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Plantar Fasciopathy – This one simple exercise can help heel it!

Plantar Fasciopathy – This one simple exercise can help heel it!

 

Do you wake up every morning and dread taking that first step when getting out of bed? It may feel like you are walking on a continuous line of thumbtacks and this quickly starts your day on the wrong foot (pun intended).

 

You notice that the first few steps are always the worst but then it slowly improves with activity as it warms up. The pain will start under the heel in your foot or in the arch after you have rested the feet all night. The lifetime prevalence of obtaining this injury is as high as 10% – That is a quite a large number of people who will be affected by this at some point.

 

Where does the pain come from?

A thick fibrous band of connective tissue called your plantar fascia (PF). It originates on the medial (the middle) aspect of your calcaneus (heel bone) and extends along the sole of the foot before inserting at the base of the toes. It supports the arch of your foot to prevent flattening. When your PF develops micro tears or becomes inflamed, this is known as plantar fasciitis.

Heels

What are the causes?

Unfortunately, no one really knows the answer to this question. There have been numerous studies performed over the years, but the findings remain fairly inconclusive. All we do know is that Plantar Fasciitis is thought to be a traction and overuse injury where the PF has been repeatedly overstretched.

 

This can be due to weak foot stabiliser muscles (the intrinsic foot muscles) and poor foot biomechanics, which causes overpronation. If the muscles in your feet are weakened, then an excessive force is transmitted to other tissues such as your PF. The pain will then arise if the tolerance of your PF is exceeded.

 

Could my running technique be causing me the pain?

It is a common assumption that the repetitive impact caused by landing on your heel when running is what causes Plantar Fasciitis. However, one study has shown that the high impact forces that occur when you overstride (poor running technique) can be a contributing factor in developing the condition.

From our experience with athletes, we have found that landing on your forefoot with your foot in front of your body is a likely technique-related cause for Plantar Fasciitis. Often runners make the mistake of intentionally trying to land on their forefoot or midfoot when they are running. This causes dropping of the forefoot but a stiffening of the foot, which quickly overloads the plantar fascia, calf muscle and Achilles tendon.

 

Research suggest that ideal landing is when your foot lands close under your body/hips and for your foot to be relaxed when it lands. However, if you run in cushioned, well supported shoes then you are more likely to contact the ground heel first (heel-striking). As long as your foot is under your body, then the impact and stress on the PF is significantly reduced compared to landing with the foot in front of the body. Now we know the cause, let’s look into the question you really want to know….

 

How do you fix it!

You might have tried a combination of orthotics, massage, new shoes, plantar specific stretching, complete rest from exercising or a number of other popular recommendations found on Doctor Google. These interventions will provide some relief but there are a high percentage of you that will still have symptoms for up to 2 years after your initial diagnosis. If those approaches haven’t worked, then it’s time to try something different: Progressive loading.

 

Recent evidence suggests that high load strength training has been placed superior to that of PF stretching in improving heel pain. Progressive loading strengthens the PF, connective tissue and foot muscles. Book an appointment with your physiotherapist to begin loading at an optimal range for you (every case is different and you might delay recovery if you load too heavy too soon). A usual starting point will begin with heel raises.

 

Toe Elevated Heel Raises

Place a rolled-up towel under the toes to stretch the PF, especially at the top of the heel raise. Start the exercise with both feet and then progress to one if that’s too easy. To decrease the risk of symptoms flaring, start loading with 12 repetitions for 3 sets and gradually work down to 8 repetitions for 5 sets.

Each heel raise should consist of a three-second concentric phase (going up) and a three second eccentric phase (coming down) with a 2 second isometric phase (pause at the top of the exercise). They need to be performed slowly and completed every day. To progress the load you can wear a backpack with books which will then involve decreasing the amount of reps but increasing the sets.

 

It is common to experience mild pain when completing this exercise. However, pain should be no higher than 3 on a 10 scale (10 being the worst pain imaginable). If you have a flare up in pain don’t stress, you may have over worked it. Next time adjust your reps, sets or weight.

 

Some individuals are lucky enough to continue running whilst rehabbing their PF, but others may need to cease training for a short while. Check in with your physiotherapist today to see what will work best for you in giving you the quickest reduction in pain.

Carbohydrates – friend or foe?

Carbohydrates – friend or foe?

In case you haven’t noticed, low-carb diets are all the rage these days. Popular diets such as Paleo and Keto have heightened the misconception that all carbohydrates are bad and should be avoided at all costs. But are carbohydrates really the enemy, or could excluding them from your diet be detrimental to your long-term health?

Carbohydrates = Fuel !!

Carbohydrates are the most important energy source for your body and the reality is your body needs them to function optimally.

