plenty of time before you leave. There are specialist travel doctors who can help you understand what shots you need for where you are travelling.
  • While at the travel doctor, pick up a script for broad spectrum antibiotics. If you do get sick you won’t have to waste time looking for a doctor and tackling the language barrier.
  • Take a supply of over the counter medications for tummy bugs, and include something to replace your electrolytes and sugars
  • If you are going somewhere that you don’t trust the water, take some water purification tablets. Sometimes, even the bottled water isn’t what it seems.
  • Make sure your luggage is not too heavy for you to lift easily – especially on the way out, as it will no doubt be full of purchases on the way home. So whatever you have packed, take 30% of it out!
  • Talk to your chiropractor about any exercises you can do while you are travelling to keep you fit and pain-free. If you have neck or back problems this is particularly important as long stretches in planes, trains and automobiles, strange beds and pillows can cause havoc on your spine.
  • Talk to your podiatrist about the right shoes for your trip. Depending on where you are going and what you are doing, your shoe needs might vary.  Comfort might not always be glamorous, but you will never regret opting for the right shoes.

 

Prevention not Cure

So, you’re all loaded up with the right gear and worded up on exercises.  But really, prevention is best.  There are a few things you can do to avoid problems:

  • Don’t have ice in your drinks. If it is made from local water it may make you sick.
  • Avoid salads, and only eat fruit you have peeled yourself. Again, it’s a water thing.
  • It’s great to eat local, but if you are not used to certain foods, don’t feel you need to try them as they can cause stomach upset. This is particularly the case with spicy foods.
  • Probiotics! These will not only help your stomach cope with unfamiliar foods and routines, but will help get you back to normal quickly should the worst happen.  Metagenics make a probiotic ideal for travel as it doesn’t require refrigeration for up to 60 days.
  • Keep up any exercise regime that your chiropractor has suggested to avoid developing problems.
  • Wash your hands Give your hands with soap and water after handling money and before and after eating. If this is not possible, give your hands a rub with hand sanitizer.
  • Remember to apply sun screen and insect repellent. Nobody needs sunburn or itching bites on a holiday!

 

 

Deep Vein Thrombosis

Since an overseas holiday for Australians generally involves a very long-haul flight, an all too common problem is Deep Vein Thrombosis.  At best, this can cause a great deal of discomfort, at worst it can be life threatening.  But there are things you can do to reduce the risk, and signs you should look out for.

 

A Deep Vein Thrombosis is a blood clot which forms in one of the large veins deep inside your body – generally the leg.  They are the result of blood not circulating freely and pooling in a vein.  These clots can cause pain, swelling and skin discolouration.  However, if the clot begins to move, or a piece breaks off, it can travel to your lung, potentially causing a life threatening pulmonary embolism.  No laughing matter.

 

Air travel, or even sitting still too long in a car (another hallmark of Australian holidays!) can cause a DVT to develop.  If you are overweight, smoke, take oral contraceptives, are pregnant or have a family history of DVT your risk is increased.  There are, however, things you can do to reduce the likelihood of this painful and potentially life threatening condition:

 

  1. Drink plenty of fluids on the flight. Yes, I know that will mean more of those awful trips to the toilet, but it’s a small price to pay.
  2. Avoid alcohol and caffeine - sorry, I know I got your hopes up with number 1!
  3. Avoid sleeping tablets – yes, I know it’s almost impossible to get any rest in cattle class without them, but it is best to be safe.
  4. Wear loose clothing that doesn’t restrict movement – jeans are not recommended.
  5. Wear flight socks – especially on flights of 4 hours or more. They may not look glamorous, but they might save your life.  Flight socks should be fitted by a health care professional or pharmacist as it is important they fit properly.
  6. Try and do some stretching and walking around the terminals during stopovers or when waiting for connecting flights.
  7. In flight exercises are a must.

 

In Flight Exercises

Agreed, there is not much room to do exercises in an economy seat – there is barely enough room for an adult – but there are a few exercises that you can do that will help avoid a DVT.

  1. Lift one knee up and hug it to your chest, keeping your back straight. Hold for 5 seconds.  Alternate sides a few times.
  2. Lift one foot off the floor and draw circles with your toes – clockwise and then anti-clockwise. Alternate sides a few times.
  3. With feet flat on the floor, lift up your heels, pressing the ball of the foot into the floor. Hold, then put your heel down, lifting the toes.  Hold and repeat a few times.
  4. When you make a trip to the toilet, try walking up and down the aisle a couple of times. Don’t try this when there is turbulence as there is a risk of injury.

