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What is RED-S? Relative Energy Deficiency in Sport (RED-S) refers to a condition in which energy imbalance leads to impaired physiological function of multiple organ systems.  RED-S is thought to be primarily caused by low energy availability (LEA) due to low energy diets, be it intentional or unintentional, and is often combined with the harmful aspects of overtraining syndrome and/or excessive exercising; thus, creating a relative negative energy imbalance.  What is Low Energy Availability?  LEA may be intentional, with the athlete intentionally restricting their dietary intake, or unintentional, in which the athlete's nutrition simply isn’t meeting the demands of their training load. Be it intentional or unintentional, the athlete will suffer the same implications to their health and performance.  Intentionally: the athlete is restricting their diet, common in sports such as cross country running and gymnastics where weight effects overall performance. This can be difficult to manage as the athlete must address their complex relationship with food and psychology. Unintentionally:  the athlete is not getting the energy availability out of their diet that their sports demand. This can be easier to manage as it may be sufficient to simply educate the patient on the nutritional demands of their training load.  Who is most likely at risk of RED-S? Most common in sports that unite the importance of a thin body type and success - gymnastics, figure skating. Sports with frequent weigh ins – boxing, rowing  Endurance sports – cycling, marathon running. Regardless of the sport, team culture and coaching staff’s attitudes can contribute to the risk of RED-S in an athlete  The understanding of REDS and its symptoms are poorly known by athletes and coaches therefore if often goes undiagnosed and untreated - this stresses the importance of the role of physiotherapists and sports clinicians in identifying the symptoms in their patients.   What is the impact of RED-S on my health? Bone Health – LEA causes a chronic state of hypoestrogenism which leads to lone bone density.  Endocrine Health – negatively effects thyroid function. Menstrual Health - can range from abnormal bleeding to amenorrhea which is when the female’s period is absent for more than 90 days.  Fertility - due to the absence of ovarian follicular development, anovulation, or luteal-phase defects, menstrual dysfunction can further lead to infertility in females.  Metabolic Implications  Gastrointestinal Implications Psychological – In individuals with REDS, there is an increased prevalence of eating disorders and disordered eating. This has significant implications for psychological well-being, by potentially exacerbating low self-esteem, anxiety and depression. What is the impact of RED-S on my performance? Increased risk of injury – stress reactions, stress fractures due to poor bone health  Poor concentration  Fatigue and poor recovery  Impaired judgement  Neuromuscular performance and reaction times are reduced.  Impaired co-ordination  Negative influence on muscular strength - because of a negative impact on muscle protein synthesis. Negative influence on endurance performance – because of a negative impact on mitochondrial protein synthesis and strength What is the role of the physiotherapist in treating RED-S? Often patients will present to physios with injuries that have been a repercussion of RED-S. Most often this is a bony injury – stress reaction/fracture and/or an overuse injury that has not healed fully. In this case the physio should look out for other red flags such as:  Oligomenorrhea/amenorrhea Recent weight loss Restrictive eating and body dysmorphia Recurrent illnesses Cardiac abnormalities It is important for physios to be able to identify RED-S and ensure the patient gets proper screening. A multi-practitioner, patient-centred approach is needed to treat both the physical and psychological health implications. Management strategies should include: Education Optimising energy availability – altering diet.  Modification of exercise and training – in some case this means only low impact exercise if BMD is very low or stopping exercise completely for a period of time. Mental health support Physiotherapists can modify and monitor an athlete’s activity levels during recovery, prescribe an appropriate training schedule for the athlete, and develop treatment goals for the patient.