Carbohydrates in the food that we eat are broken down into smaller sugars (glucose) and used as fuel – even the simple task of breathing relies on this fuel source. Any unused glucose is then stored in the muscle in the form of glycogen for future use. Our body recruits this stored carbohydrate during exercise or whenever glucose levels in the blood are low.

It is therefore no surprise that a low carbohydrate diet can result in low energy levels as well as fatigue and delayed recovery from exercise. In addition, the brain depends solely on carbohydrates – it is unable to used stored energy. As a result, low-carbohydrate diets may also adversely impact cognitive function and mood.

Fibre

Carbohydrates are a major source of dietary fibre and as a population we are far from meeting the recommended intake of 30g per day. Fibre is essential for our digestive health. It helps you feel fuller for longer, can improve cholesterol and blood sugar levels, and can assist in preventing a number of diseases. Considering its importance, avoiding carbohydrate foods rich in dietary fibre is not a good idea.

All carbs are not created equal

Not all carbohydrates are equal when it comes to nutrition. Eating the right type of carbohydrates, in appropriate amounts for your individual requirements, is definitely worth incorporating in your diet.

Complex carbohydrates such as those found in whole-grains, legumes, fruit and vegetables are digested slowly and released into the blood stream gradually. They are also packed with dietary fibre and have important vitamins and minerals adding to their value. Including a serve of these carbohydrates in main meals is advisable. Some examples include:

Oats

Legumes

Whole-grain bread

Quinoa

Barley

Brown rice

Starchy vegetables such as sweet potato

Fruit

Simple carbohydrates on the other hand are often refined and stripped of fibre. They are digested quickly and can cause a rapid spike and then drop in your blood sugar levels. While all foods can have a place in a healthy diet, limiting simple carbohydrates is recommended. Simple carbohydrates can be found in:

Refined breakfast cereals

White bread

Brown or white sugar

Fruit juices – particularly concentrate

White rice

Flavoured yoghurt

Confectionary

Soft drinks

Getting portions right

Carbohydrate requirements vary considerably and some individuals do indeed eat too much. A good starting point is to include a fist sized portion or ½ cup cooked complex carbohydrate with your main meals. Remember, this portion will need to be increased significantly for some – particularly those exercising regularly.

While there is no best diet for everyone, a restrictive way of eating is usually not the right path for most. Low- carb diets such as Paleo and Keto – that promise fast weight loss – can seem attractive but their effectiveness and safety long term is unknown.

Our dietitians can help you find a carbohydrate balance and plan that will work best for your individual needs. To make an appointment call us on 8068 5158 or book online

Strapping Basics – Notes from our Level 1 Course

LEVEL 1 STRAPPING COURSE

 

Strapping tape and Supportive taping is commonly used by physiotherapists and trainers to:

 

  • relieve your pain
  • improve joint stability
  • enhance athlete confidence
  • reduce injury recurrence
  • prevent injury

 

 

TYPES OF STRAPPING TAPE:

 

Rigid strapping tape commonly used in taping or strapping is often referred to as “sports tape” or “athletic tape” and is most often a rigid style of strapping tape.

Elastic strapping tape can also be used when less rigidity or support is required, or as an overwrap to provide added support.

Kinesiology tape (or K-Tape) is an improved version of elastic sports tape that acts to dynamically assist your muscle function.

Underwrap tape is used to protect any sensitive areas.

 

One of the main functions of tape is restriction of movement

  • Elastic tape DELAYS the movement
  • Rigid tape LIMITS the range of movement by up to 25-50%
  • Use of underwrap – loss of 30-50% of effectiveness

 

Other main function of tape is stimulation of our proprioceptive system!

Serves as a ‘Reminder’.

 

 

Competition – NRL Premiership
Teams – Wests Tigers v South Sydney.
Date – 28th or April 2016.
Venue – ANZ Stadium Homebush, Sydney NSW.
Photographer – Grant Trouville.
Description –

 

 

Preparation and Protection of the skin:

 

  1. Check that the person to be taped is not allergic to adhesive tape. They may not know this if they have not been taped before but it is best to ask. Also, make sure there is no broken skin or existing rashes.

 

  1. You may ask the patient to shave to remove hair from the area to be taped (generally only for patient comfort upon removal only). For best results this should be done 12 hours before application of tape to reduce skin irritation.

 

  1. Clean and prepare the skin. Before taping the area and skin should be clean and free of any oils or creams, as they will reduce the effectiveness of the tape’s adhesive. If the athlete has particularly oily skin or you want increased adhesion you may opt for a pre-tape adhesive spray

 

  1. Pad any sensitive areas or cuts with underwrap. We utilise Leukofoam Lite or Elastowrap (or other hypo-allergenic underlays) on areas where ‘tape cuts’ are more common (e.g ‘heels’ or ‘laces’ for ankle taping).