 

Finally, keep an eye out for the symptoms of DVT for about a month after a long-haul flight and go straight to the doctor if you experience swelling, pain or skin discolouration.  If you think you may have a DVT and you experience shortness of breath, chest pain, dizziness or fainting or you begin coughing up blood go directly to a hospital.

 

If you are off on an overseas holiday, firstly – you lucky thing!  Secondly, you can’t start preparing early enough.  Our specialist Chiropractor and Podiatrist can help ensure you are fit as a fiddle so that you finish your journey as strong and health as you started it.  Call our Hills District clinic on 9639 7337 to make an appointment.

 

 

By tips, wellbeing0 Comments
Read more...
18Sep

Frozen Shoulder

getting it thawed out

 

 

The shoulder is the most mobile joint in our body. But what happens when it becomes immobile? Frozen shoulder is a condition that affects around 3% of the population, and since it can take up to 3 years to resolve itself, it can be a real pain in the,… well, shoulder.

 

 

What is Frozen Shoulder?

Frozen Shoulder – more correctly known as Adhesive Capsulitis – is a stiffening and pain in your shoulder joint. The shoulder joint is a ball and socket joint which is made up of three bones – the upper arm (humerus), shoulder blade (scapula) and collarbone (clavicle). Connective tissue known as the shoulder capsule surrounds this joint. When scar tissue forms in this capsule it thickens and tightens and the synovial fluid, which lubricates the joint, reduces, causing Frozen Shoulder. Some people mistakenly think this is Arthritis, but in fact the two conditions are completely unrelated.

 

 

Risk Factors

Around 70% of all sufferers of frozen shoulder are women, most between 40-60 years of age. It is also more common amongst people with conditions like thyroid disorders, tuberculosis and Parkinson’s Disease. 10-20% of diabetes sufferers will experience frozen shoulder. It is uncommon to suffer this condition twice in the same shoulder, however it may occur in the other shoulder.

 

Often, Frozen Shoulder strikes when the shoulder joint has been immobilized for a period of time - for instance when you have had your arm in a sling following a fracture, have had a stroke, or a mastectomy.

 

 

 

 

Three Stages of Frozen Shoulder

Frozen Shoulder occurs in three stages:

 

  1. Freezing – this stage is the most painful. Generally symptoms come on gradually and may take 6 weeks to 9 months to fully develop. Pain is often worse at night. The pain is generally dull and achy, and may extend across the shoulder and down the arm.
  2. Frozen – you may experience less pain, but the shoulder will be stiff and movement restricted. This can last for 4-6 months.
  3. Thawing – a gradual return to normal function and movement can take 6-12 months.

 

 

Diagnosis

A diagnosis can generally be made by physical examination. However, your health practitioner may suggest an xray or MRI in order to rule out other conditions such as a torn rotator cuff or arthritis.

 

 

Treatment

Treatment of Frozen Shoulder is all about reducing pain and discomfort and restoring range of motion.

 

Over the counter pain relievers and anti-inflammatories can help, particularly in the Freezing phase, where pain can keep you awake at night.

 

A chiropractor will treat the condition with, heat treatment, soft tissue manipulation, acupuncture and transcutaneous electrical nerve stimulation (TENS). Gentle massage might also be considered. Range of motion and stretching exercises for you to do at home will be prescribed to help re-mobilise the joint.

 

In very rare cases surgery may be considered if non-invasive therapies do not provide relief.

 

 

If you are suffering from shoulder pain and stiffness call our Hills District clinic on 9639 7337 to make an appointment to see our qualified Chiropractor for a diagnosis and treatment.

 

By chiro, condition0 Comments
Read more...
13Sep

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.

 

 

By chiro, massage, tips, wellbeing0 Comments
Read more...
11Sep

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.

By wellbeing0 Comments
Read more...
06Sep

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!

By tips, wellbeing0 Comments
Read more...
04Sep

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.

 

 

By podiatry0 Comments
Read more...
30Aug

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!

 

By chiro, podiatry0 Comments
Read more...