Contact ports, with all their excitement and thrill, come with a fair share of risks, and one of the most concerning is the prevalence of concussions. These traumatic brain injuries can have profound effects on athletes, both in the short and long term. In this blog post, we will delve into the causes, symptoms, assessment methods, and the crucial role of physiotherapy in the treatment of concussions. Additionally, we'll explore the intriguing connection between neck rehabilitation for migraine symptoms and its influence on dizziness or vertigo. Causes of Concussions Concussions occur when a forceful impact to the head or body causes the brain to move within the skull. In sports, this can happen due to direct contact to the head with another player or implement, falls, or any abrupt force that jars the head (whiplash from a tackle). Symptoms of Concussions Recognising the symptoms of concussions is vital for prompt intervention. Athletes who experience a concussion may exhibit a range of symptoms, including: • Headache • Dizziness • Nausea • Fatigue • Confusion • Memory loss • Sensitivity to light and noise • Impaired balance and coordination Assessment of Concussions Healthcare professionals use a combination of clinical evaluations, cognitive tests, and imaging studies to determine the severity and extent of the injury. Immediate assessment is crucial to guide appropriate management and ensure the safety of the athlete. If you feel you may have had a concussion it is recommended you get assessed as soon as possible. Physiotherapy Treatment for Concussions Physiotherapy plays a pivotal role in the comprehensive management of concussions. The primary goals of physiotherapy treatment include: 1. Restoration of Balance and Coordination: • Physiotherapists will prescribe you with training drills to retrain balance and coordination, addressing the impaired motor skills often associated with concussions. 2. Gradual Return to Physical Activity: • Through a structured and supervised program, athletes can safely reintegrate into physical activities without risking a relapse if they successfully pass the stages of the return to play protocols. 3. Neck Rehabilitation: • Neck rehabilitation is essential as it has a huge impact on concussion symptoms. Addressing neck issues can alleviate symptoms such as headaches, dizziness, and vertigo commonly associated with concussions. Neck Rehabilitation for Migraine Symptoms and Dizziness after concussion: The relationship between neck issues and migraine symptoms, as well as dizziness or vertigo, is clear. The intricate system of joints and layers of muscle that work to orientate and support the head are usually affected with a contact injury to the head. When this system is not working properly it can cause problems upstream, at the head. Addressing neck-related issues through targeted physiotherapy exercises and manual techniques, such as dry needling, may not only alleviate migraine symptoms but also contribute to the overall recovery of athletes with concussions. At PhysioK our physiotherapists combine the best manual therapy techniques with state of the art training equipment such as the IronNeck™ and the Chattanooga Stabilizer Pressure Biofeedback Unit™ to rehabilitate you. Concussions in sports demand a holistic and multidisciplinary approach to ensure optimal recovery and minimise long-term consequences. Our tailored exercises and innovative interventions, prove to be a cornerstone in the treatment of concussions. The evolving understanding of the relationship between neck rehabilitation and symptoms like migraines, dizziness, and vertigo further emphasise the importance of a comprehensive and individualised approach to concussion management for our patients. As we continue to unlock the mysteries surrounding head injuries, one thing remains certain – early recognition, proper assessment, and timely physiotherapy intervention can make a significant difference in an athlete's journey back to full health.

Osteoarthritis (OA) is a normal part of aging. It is a process whereby inside of surfaces of a joint wear away and the cartilage deteriorates. Bony formations can also occur which change the shape of the joint itself. This wearing away of the joint surface can cause symptoms such as pain, swelling and loss of range of motion at the joint. However, these symptoms are not present in all people who have OA. 1 in 13 Australians report having osteoarthritis, with 2/3 of these people being female. The prevalence of osteoarthritis steadily increases with age. Some people will get to a point in their life where a knee or hip replacement is brought up by their health care provider after a period of joint pain that is affecting day-to-day life. Sore knees stopping you from participating in the things that make you happy? Are you unsure about whether to get a hip replacement? Have you tried physiotherapy? In this blog post we address some facts about osteoarthritis and the role physiotherapy can play in helping you manage your knee or hip pain. How do I know if I have OA? A physiotherapist can diagnose your OA using clinical criteria developed by The National Institute for Health and Care Excellence (The NICE guidelines). The Royal Australian College of General Practitioners endorses the use of clinical criteria without the need for imaging. A physiotherapist may request imaging if the presentation of a person’s OA is not typical, such as: · A history of trauma · Rapid worsening of symptoms · A hot or swollen joint · Or suspicion of a more serious pathology What are the risk factors for OA? A traumatic joint injury is one of the strongest risk factors for developing OA. 50% of people will develop OA within a decade