 

Rules of tape application:

 

  1. Place limb or joint in position that offers most stability and comfort to athlete. Joints are normally strapped in the ‘neutral’ or functional resting position. Positioning is one of the most important things to consider when strapping!! Need to ask yourself – “What are we trying to achieve?”

 

As sports physiotherapists and trainers we need to identify the positions in which the joint/ligaments is most at risk, and therefore should tape the joint in a position of protection.

 

For example, an anterior shoulder dislocation taping is performed with the athletes shoulder in internal rotation, to protect the shoulder from the ‘at-risk’ position of external rotation and abduction.

 

  1. Choose an appropriate thickness of tape for the part to be strapped. Take into consideration the size and musculature of the person you are tapping.

 

  1. Follow natural anatomical boundaries for tape application. Due to the conical shape of the limbs (e.g. the calf muscle) applying the tape perpendicularly leads to uneven pressures at the top and bottom portions of the tape.

 

 

  1. With musculature, allow for contraction/expansion.

 

  1. Hold the roll in one hand and pull off the roll with the other, then apply to the body part. Alternatively cut or tear lengths of tape to fit the part, then apply.

 

  1. Each layer of tape should overlap the previous layer by approximately a third to half the width of the tape.

 

  1. Smooth and mould tape as it is laid on skin. The strapper should be acutely aware of the ‘line of pull’ of the tape which they apply. Novice strappers often just lay down the tape in pre-learned directions without thought about what they are trying to achieve.

 

  1. The tape should mould to the anatomy of the region and follow the line of the ligaments to be supported. Allow tape to fit natural contours of skin/body part.

 

  1. Always start taping with anchor pieces and finish with closing pieces (lock-off).

 

  1. Where maximum support is required tape directly on skin (use minimal underwrap).

 

  1. Tape should be applied firmly to the skin but not so firmly as to cut off the blood supply.

 

  1. Use an amount of tape sufficient to support the joint. Too much will restrict the joint and too little will offer poor support.

 

  1. With practice you will get better at applying and judging the amount required. Like any other skill – it takes years of practice to master!

 

  1. When finished tape application, check tape job for support, tidiness and flaws

 

Caution:

 

  1. Always check once you have completed the taping to see if it is too tight and loosen or reapply if necessary.

 

  1. Check circulation distal to tape. This is more of an issue with wrists, thumbs and fingers.

 

 

Removal of tape:

 

 

  1. Tape should be removed immediately if the circulation appears to be affected or the person taped complains of itching or develops a rash.

 

  1. Under normal circumstances, it should be removed once the activity it was put on for has finished.

 

  1. Use either bandage scissors (which have a rounded end so as not to cut the person) or take the tape off in individual pieces.

 

  1. With the scissors slip them between the tape and the skin in a muscular part of the body, not against the bone. Slide and cut at the same time.

 

 

 

Common flaws of tape application:

 

  • skin not prepared properly (too oily)
  • wrinkles/rolling of tape
  • tape applied to tight
  • tape applied too loose
  • ‘windows’ in tape job
  • natural anatomical boundaries ignored
  • failure to apply proper anchors
  • failure to use sound biomechanical principles

New concepts in ACL injury management

Anterior Cruciate Ligament Injury

 

Most people wanting to return to sports after an anterior cruciate ligament (ACL) injury are commonly recommended anterior cruciate ligament reconstruction (ACLR). Consequently, the annual incidence of ACLR continues to rise, particularly for younger patients and those seeking revision surgery. Unfortunately, only 65% of patients return to their pre-injury level of sports participation following ACLR, and of those who do, nearly one in four experience a subsequent ACL injury

 

It is important to understand that neither surgical nor conservative management will guarantee an uncomplicated return to sport, but there is now strong evidence that conservative management of ACL injuries does not result in inferior outcomes compared to surgery.

 

The rehabilitation process following an ACL injury is very similar whether you have opted for the surgical or non-surgical path. however timeframes for non-surgical management are usually faster, given there is no need to recover from surgery, or graft to monitor.

