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Whiplash

Quick treatment is the key

Whiplash is one of the most common injuries dealt with by Chiropractors. It can range from mild to severe, and in some cases can become chronic, causing related psychological issues. In this blog, we will look at what it is and how to treat it.

What is Whiplash?

Whiplash is an injury to the muscles, tendons, soft tissue, bones, discs and nerves of the cervical spine. It is the result of vigorous or violent movement of the head either sideways, or more commonly, front and backwards. Whilst whiplash can be the result of a fall or blow to the head during contact sport, most often it is caused by a rear-end motor vehicle accident.

Recent studies have shown that the sharp forwards/backwards motion causes the lower cervical vertebrae (lower neck) are forced into hyperextension (forwards) while the upper cervical vertebrae are forced into hyperflexion (backwards). This causes an abnormal S shape to form, causing damage to the entire neck area.

Generally, a whiplash injury is acute. However, in around 30% of cases, pain persists and the condition becomes chronic. This is one of the reasons it is imperative to seek treatment for a whiplash injury quickly.

Symptoms

Symptoms of whiplash can range from mild to severe, and may include:

  • pain in the neck, shoulders and even arm and upper back
  • mild swelling and bruising
  • headaches
  • dizziness
  • weakness
  • difficulty concentrating
  • hearing and visual disturbances, including tinitus
  • difficulty swallowing or speaking

Generally, symptoms will start to develop within 6-12 hours of the accident, and may worsen over the following days. Symptoms can last for days, even up to months, depending on the severity of the injury.

In severe cases, you may start to experience numbness or pins and needles in the face, difficulty with balance or walking, fainting and problems controlling your bowel or bladder. If this is the case, seek medical treatment immediately.

Whiplash Associated Disorder

Whiplash Associated Disorder (WAD) refers to symptoms of psychological distress that can sometimes accompany a more severe case of whiplash. Symptoms include:

  • depression
  • anxiety
  • anger & frustration
  • sleep disturbances
  • PTSD

WAD is more likely to occur in cases where the original whiplash injury has not fully resolved and pain is still present months after the injury. These cases are considered to have become chronic.

It is important that as well as seeking treatment for the physical symptoms of whiplash, WAD sufferers seek treatment from a psychologist or counsellor trained in pain and injury related conditions.

Diagnosis

Generally, the severity of a Whiplash injury is classified from 0-4 – 0 being no pain, to 4 allowing for potential fracture.

Diagnosis is generally made via examination, and questioning, and then confirmed with either an X-ray or MRI.

Treatment

Years ago, Whiplash injuries were treated by immobilisation. A soft or hard collar was often prescribed. It has now been proven that excessive immobilisation of the neck can actually lead to muscle atrophy (wasting) and decreased blood flow, which slows healing and reduces eventual mobility. That being said, it is important treat the neck carefully, which is why it is best to seek the advice and treatment of a chiropractor to ensure your injury is receiving appropriate care.

These days your Chiropractor will use a range of treatments, depending on the severity of your injury, and your particular physiology and symptoms.

In the acute phase, your Chiropractor will focus on pain and inflammation reduction. Ultrasound, TENS (Transcutaneous Electrical Nerve Stimulation), gentle stretching, ice and anti-inflammatories will be included.

Once the pain and inflammation has begun to subside, your Chiropractor will treat your injury with gentle manual manipulation of the spine including flexion-distraction; soft tissue therapy with SmartTools; joint stretching and resistance; trigger point therapy, including dry needling; and therapeutic massage. The number of treatments you require will be based on the severity of the injury, and the way in which your body responds to treatment.

Your chiropractor will help you with what exercises you can do, whether your pillow is right for your injury, what pain and anti-inflammatory medications you can use and answer any other questions you may have.