after injuring a joint. Obesity also contributes to the development of OA due to the increased mechanical stress applied to joints in the body and through obesity related metabolic factors which can cause pro-inflammatory processes in cartilage and bone. Jobs that require high levels of physical labour (e.g. Brick layer or builder), particularly those that require kneeling or lifting also increase the risk of OA. Everyone experiences OA pain differently. Pain is not simply an ‘alarm’ arising from a damaged part of the body. Pain is a complex emotional response to physical stimulus that is associated with memories, beliefs and social or environmental context. Pain experienced from OA is no different. People may experience OA pain before any structural changes appear on imaging and in contrast those with advanced OA may experience little to no pain at all. Physiotherapists understand the complex nature of pain and will focus less on the imaging of a joint and focus more on the individual and what factors may be influencing your pain such as general physical and psychological health, social and environmental factors and a person’s beliefs about pain. Why not replace the joint sooner? It is a common belief that the only way to ‘cure’ OA is through surgery. Many people do get relief from a joint replacement, however, nearly 20% of people who have a knee replacement are not happy with the outcome and 30% of people still suffer from pain, stiffness and difficulty with activity day to day. 93% of people who have a hip replacement are satisfied with the outcome however the remaining people report having a worse quality 12 months after surgery, worse than compared to pre-surgery. How can Physiotherapy help you with OA? All guidelines for OA recommend that exercise be the first intervention prescribed. It is a common misconception that exercise can make OA worse. Findings from two recent studies that included 1700 participants concluded that exercise does not trigger increased inflammation or damage the surfaces of joints in people with OA. Exercise strengthens the muscles around a joint leading to improve stability and mobility and is essential for joint health as it can stimulate cartilage regeneration. Therefore, a physiotherapist will not recommend rest but encourage you to engage in a guided physical activity program that is also very beneficial for your general health. Physical activity can also help prevent over 30 chronic diseases, many of these are also common in people with OA, especially obesity which as discussed plays a large role in the development of OA. Surgery should be discussed after attempting a thorough high-value care plan with your physiotherapist that includes exercise therapy, education and if required a weight management plan.

Having trouble running or walking without foot pain? Have you been told you have a flat foot? Have you been pitched an orthotic insert for your shoe? BUT… Has anyone told you that you can rehabilitate a flat foot with physiotherapy? That you don’t need to rely on an expensive splint that gets lost, doesn’t fit in our new shoes that wears down and must be replaced? Not to mention that an orthotic doesn’t treat the source of your problem. What does ‘flat feet’ mean? Flat foot can be described simply as dropped arch height and an inward roll of the foot, although it can be a little more complicated than that. Other names that you may have heard of are Pes Planus or Pes Planouvalgus. People with symptomatic flat feet will experience foot pain in the base of the heel or along the fascia that spans the arch of the foot. People may also experience pain in the shins, knees or hips due to the altered mechanics of the foot during walking and running. Most people will experience little to no symptoms of flat feet, however the change in foot posture can have upstream affects at the knee, hip and back. The effects of which may not be obvious until they reach a tipping point and either an injury occurs, or a chronic condition develops (tendonitis or shin splints). Why do Orthotics work? The orthotic acts as a bolster and physically pushes the arch of the foot upwards placing it in a better position. This in the short term will improve foot position and reduce the pain associated with flat feet. That’s it. Take the sole away and the arch drops, and the pain returns. This may help with acute episodes of foot pain and can help people with high workloads manage their pain (labourers, soldiers, athletes) but ultimately the orthotic has no lasting change on the condition itself. In fact, becoming reliant on highly structured shoes with or without insoles deconditions the foots intrinsic muscles and sensory nerves further, meaning when you take the insole away you will probably be in more discomfort! So, how can Physiotherapy build the arch in our foot? Physiotherapy aims to build the arch in your foot by training the soft tissues in your foot and lower limb. This can take some time, but it makes lasting changes. These therapies involve strengthening, stretching, mobilisations and activities that redevelop the neural functions in your foot such as proprioception. Modern footwear deconditions the foot and its structures and graded exposure to flat soled shoes and bare foot walking is also incorporated into the rehabilitation program. Our physiotherapists can assess your feet and develop a personalised evidence-based program that involves activity modification, load management, stretching, strengthening of the tissues that support the arch of your foot. Using orthotics can help with your day-to-day function and reduce pain but in our belief treating the source of the problem is more effective than simply treating symptoms.