 

The initial consultation

Development of a comprehensive, long-term structured rehabilitation program for any patient with an ACL injury begins at the initial consultation. It is common thought that surgery is a ‘quick-fix.’ A key part of a physiotherapist’s role is to help the patient understand that irrespective of their end goal, they need to commit to a purposeful rehabilitation program, as this is a key factor in the determinant of successful outcome (Ericsson et al 2013, Eitzen et al 2010)

As a priority, our physiotherapists at Redfern Physiotherapy and Sports Medicine like to use the subjective exam/interview to get a feel for the patient’s beliefs, expectations and goals around the injury, with the best research showing it is these elements that determine whether a patient chooses surgery, or not (Thorstensson et al. 2009). Here are some simple questions we commonly use to help us understand your goals, understanding of injury and potential barriers to recovery:

  • ‘What do you understand the best research-evidence says about the management of ACL tears?’
  • ‘Would you be pleased to know that for many patients, physiotherapy and exercise actually becomes their treatment?’
  • ‘How long do you think it will take to get back to your desired level of activity?’
  • ‘Are you worried about using your knee again?’
  • ‘Do you believe that if you feel pain you are causing damage?’
  • ‘If you feel an increase in your knee pain during an activity, do you stop or carry-on? Why/why not?’
  • ‘How fearful are you of re-injuring your knee?’

Having identified a series of functional limitations in the patient interview during the initial consultation, Our physiotherapist’s then like to attempt to show a patient that often their pain can quickly be modified. This can be as simple as supporting the painful site.

Many patients who have injured their ACL, can be pleasantly surprised at how quickly their resting pain and pain with functional tasks can be considerably abolished with simple strategies like this, which diminishes a reductionist focus on the ligament as being the sole cause of their pain.

At the first session, we like to conclude by recorrecting any aberrant functional movement patterns and then use these as the initial building blocks of an exercise program. They might include repetition and practice at home of a relaxed sit-to-stand, two-legged squats or ‘baby lunge’ tasks within pain tolerable limits.

 

Controlled, high-quality, supervised rehabilitation over time

Generally, by the end of the first or second consultation, We like to talk about prognosis in terms of time frames with patients. Clinical guidelines and the best trials of non-surgical management for this injury recommend three to six months for returning to pre-injury activity for non surgical management and nine to twelve months for surgical management. Time frames can be quicker or longer than this (Rooney 2018, Frobell et al 2010). For non surgical management, we generally outline to patients verbally three key, fluid phases, with approximate timeframes and key focuses of management, which may include:

 

  1. Weeks 0-4, symptom relief: Manual therapy techniques, active range of motion exercises, balance/proprioception exercises, restoring normal functional movement patterns, 2- and 1-legged exercises as able, cycling and normal gait with graded walking programs
  2. Weeks 5-13, a progression of functional exercises and strengthening: Advancing 2- and 1-legged functional exercises, then stationary plyometrics, jogging/running/sprinting
  3. Weeks 14-28 and beyond, return to sports progressions and assessments:Dynamic plyometrics, cutting/agility drills, sports-specific drills, psychological readiness, prevention/performance-enhancing exercises.

WHAT TO EXPECT FROM SEEING A DIETITIAN

WHAT TO EXPECT FROM SEEING A DIETITIAN

 

Prior to your first appointment

Before we even see you, our reception staff will send you a form to fill in. This is to help us get to know you better before the first consultation. The form includes questions about your medical history, food history and lifestyle habits, along with what you are hoping to achieve from working with us.

At your first appointment

At your initial consultation we spend time going over the initial questionnaire to ensure we have clarified any information, gain more insight and information into any medical symptoms, training program or lifestyle habits that may be impacting you, and then put together initial strategies to help you work towards achieving your goal. This may be some specific changes to your current food intake, or education around a certain aspect of nutrition that will be the most effective first step towards best health.

 

How long is an appointment?

Your first appointment is scheduled for 45 minutes. Follow ups are scheduled for 30 minutes. If you require a longer appointment, this can be discussed with our reception team at time of booking.

 

How many times, and how often will we see you?

This really depends on your personal needs, and the reason you have to come to see us. Regular reviews with your dietitian have been shown to improve compliance and achieve better health outcomes compared with going it alone. Follow up appointments are essential to provide you with all the relevant information and practical advice you need to achieve your health goals. In your follow up sessions, we build on the information you are already familiar with and adjust the content to target your priorities. We will always discuss your treatment pathway with you as well, to ensure you understand why and when we want to see you.

Example Client 1: Stress fracture in endurance runner
Initial consultation and information from pre-assessment
form has shown the client has low energy levels; poor
mood, is not sleeping well and overall is not fuelling with
enough food, or at appropriate times. Training also
currently includes 1x long run per week, for which no fuel
is consumed during, due to concern of gastrointestinal
issues. Body composition assessment shows low body
weight and fat mass.
Likely number of sessions needed 6-8.
Education, planning and strategies needed regarding
quantity of food and adequate fuelling, timing of meals,
fuelling for long training sessions, hydration strategies,
race day planning and management of anxiety around
overall quantity of food that is required to support
training load, along with work and family requirements.
Frequency of sessions: Initially 1-2 weeks is recommended
For optimal client outcomes to assist with motivation,
Accountability and assessment of impact of changes.
After the first 3-4 sessions, this will likely be extended to
4-6 weeks, pending when the client’s race is, and their
Individual requirements.