Self Care

In addition to seeking the care of a qualified Chiropractor, there are some things you can do yourself that will help in your recovery:

  • in the hours immediately after the accident, apply ice to the injury. We talked about ice treatment in our blog Blowing Hot & Cold
  • Try not to ‘favour’ your neck, but be gentle in all your head movements
  • Over the counter pain killers and anti-inflammatories will help, discuss this with your health care professional
  • Watch your posture, try not to slump as this puts pressure on your neck
  • Avoid heavy lifting and contact sports until your Chiropractor says it is safe to return to normal activities
  • Make sure your pillow offers you the right support for your head and neck, again your Chiropractor can help with this

Prevention

Since Whiplash is generally the result of an accident, it is not possible to entirely eliminate the risk. You can, however, reduce the risk by ensuring the headrests in your car have not been removed, and that they are correctly positioned directly behind your head. If you do not have headrests, it is worth seeing if you can have some fitted to protect your head and neck.

If you are concerned you may have a whiplash injury, contact our Baulkham Hills Clinic on 9639 7337 to make an appointment for diagnosis and treatment with our experienced Chiropractor. If you are suffering from any of the more severe symptoms we mentioned, contact your doctor or local hospital immediately.

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Hayfever and Acupuncture

Dealing with the symptoms and the cause

Well, the weather today might not reflect it, but it’s Spring! For most people Spring means the start of beautiful weather and looking forward to spending more time outdoors. For many people, however, the start of Spring means the start of misery. Hay fever. Runny nose, itchy watery eyes, sneezing, the list goes on. But there are things you can do about it that will relieve your misery, and maybe even have you outdoors enjoying the warmer weather.

What is Hayfever?

It is estimated that up to 3 million Australians suffer from hayfever. It is most common in the 25-44 year old age bracket. In the simplest terms, hayfever is an exaggerated immune response. This can be a response to all sorts of things – dust, pets, and very commonly, pollen.

When you are allergic, your body responds by flooding your blood stream with histamines. Histamines boost blood flow to the affected area, causing inflammation and signaling to the body’s immune system that help is needed. This is what creates the symptoms we know as hay fever. These symptoms are designed to do one of two things – flush the allergens out of your body (via the mucous membranes) or stop the allergens for getting into your body, by swelling up. Symptoms include:

  • Runny, watery eyes
  • Runny, itchy nose
  • Sneezing
  • Itching and swollen eyes, roof of your mouth and throat
  • Dark circles under the eyes

A tendency to hay fever is usually genetic – you will find a parent or sibling with the same problem. And it often accompanies asthma or eczema.

Treatment

Western medicine tends to treat the symptoms of hay fever, rather than the cause. Avoiding the outdoors during spring, saline sprays for the nose, and antihistamine tablets will reduce the severity of the symptoms. However, they don’t treat the cause. And the side effects of some antihistamines, like drowsiness, can present problems of their own. In fact, The World Health Organization believes acupuncture to be a more effective way of treating hay fever than antihistamines.

Traditional Chinese Medicine focuses on balancing the body, and so works on not only addressing the symptoms, but resolving the root cause. A combination of Traditional Chinese Herbal Medicine and Acupuncture will help with both.

Since hay fever is essentially an overreaction of the immune system, it makes sense that making sure the immune system is balanced and health is a good place to start. Traditional Chinese Herbal Medicine will help strengthen the immune system by working on the spleen, lungs and kidneys. They will also assist with draining the dampness in the mucous membranes – particularly the nose.

Acupuncture treatment will directly target the site of the inflammation, and assist with strengthening the immune system.

You should feel relief from the symptoms in the first treatment. Over the course of treatment – which, depending upon the severity of the condition may take up to 8-10 sessions, improvement will continue until you should only need occasional ‘maintenance’ appointments.

As an added benefit, you will sleep better, have more vitality and better digestion as the treatment continues.

So if you suffer from debilitating hay fever every spring, call our Hills District Clinic on 9639 7337 to make an appointment with our specialist Acupuncture and Traditional Chinese Medicine practitioner.

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Diabetes and Foot Care

Why a Podiatrist is so important

It is currently estimated that around 1.7 million Australians have diabetes. This makes it one of the largest challenges faced by our health system. On a personal level it can be just as challenging. Diabetes can cause all sorts of related complications, which, if not treated properly, can lead to long-term pain and discomfort. One of the areas most at risk of related complications is your feet.

First a Word about Diabetes

Diabetes – both Type 1 and Type 2 - is a condition whereby the body either does not produce sufficient insulin or the cells of the body no longer react to insulin. Insulin is produced by the pancreas, and helps your body use the sugar in the food you eat either for energy, or to be stored for future use. When it is working effectively insulin balances the level of sugar in your blood.