Hopefully my discomfort will just go away….. No. The Power of Early Intervention and Consistent Supervision in Musculoskeletal Rehabilitation. Musculoskeletal conditions can have a profound impact on our daily lives, hindering our ability to move, work, and enjoy activities we love. Whether it's back pain, joint stiffness, or sports injuries, finding effective relief is crucial for restoring functionality and improving overall quality of life. In this blog post, we will explore the importance of early intervention and consistent supervised treatment sessions with a physiotherapist. 1. Early Intervention: A swift path to recovery. Timely intervention is key when it comes to managing musculoskeletal conditions. By seeking professional help from a physiotherapist at the earliest signs of discomfort, you can significantly improve outcomes and accelerate the healing process. Early intervention is backed heavily by research, for instance: a) A study published in the Journal of Orthopaedic & Sports Physical Therapy found that early physiotherapy intervention within the first 14 days of low back pain reduced the risk of chronic disability by 50% compared to delayed treatment. b) Research published in the American Journal of Sports Medicine showed that early physiotherapy intervention for acute ankle sprains led to faster recovery, reduced pain, and improved functional outcomes compared to delayed treatment. These importance of early identification and immediate involvement of a skilled physiotherapist to prevent chronicity and promote a faster return to normal activities. 2. The Benefits of Supervised Treatment Sessions: Unsupervised physiotherapy exercises or home-based interventions, which we do recommended, may not always provide the same level of effectiveness as supervised treatment sessions. Here's why consistent supervision matters: a) Correct Technique and Progression: Proper technique and progression are crucial to optimize healing and prevent further injury. A study published in the Journal of Orthopaedic & Sports Physical Therapy (2020) revealed that supervised exercises for rotator cuff tendinopathy resulted in improved outcomes compared to unsupervised home-based exercises. b) Motivation and Compliance: Consistency is key in rehabilitation, and supervised treatment sessions provide a supportive environment that encourages adherence to prescribed exercises. A study published in the Journal of Back and Musculoskeletal Rehabilitation (2018) demonstrated that patients who attended supervised physiotherapy sessions had higher compliance rates and better treatment outcomes compared to those who relied solely on unsupervised exercises. c) Real-Time Monitoring and Feedback: During supervised sessions, physiotherapists can monitor your progress, modify exercises when necessary, and provide immediate feedback. This personalized attention enhances the effectiveness of treatment and minimizes the risk of incorrect execution, preventing further complications or delaying recovery. Early intervention and consistent supervised treatment sessions with one of our physiotherapist’s can significantly improve your rehabilitation outcomes. By seeking our help promptly, and combining effective manual therapy such as dry needling, joint mobilisations and soft tissue release, with physical reconditioning programs you can mitigate the risk of chronic disability and achieve faster recovery. At PhysioK, we understand the importance of early intervention and consistent supervision. Our team of experienced physiotherapists provides personalized care, evidence-based treatments, and ongoing support throughout your rehabilitation journey. Don't wait for your condition to worsen—contact us today and experience the transformative power of early intervention and supervised treatment sessions.

It is a daily occurrence here at Physio K that a patient will say, my back/neck/shoulder hurts because I have poor posture! Most people believe that by sitting up tall and having a straight back, they have achieved perfect posture. Well, think again… Over recent years research has shown that the ties between developing low back, or neck pain and the shapes and curves of our posture, are non existent! Researchers have also concluded that postures with a reduced lumbar curve and erect upper back (basically sitting upright) requires increased muscular activity and can cause discomfort and fatigue of those muscles, inevitably leading to pain. Below, we have listed 4 myths we want to debunk on posture. Sit Up Straight There are very few people who haven't heard the phrase, “Sit up straight or you’ll hurt your back!”. While keeping your back straight won’t cause you permanent harm, posture is more about how you feel, rather than how you look. Since every person's body is unique, a pose that works for one, may not work for all. In reality, the most important posture is one that is comfortable. This does not mean that you may spend the entire day curled up on your bed or on the couch. It means that you shouldn't feel forced into one particular, fixed position. In the end, the best thing is to avoid slouching or hunching your shoulders and keep moving! Bad posture = PAIN While it is true that slouching and hunching your shoulders will not lead you to a perfect posture, these issues are not the cause of the pain associated with “bad posture”. The aches and pains we feel in the back may be as a result of a different issue entirely. Think of how tense and slumped your shoulders become on a chilly day. Yes, you will feel the pain in your mid/upper back but is your back the root issue here? Another example of things that can contribute to back pain is the feet. Changes in gait can lead to improper loading up through the body and manifest as back pain. This is the key to treating back pain - not to look at where it is, but where is it coming from! Make A Conscious Effort There aren't many things we can do for self-improvement that won't involve making a conscious effort. However, the issue with constantly actively trying to correct your posture is that it simply doesn't work. Unfortunately, no matter how hard you try, as soon as you take your mind off it, you will forget to maintain your position. So it won't work unless you intend to focus solely on your posture with your mind. Good posture is dynamic, just like our minds. So, as long as you prioritize comfort and movement, good posture will follow. Sit Still The changes in good or bad posture happens slowly over time, just like so many other aspects of our physical health. Many of us are under the impression that by actively forcing our bodies to maintain what we believe to be the "perfect posture," it would eventually improve. However, the contrary is actually true. When you don't move enough, a lot of the pain and issues associated with poor posture, such stiffness, will arise. The back is no different from any other part of the body in that it will become more rigid the longer it remains still. Your back needs to move, whether it means occasionally swapping seats or taking a brief stroll. It is recommended to get up from the desk to move approximately every 30 minutes throughout the work day. These common myths we have discussed are spread by well-meaning individuals, and they may not be completely baseless, most of them are creative spins on the truth. The primary message is this, your posture should be comfortable, not effortful. If you catch yourself constantly adjusting your posture and still experience pain, contact us for an appointment or book online today!