 

 

Example Client 2: Recent Diagnosis of IBS
Initial consultation and information from pre-
assessment form has shown the client has
regular disrupted bowel motions, varying from
constipation to diarrhoea. They are frequently
stressed, and their symptoms are impacting
their day to day life. Food history shows high
intake of foods likely to trigger IBS.
Likely number of sessions needed: 5-6
Education around dietary changes required for
management of IBS, how to most easily adjust
current diet, provision of resources to assist with
making changes for elimination of likely trigger
foods, determination of triggers, a re-inclusion
of foods in the daily food intake.
Frequency of sessions: initially 2 weeks is recom-
mended for optimal client outcomes to assist
with motivation, accountability and assessment
of impact of changes. After the first 2-3 sessions,
review will likely be extended to 4-6 weeks wor-
king around challenge protocol of foods, and re-
Introduction of foods back into the diet, of
course pending their individual requirements.

*Please note these clients are examples only, and your treatment may differ to that outlined here, based on your individual circumstances and needs.

 

A HEATED TOPIC ABOUT COLD THERAPY

I want you to think back to the last injury you had. Did you have an initial impulse to put an ice pack on it? Or did you prepare a heat pack in the microwave? Well, different types of injuries require different types of management.

 

We all know that both cold and hot therapy can help treat many injuries. They are both quick, drug-free, inexpensive and easy self-treatment options. But do you know when it’s appropriate to use a cold or hot pack to treat a problem? Here I will explain when you should use hot or cold treatments.

 

 

Firstly, how does it work?

 

  • In the initial stages following an injury the immune system responds with an inflammatory response which sees an increase of blood flow to the area. This causes a rush of white blood cells, antibodies, proteins and other fluids to the injury site. This increase in swelling and inflammation causes the pain. Too much swelling will slow down the healing, be uncomfortable and also limit joint range of motion.

 

  • Ice reduces tissue temperature by slowing down metabolic activity around the injured area and as a result, decreases tissue damage. This will also lessen the pain by numbing the nerve endings involved.

 

  • Heat increases the surfaces temperature of the skin, which stimulates your sensory receptors and as a result, blocks the pain signals being sent to the brain. Heat also makes your muscle tissue more elastic, which releases tension and increases blood flow. Therefore providing oxygen and more nutrients to the painful area to aid in the healing process and restore range of movement.

 

How do you know which one to choose?

 

Cold Therapy:

  • Think ‘acute’ sports injuries. These include sprained ankles, torn muscles/ligaments and bruises. When an acute injury occurs they become red, swollen and hot due to damaged muscle tissues.
  • Get it on fast! Ice is most effective immediately following an injury and loses its affect significantly after approximately 48hours. The sooner you get it on; there is a greater chance of reducing swelling and minimising inflammation.
  • What form of ice? Ice therapy includes raw ice, gel packs (used with a towel to reduce intensity), ice baths or the trusty bag of peas. The most effective method is the use of crushed ice in a bag applied to the injury site.
  • You can purchase gel packs that turn into ice in your freezer or, to make things quick and easy on the sideline of a game, use instant ice packs, which are designed to turn cold instantly with a simple squeeze.
  • A commercial device such as a Game Ready is commonly used in an outpatient setting. It provides intermittent compression whilst delivering cryotherapy (cold therapy) to the injury site. This is the best way to deliver cold and compression therapy to an injured site and is used commonly by the world’s best athletes. Redfern Physiotherapy is equipped with its very own Game Ready machine to help manage your acute injuries!
  • Did you know? Ice has been shown to be more effective than gels (a common item in a sports parents freezer) at reducing skin surface temperature. It has the ability to absorb more heat as it goes through a state of physical change – melting from ice to water.

 

Hot Therapy:

  • Think ‘chronic’ sports injuries. Is best used for consistent pain (pain lasting from weeks to months), stiffness, muscle spasms, whiplash, arthritis and to loosen and relax tired muscles. However, it should not be used directly after exercise.
  • No Exceptions! Refrain from using heat for at least 48-72 hours after a new injury has occurred. If swelling or redness to the skin occurs following an injury then do not apply heat.
  • Signs of a chronic injury include a dull ache when at rest or pain when performing an activity.
  • Ways to heat it up? Heat therapy includes wheat packs, hot water bottles, a sauna or hot bath. Deep Heat and Tiger Balm are often used to provide a neurological distraction due to their warming sensation on the skin only.
  • Did you know? The continuous application of low-level heat eased low back pain better than two common over the counter painkillers.