Type 1 Diabetes is an autoimmune disease, and often begins in childhood. Type 2 Diabetes is generally related to lifestyle, occurring most commonly in people who are overweight. Around 95% of all diabetes sufferers are Type 2.

If there is too much sugar in your blood for a prolonged period, organ and tissue damage can occur – including damage to your heart, blood vessels, nerves, kidneys and eyes.

How does Diabetes Affect your Feet

There are two key problems created by Diabetes that affect your feet:

Neuropathy – damage to the nerves. Causes pins and needles, tingling, numbness, pain and a burning sensation. Symptoms can come on very slowly, so that the condition is quite advanced before you notice it. When numbness is present, damage to the skin of the feet – cuts, grazes, blisters – can go unnoticed and infection can set in. Infection may turn to ulceration, which can penetrate to the bone (osteomyelitis) causing a chronic infection, possibly leading to amputation.

Peripheral Arterial Disease – or narrowing of the arteries. Fat and calcium building up in the walls of the arteries (atherosclerosis) reduces blood flow, particularly in the legs and feet. Symptoms include leg pain when walking, known as claudication. Pain can be anything from mild to severe. However, the biggest risk here is the increased risk of infection caused by the restricted blood flow. When blood flow is restricted, healing slows and ulceration can be the result.

Foot Amputation

Complications related to the feet account for the majority of diabetic problems, and most of these relate to ulceration. It is alarming to think that 80% of all foot amputations are caused by ulceration, and up to 80% of amputations could potentially be avoided if the patient had sought timely, structured and appropriate care.

Ulceration

Regular appointments with a Podiatrist are essential if you have diabetes. The combination of reduced sensation and blood flow can create the optimum environment for the development of ulcers. As with many things, prevention is far better than cure, as it is very, very difficult to cure an ulcer, but easy to prevent their development with the right care.

One indicator that an ulcer may be developing is an increase in skin temperature. If you notice a ‘hotspot’ on your foot, hotfoot it to the Podiatrist as quickly as you can.

Caring for your Feet

Daily care of your feet at home is essential:

  • be familiar with your feet – thoroughly wash, dry and check them for changes daily. If you notice anything different, talk to your Podiatrist to make sure it is not cause for concern
  • Keep your feet well moisturised to avoid cracking and peeling
  • Avoid tight or scratchy socks or stockings
  • Take care when cutting your toenails – straight across, not curved into the corners
  • Make sure your shoes are well-fitted and comfortable to avoid blisters, corns and calluses
  • Don’t use DIY corn treatments
  • Treat any cuts, abrasions or blisters immediately with an antiseptic such as betadine and a sterile dressing, and make an appointment to visit the Podiatrist if you do not see improvement within 24 hours, or if there is any sign of infection.
  • Ensure regular visits to a Podiatrist – aim for every 3-6 months

How a Podiatrist Can Help

Visiting a Podiatrist every 3-6 months is essential if you have diabetes. A Podiatrist will:

  • check the blood flow in your feet and lower legs to rule out the development of Peripheral Arterial Disease
  • Check sensation and reflex to rule out Neuropathy
  • Examine your feet for any unusual foot shapes like bunions or hammer toes
  • Treat corns and calluses effectively
  • Trim toenails safely
  • Ensure there are no potential areas where ulceration might be beginning to occur
  • Ensure your shoes fit correctly, and possibly recommend orthotics to offset any inappropriate pressure which may cause ulceration
  • If an ulcer is present, a Podiatrist will treat it with dressing and debridement, and possibly orthotics to reduce pressure on the wound

It is very important if you have diabetes to see a Podiatrist as soon as you notice anything unusual or different in relation to your feet. Since symptoms often develop slowly, once you notice them the problem is often well advanced.

If you have diabetes, or you are experiencing any of the symptoms we have mentioned, call our Hills District Clinic on 9639 7337 to make an appointment to see our specially trained Podiatrist.

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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.

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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.

 

 

 

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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.

 

 

 

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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.

 

 

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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.

 

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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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