These days, everybody is talking about “strengthening their core”. When people say this they are often referring to the uphill battle of toning and defining our abdominals. Did you know that the “core” is actually made up of approximately 35 separate muscles, your abdominals only being a few… So, what is it then? The best way to describe the core is to imagine it as a cylinder. The top of the cylinder is composed of the diaphragm, (aka the breathing muscle) and the bottom is composed of the pelvic floor. Everything in between these muscles is our core, or often referred to as the trunk. The core has numerous functions that allow us to move, twist, turn and jump, but to name a few. The primary function of our core is stabilisation. This local stabilisation works to protect the spine. The protection of our spine is also facilitated by the global stabilisation system - the way in which loads transfer between extremities during functional movements. The system of muscles that lie more locally to the core are deeper than your abs and obliques. Why is the core so important? A strong and healthy core allows you to move your arms and legs freely without causing friction, shearing or excessive strain on your spine. Anticipatory action is the way in which the core can work to protect the spine prior to body movement occurring. If we lose strength in the muscles of the core, anticipatory action is lost, leaving our spine to become more vulnerable to jarring and twisting movements. Lets recap: The body is made up of a local and a global stabilisation system. These systems have the respective roles. The global muscles generate movement, the local stabilisers protect the joint that drives these movements. A good example of this is; when you pick something up off the ground, the muscles of your hip and knee contract to generate force. While this is happening, our “core” engages to protect the joints of the spine and prevent shearing/friction/torque to transfer to those areas. The importance of having a strong core. Our main line of defence against putting undue strain on our joints while moving through regular tasks is the core. That barrier of defence disappears when the core is compromised or not operating properly. If this happens, the joint/capsule/muscles/ligament or nerves of the spine are put at risk from movements and tasks as simple as putting on your shoe. The core is the main support for the spine. If not maintained, it leaves us susceptible to injury. But it's not all injury risk and potential harm! The good news is that the core is easily trained. We can strengthen and ensure coordinated movement with the right exercises. How do I do this? The benefits from core training are endless. Whether suffering low back pain, or being proactive the preventative effects of core training are endless. All core training plans should be individualised, and improve motor control and stabilisation. Other factors showing a good core training program include: systematic, progressive, functional, and emphasise training of the deep local stabilising system, then integrating the coordination and use of global muscle systems for optimal functional movements. As all training, we aim for progression and variation. The use of stabilising or balance devices has proven to increase recruitment and benefits of core training exercises. As the exercises progress to fundamental movement skills, they should be progressed to include sport or activity specific movements. If you want to learn more about core strength and want professional advice & a personalised core training program? Contact us here at Physio K to book your appointment and get stable and strong today!