 

Friendly reminders:

  • How long? Whether hot or cold, be sure to keep exposure to 20 minutes per session. You should wait at least 1 hour between treatments (starting when you take off the ice until you reapply the ice).
  • Protect your skin from burns by wrapping packs in a towel or cloth before applying.
  • What a mess! A Ziploc bag is a great solution for keeping ice therapy mess-free! No bag or cloth to use? Perform an ice massage by constantly moving the ice around the area of discomfort.
  • The Price is right! A common acronym to remember what steps to take in the initial stages of an acute injury is
    • Protect = Protection from further damage
    • Rest = rest to avoid prolonged irritation
    • Ice = To control pain, bleeding and edema (swelling)
    • Compression = For support and to control edema
    • Elevation = Place the injury site above the heart to drain fluid away from the area.

 

As a general rule of thumb, you should use heat on stiff, aching and chronic injuries and ice on acute or new injuries that occur suddenly. Remember! Ice and heat provide symptom relief but are not going to treat the underlying issue. To find out how to recover from your acute or chronic injury, book an appointment with our team of physiotherapists to help you follow a customized rehabilitation management plan.

Food Packaging Label Reading Made Simple

Food Packaging Label Reading Made Simple

 

Label Reading

 

Food labels are meant to be helpful – a quick scan and you should be able to compare products and make a healthy choice. But all too often, they cause more confusion than clarity, and add to the hassle of supermarket shopping. Does this breakfast cereal have too much sugar? How important is sodium? Should I even worry about total fat? It can be difficult to know what to look for!

 

Below are some simple tips to help you take the stress out of label reading and choose products with the right balance of ingredients.

 

Start with the ingredient list

All ingredients must be listed on a product in order of the most to least by weight. Therefore, if a source of fat, salt or sugar is listed as one of the first few ingredients, this product may not be a healthy choice. My advice; choose products with a short ingredient list. If you pick up a product with numerous ingredients you’ve never heard of before, or lots of numbers, it is generally a good idea to put it back on the shelf. Familiarising yourself with the alternate names for sugar, salt and fat can also be helpful. Did you know that corn syrup, dextrose, glucose and rice malt are all just other names for sugar?

Check serving sizes

Always use the per 100g column on food labels to assess and compare products. Use the per serve column when looking at energy (kJ) content or sugar per serve. Remember there are often multiple servings in one package. Therefore, if a bag of potato chips contains three servings and you eat the whole bag, you’re going to need to multiple the kJs per serve by three.

 

Take energy into account

Everybody’s energy needs are different, so providing a kJ recommendation for food products is tricky. Some manufactures choose to include information about percentage (%) daily intake, which can be used as a guide, but remember this has been calculated on the needs of an ‘average adult’. Aim for 600 kJ or less per serve for a snack.

 

Watch out for added sugar

You’ll find sugar where you least expect it so always check this one. Stick to products that contain less than 10g per 100g and no more than 5g per serve. The exception to this rule is if the product contains fruit (as one of the first three ingredients), 20g per 100g is acceptable in this case.

 

Keep an eye on fat

While it’s a good idea to keep an eye on total fat, the others are more important!

Saturated fat and trans fat should be as low as possible, as these are the fats associated with disease risk. Look for products with less than 2g of saturated fat and no more than 1g trans fat per 100g. Monosaturated and polyunsaturated fats are an essential part of our diet and important for good health. Consume fish, avocado, nuts, seeds, extra virgin olive oil in small amounts. Less than 10g per 100g is ideal.

 

Check the sodium content

Sodium is used to enhance flavour, and even ‘non-salty foods’, can contain high amounts. Less than 120mg per 100g is considered low and anything greater than 400mg per 100g high. Compare products like bread, crackers and canned produce and choose ‘no added salt’ where possible.

 

Fill up on fibre

Particularly important when looking at products like bread, breakfast cereals and crackers. Products made with wholegrains will generally be high in fibre and do a better job of filling you up. Aim for 7.5g of fibre per 100g.

 

Be mindful of nutrition claims

Nutrition claims are statements made by food businesses and can often be misleading. Example, ‘baked not fried’ does not mean the product is lower in fat or energy, it may still be baked in oil. This is where knowing a few simple label reading tips can be helpful.

 

Our dietitians Chloe and Fiona, are available for individualised advice on reading food labels and help meeting any nutritional needs you may have.

5 Office Exercises for Relieving Neck Pain

5 Office Exercises for Relieving Neck Pain

 

You wouldn’t go running, bench press or sit in a car for 8 hours continuously without a break or two to move around, would you? So why do we find it perfectly normal to sit, hunched over, with muscles in constant contraction, straining our eyes as we stare into a fluorescent screen all day? It’s absolute madness…

Never fear however as help is at hand for relieving those aches and pain as well as tight neck muscles that leave you feeling sore, tired, heavy and at quite possibly with a splitting headache. Fortunately, we have some easy to do, take anywhere, anytime exercises that will get you loose as a goose and ready to face the afternoon slog.