Have you heard of dry-needling? Perhaps you’ve even experienced it for yourself! We have discussed dry-needling on the website before, (catch up here if you missed it!) but given we get asked a lot about the specifics, we wanted to go into a little more detail! In this post we’ll be discussing the important differences between dry-needling and its arguably better-known cousin; acupuncture. Whilst the needles used for acupuncture are quite similar to the ones used for dry needling, there are distinct differences between the two modalities. Let’s sum up the 5 biggest differences between the two: 1. Positioning Acupuncturists position needles in anatomical spots which aim to alter the energy flow or ‘chi’. These spots are the same in every human body and have to be memorised. With dry needling, we will search for a trigger point (points in the muscle that can cause local or referred pain). These are different with everyone and depend on your pain pattern. Dry needling will be tailored to the specific needs of each patient. We focus on the clinical reasoning and will do needling in muscles that cause your pain, not necessarily in the muscles that are giving you symptoms. 2. Depth In acupuncture, the needles will only just puncture through the skin, generally quite superficially. With dry needling, we will search for the trigger point. This can either be superficial or deep in the muscle, depending on your individual issue. We use needles produced by GEMt; a Melbourne-based business which conducts professional training in dry-needling world-wide. The design of the needle itself has been refined and perfected after repeated clinical testing, and these are the best available on the market at present. Our fully qualified physiotherapists have completed certified GEMt training courses, ensuring they have the most up-to-date training and experience. Of course, safety and hygiene are of the utmost importance in any treatment of this nature. To ensure this, our therapists also disinfect their gloves before starting each procedure, and needles are safely disposed of following treatment; NEVER re-used. 3. Duration Where an acupuncture treatment can take 20 or 30 mins with the needles inserted, whereas with dry needling at Physio K, we use efficient and effective techniques for stimulating the neuromuscular system that takes only about 10 seconds per targeted area. This means we’ll be with you the entire time, rather than leaving you for longer, as is often the case with acupuncture. 4. Reaction With acupuncture, you normally don’t feel much of what’s happening. In dry needling, we will search for a twitch response, which will feel like a short spasm of the muscle. This is a quick contraction followed by a release of the muscle fibres, which will have a beneficial effect on the tissue and will normalise the tone of the muscle. Some ‘dormant’ muscles can get activated by this process, other ‘overactive’ muscles will relax. The end result will be a better functioning muscle. 5. Results Contrary to acupuncture, you’ll feel or see immediate results with dry needling. It is very easy to assess and reassess the effectiveness of the treatment. It’s very common to have an immediate increase in range of motion in the joint or a release of tension in the muscle. We often use dry needling as a treatment modality in combination with other techniques and we do not charge extra for it! Let us know if you’re interested in this very effective method in order to get you moving pain free again! To book online: click here

What the HEEL is going on??? Do you ever experience pain on the bottom of your foot, around your heel or arch while walking or running? You may be experiencing Plantar fasciitis. Most of us who have experienced plantar fasciitis know first-hand how debilitating and frustrating it can be. Every morning resembles being forced to walk on glass and you quickly become annoyed and dissatisfied. The prevalence in the general population is estimated to range from 3.6% to 7% and may account for as much as 8% of all running-related injuries. What is Plantar fasciitis? …. Plantar fasciitis is an inflammation of the fibrous tissue (plantar fascia) along the bottom of your foot that connects your heel bone to your toes. Plantar fasciitis can cause intense heel pain. Ok so, I understand what it is but how did I get it? …. Well, it is not always clear why this happens. You may be more likely to get plantar fasciitis if you: recently started exercising on hard surfaces exercise with a tight calf or heel overstretch the sole of your foot during exercise recently started doing a lot more walking, running, or standing up wear shoes with poor cushioning or support are very overweight While there isn’t just one specific cause of inflammation, it can be difficult to discern the exact cause as there are many reasons that can lead to it. The one thing that all these causes have in common is that they cause a lot of pressure on the plantar fascia tissue, leading to excess stretching or overuse. My GP has told me I have Plantar fasciitis. What should I do next? …. Book in for a session at Physio K! As physiotherapists we can help you to manage your pain, symptoms and mitigate flare ups through a variety of different treatments. Treatment is always individualised to each client we see. We will carry out an assessment so that we can provide the most appropriate treatment based on your level of pain and what stage of rehab you are at. What should I expect from physiotherapy for this? …. We will be able to help guide you through the rehabilitation process; help you understand signs of plantar fasciitis healing and get you back to doing what you love! Some of the treatments you can expect to receive, but are not exclusive to are: Massage or soft tissue work Home exercise programmes for stretching and strengthening Advice and education Dry Needling What should I do while waiting to see my Physiotherapist? …. There are many home practices you can adopt to aid in your recovery from plantar fasciitis. It is always recommended to see a professional.