 

  1. Active Neck Rotation

This is a great one for general mobility of the neck when it feels tight. Starting incorrect posture (which is sitting tall, shoulders slightly back and down, chin tucked in and head facing forward) slowly rotate the head to the left keeping the line of sight parallel to the ground (not looking up or down). When you reach a position where the neck is slightly uncomfortable with the stretch pause for 1 second and then turn the head back through centre and to the right. Repeat this in a slow controlled motion for one minute, take a short 30-second break and repeat.

             

            2 sets of 1 min

 

  1. Levator Scapulae Stretch

 

If this muscle could be renamed it would surely be the gremlin muscle. When your neck and shoulders get tired you can trust good old Levator Scapulae to take over and try to hold things up but it comes at the cost of a tight neck, sore shoulders and even headaches. To stretch it out place one arm by your side (or even tucked behind your back) and rotate your head to look the opposite way, gently look down and with your free arm reach over the head and apply moderate pressure for 30 seconds then repeat on the opposite side. Stretch both sides a total of three times applying slightly more pressure each repetition.

 

      Levator Scap Stretch                           Chin Retractions

                                                          

3 sets of 30 sec each side                    10 sets of 10-20 sec hold

 

  1. Chin Retractions

Ever wondered why your neck gets tired and sore? Does it feel like you head weighs 100kilos by the end of the day? Chances are you’re spending your day with your head tilted forward and your chin poking out, which places huge amounts of strain on your neck. To counteract this, the chin retraction exercise is our favourite.

Start by standing up tall and looking straight ahead. Raise one arm and shape your thumb, pointer and middle finger into a tripod. Place the thumb and middle finger on each collar bone and the pointer finger on your chin. This should cause you to retract your chin and engage to muscles as the upper back of your neck (where it connects to the skull). Hold this posture for 10-20 seconds and rest 5 seconds. Repeat 10 times

 

  1. Neck Stretches:

Now it’s time to stretch out all those tight muscles, particularly the Upper Traps that spend all day working overtime and also your neck extensors which are under strain from crooning your neck forward to peer at the screen or look at the keyboard. Flex your head to one side, reach over with same side hand and apply a moderate amount of pressure to increase the flex to the desired side. Hold for 20 seconds and then repeat on the opposite side. Stretch both sides twice before moving on to the back of the neck. Looking down, place both hands on the back of your head and lightly apply pressure in a forward motion and hold for 20 seconds (repeat this twice more). Your neck should feel nice and loose now so let’s move on to posture.

 

2 sets of 30 sec each

  1. Isometric Neck Strength:

Finally, it’s time to make our neck resilient and robust. The idea is to apply only a moderate amount of force and match it in the opposite direction with your hand so that the head remains in the same place. Looking straight ahead, place either your right or left hand onto the side of your head and push into the hand meeting the resistance. Hold this for 5 seconds and relax (Repeat 10 times). Now swap to the opposite side and repeat. Finally, placing your hands behind your head similar to the neck stretch, push back into your hands and hold for 5 seconds (repeat 10 times).

 

1 set of 10 reps (5sec hold) for each

 

Neck pain is common but most cases are not caused by serious problems. These exercises, if done correctly and regularly, should help keep you pain-free and moving well.

If your pain persists or is getting worse, it is advised you contact your physiotherapist for a detailed assessment and management plan

Physio vs Remedial Massage

What is the difference between Physiotherapy and Remedial Massage???

Often when seeking injury attention, it is difficult to know where to go or who to see. Today we help you answer this question.

Below are a couple of key differences which should help you better understand when to visit your local Redfern Physiotherapy therapist, and who to book your consultation with.

 

Physiotherapist Massage Therapist
 

  • Diagnosis – Ability to identify specific illness or injury based on an examination of symptoms.

 

  • Assessment – Provide a detailed assessment of condition with greater emphasis initially on consultation and education.

 

  • Sudden severe pain – Acute injuries requiring more frequent treatment should seek advice from a physio.

 

  • Variety of techniques – Offer a range of techniques including: dry needling, exercise prescription & manual therapy.

 

  • Investigative Scans – Ability to refer for further diagnostic testing (e.g. x-rays) or to medical specialists.
 

  • Prognosis – Ability to provide an experienced professional opinion on the likelihood of an outcome.

 

  • Less talky, more touchy – More hands- on time to really get stuck into those tight muscles.