Bone is changeable tissue that responds to variables in mechanical loads by altering its mass, structure and/or strength. Today's blog will explore some of the key principles behind exercise for bone health. Principle of Specificity: The way bones change in relation to loading is site-specific and not systemic in nature. In other words, when your physiotherapist prescribes exercises, they must include targeted activities that are known to directly or indirectly load the bones giving trouble. The most common sites of fractures are the hips, the spine and the wrists. Principle of Progressive Overload: The load put on bone, either directly or indirectly, must push a little bit further than what we are used to during everyday activities. Bone is adaptable. If you lift at the same weight session after session, you will be unlikely to see any improvements. If you lift a little bit heavier each time, you will notice changes in lifting capacity and muscle definition. The same happens with bones, if you don’t progressively overload them - nothing will change! Principle of Reversibility: any positive bone adaptations resulting from exercise training will be progressively lost once the exercise is stopped.The findings from a 16-year non-randomized study involving a “multimodal exercise program in early postmenopausal women with osteopenia found that at least two sessions per week was the minimum effective dose to positively influence bone over the long-term”. So… Now you know the importance of exercise for healthy bones, but what can you do? Take a look at our suggestions below of exercises for bone health! Exercises for bone health: It is recommended to have a mix between weight-bearing and resistance based exercises for best bone health. Weight-bearing exercises ● Walking ● Hiking ● Jogging ● Climbing stairs ● Playing tennis ● Dancing. Resistance based exercises: ● Lunges ● Deadlifts ● Squats ● Rows ● Flys ● Overhead pres If you have a bone density deficiency or want to prevent it, check in with a member of our team here at Physio K to see how you put the steps in place to lead a stronger, healthier and happier life!

With the recent spike in lockdown restrictions most people have been advised to return to working from home. As a result, I’m sure the dust has been blown off many home set-ups that were installed during the peak of the pandemic in 2020. For most of us this ‘temporary’ setup consisted of a four-legged chair, kitchen bench and our laptops, or even worse…our beds! But is this really the best idea? What did the home office change? For a majority of the workforce, the COVID 19 health emergency introduced us to remote working for the first time. With the primary goal being to minimize physical contact and potential contamination of the workplace, it was a feat of technological brilliance that allowed most companies to continue to operate despite these restrictions. Yet with this in mind, the shift to a home set up has resulted in a considerable change to the environment in which we work. Among the advantages of this we see reduced time spent commuting to and from work, possible increases in productivity and motivation as well as a better work-life balance. However, not everything has changed for the better. Common struggles such as a lack of separation between work and rest, no personal human interactions or communication problems are the obvious disadvantages that most of us would identify when talking about the harm of working from home. But what if I told you that working from home was also affecting your physical health? Is your home environment detrimental to your health? A study conducted in 2020 (Moretti et al., 2020), targeted the changes in working life that most of the population has experienced since the COVID-19 health emergency. In this it analyses the physical health issues related to remote working. The two major factors identified were the increased periods of inactivity and the adoption of poor posture due to lack of environmental support. It suggested that our home environment is inferior to the workplace, particularly due to the “absence of ergonomic office furniture which may impede the adoption of a healthy posture and promote the onset of musculoskeletal disorders.” SO... WHAT DOES THIS MEAN IN ENGLISH? In simple terms our use of a four-leg dining chair, kitchen bench and laptop are a poor substitute for an office desk with an adjustable chair and height adjustable monitor. In fact, this shows that it can lead to the development or worsening of physical disorders notably lower back and neck pain. It reported that 70.5% of participants had musculoskeletal pain with the lower back being responsible for 41.2% of complaints and the neck accounting for 23.5%. Now given that lower back pain itself is quite complex it would be wrong to suggest that the poor remote working station is the only reason for this spike in pain. However, if we frame the entire working from home lifestyle and take the big picture into consideration, it is quite easy to see how these factors can play together. If we combine the reduced activity levels, with poor body positioning whilst sitting, poor psychosocial factors from time in isolation and the continued stress of repetitive work, it starts to paint quite an ugly picture for our overall spine health. Furthermore, it is well documented that working in the same position for an extended period significantly increases your risk of injury. Considering that the most frequent health problems presented within the working population are spine related, this finding is not too surprising. What can you do to prevent this? Whilst we are going to give you some tips below on how to adapt your workstation, to maintain good health and wellbeing throughout this period of remote working change should not stop there. It is essential that you continue to maintain boundaries with work. If possible, schedule time away from your desk. Try to maintain physical activity throughout this period aiming for at least 30 minutes of moderate physical activity every day. Furthermore, maintaining social relationships during this period will also help alleviate stress and other psychosocial factors that may influence your pain. If you can adjust your home set up it should include the following changes: 1. Adjust your screen height. The ideal screen sits in line with your shoulders so adjust your desktop to this height and if you have a laptop elevate it with a platform or some sturdy books. This will prevent excessive craning of the neck or other less ideal positions. Working with one screen is also preferable as it prevents you rotating your neck repeatedly to one side which can contribute to imbalance. 2. Lumbar support. If you do not have an office chair at home, a rolled up towel positioned at the small of the back can act as a substitute helping to assist you into an ideal position. 3. Keep your keyboard and mouse close to the edge of your desk. This will prevent excessive forward leaning. 4. Keep your feet flat on the floor. If you have a height adjustable chair this would be ideal. If not, using a footstool beneath the feet can offer the same support. 5. Keep moving. Try to avoid being stuck in the same position for long periods of time. Remember, your next position is your best position! Moretti, A., Menna, F., Aulicino, M., Paoletta, M., Liguori, S. and Iolascon, G., 2020. Characterization of Home Working Population during COVID-19 Emergency: A Cross-Sectional Analysis. International Journal of Environmental Research and Public Health, 17(17), p.6284.

We see many patients who have the habit of cracking their own neck or lower back. In most cases, people experience stiffness after prolonged sitting or looking at a computer screen. Many crave the feeling of relief that comes from a crack or pop in the neck, but is it actually good for you? The short answer is no, and it could actually contribute to your problem or maintain your long term stiffness. WHAT IS THAT CRACKING OR POPPING SOUND? The first cause of a crack or pop when doing a movement is either a ligament or tendon that moves over a bony part or one another. A ligament connects bone to bone; it restricts movement. A tendon connects your muscle with your bone. Sometimes these ligaments or tendons are tight and will roll or rub over your bones and a clicking sound will appear. This is the case when the click keeps happening with every movement you do. The second cause of a cracking sound is called cavitation. Our joints contain gases, such as nitrogen, oxygen and carbon dioxide; together with fluid they cushion and lubricate the joints. Specific movements or pressure in the joint will create gas bubbles that make a cracking or popping sound. Getting that cavitation can give you relief and can ease the discomfort in a tight area. Getting the crack or pop in your spine (neck, mid back or lower back) can give you endorphins and will feel good initially, but it’s not necessarily what you need and can cause you more harm in the long run! WHY IS CRACKING YOUR OWN SPINE BAD? Leave the adjustments to a specialist health practitioner, who has extensive knowledge and experience. There are many arteries and veins that can be damaged by cracking your neck if you’re not sure what you’re doing. These vessels carry blood to and from the brain, so forceful movements could increase the risk of a stroke. Another danger of repeatedly doing these movements is damaging or stretching your ligaments. This can cause hyper-mobility and/or instability, which could cause muscle tightness. This will then give you the urge to crack your spine again, and so on. It’s a negative spiral that you need to stop as soon as possible. HOW DIFFICULT CAN IT BE TO STOP DOING THAT? Many people find it hard to stop cracking their own spine; it’s a habit and changing behaviour is not easy. The first step is being made aware of it and realising that it can be causing or contributing your problem, rather than solving it. Many people don’t even think about it or do it consciously. When you stop for a few weeks, in most cases your soft tissue will normalise and the urge to crack will reduce or ideally disappear. Strengthening your core muscles can be helpful to help support and improve your spine mechanics. WHICH CRACKS ARE OK AND WHICH ONES SHOULD I AVOID DOING? Generally speaking, the clicks or pops that give you an instant relief when you search for it are the ones you should avoid. When something repetitively pops with normal movements, but it doesn't give you that relief that you're after, that's usually ok. E.G. When you roll your shoulders backwards or forwards, you might hear a popping sound every time you do that movement. This is most likely not a cavitation, but muscle fibres flicking over your ribs. That's ok and is not dangerous. CAN I CRACK MY KNUCKLES AND WILL IT GIVE ME ARTHRITIS? The story of arthritis that’s caused by cracking your knuckles is an urban legend. It was probably invented by someone who didn’t like the sound and your mom used it to scare you. There is no evidence or research showing direct links between arthritis and cracking joints. The fingers or toes are simple joints and will not be impacted by these actions. If you can’t resist cracking something, go ahead and pop your knuckles. Oh, and tell your mom that it won’t hurt, refer her to this article :-)