 

  • Ongoing maintenance – After initial treatments, there will likely be longer periods between massages, and sessions are focussed on maintaining your level of mobility

 

  • No more stress! – Promotes stress relief and relaxation for the busy modern day workers lifestyle

 

  • Race day! – Sports massage before and after an event has proven beneficial for performance and limiting the dreaded DOMS! (Delayed Onset Muscle Soreness)

 

Physio v Remedial Massage

Both Physiotherapists and Remedial Massage Therapists can prescribe their patients with rehabilitation programs which may include mobility, strength, and postural alignment exercises. These two disciplines work hand in hand and complement each other so for best results it is recommended to take a holistic approach and our therapists at RPSM work closely with each other to ensure you are given the best possible tailored treatments for a speedy recovery.

Hopefully this helps distinguish between the 2 disciplines and we look forward to seeing you all in the Redfern Physiotherapy and Sports Medicine clinic to assist with any of your health-related needs.

May is Crohns and colitis awareness month

May is Crohns and colitis awareness month

The month of May is Crohn’s and Colitis awareness month. So what better time to share part of my personal story, to help us explore the impact that inflammatory bowel disease (IBD) can have on physical and emotional wellbeing.

10 days after my 20th birthday I was diagnosed with Crohn’s disease. I’d never heard of this disease before and to be honest, I thought that Crohn’s was an “old person’s” disease. But I was wrong – Crohn’s Disease & ulcerative colitis are lifelong, and affect many lives, starting from young children, right through to adulthood. Australia has one of the highest incidence in the world with more than 80,000 Australians living with these conditions, and numbers expected to increase to more than 100,000 by 2022.
https://www.crohnsandcolitis.com.au

For those that don’t know
IBD is an autoimmune disorder – this occurs when a person’s immune system mistakenly attacks their own body tissues. In many ways IBD has more in common with other autoimmune disorders – such as rheumatoid arthritis (which affects the joints), psoriasis (which affects the skin) and lupus (which affects the connective tissue) – than irritable bowel syndrome (IBS).
Unlike IBD, IBS does not cause inflammation, ulcers or other damage to the bowel. The digestive system looks normal but doesn’t work as it should. Irritations include stress, infection and some foods can aggravate the condition.

A small percentage of people with IBD may also experience problems outside the gastrointestinal tract including joint pain, skin conditions, eye inflammation, liver disorders, and thinning of the bones (osteoporosis).
Crohn’s disease may not have a cure, and there is no replacement for regular consultations with your Doctor, dietician, or other medical professionals (physiotherapy). But with the right advice and management, you can ensure a happy & healthy life is possible!

RPSM’s massage therapist Haylee Rawson and her amazing progression through the years of dealing with her Chron’s

Being diagnosed with a lifelong disease has not stopped me or slowed me down. This has been largely in thanks to the support of my Dad. He has showed me that a good life is possible despite suffering from ankylosing spondylitis (a bad form of Rheumatoid Arthritis) by combining a few different therapies over the years. To this day we are both living our lives to the fullest!

Massage has saved me many times through the tough days of fatigue, muscle pain, body aches, depression and stress. Though it may seem to be a somewhat unconventional remedy, massage actually has many benefits. Massage therapy can help relieve stress. And by lowering stress levels, you can help reduce inflammation and other symptoms.

https://www.upwellbeing.com
https://spacecoast.edu

General strengthening of muscles surrounding peripheral joints provides additional joint stability, reducing stress placed on the joint itself.
Postural and stretching exercises are beneficial for improving symptoms of axial arthritis.
This is where a physiotherapist can complete a thorough assessment and provide individual exercises tailored to suit your symptoms and requirements.

https://www.painmanagement.org.au

Whilst making dietary changes will not cure Crohn’s or ulcerative colitis, it can significantly help with symptom management and ensure overall good nutrition is achieved and maintained.

Each and every person with IBD, has an individual experience with nutrition. Foods that cause problems for one person, may not impact another at all.

For example, some people find that a bland, low-fibre diet is easier to tolerate than one that contains high-fibre or spicy foods when experiencing a flare-up. Others have found that adopting a low FODMAP diet helps manage their symptoms.

As well as managing symptoms, attaining adequate nutrition can also be challenging for individuals with IBD due to symptoms, disease complications and medications. Adjusting the diet with guidance to avoid nutritional deficiencies is often necessary.

One of the best ways to understand how diet affects your condition is to start recording a food and symptom diary and to see an Accredited Practising Dietitian for tailored management and a diet plan. Consultation with an experienced dietitian is strongly recommended and the therapists at RPSM are ready to help guide you through this journey.

I hope this has helped you find a few answers, especially if you have been newly diagnosed or never had someone in the family go through the emotions and hidden pain you deal with on a daily basis. As lucky as I have been over the last 17years managing Crohns disease, there are definitely some days that are better than others. So be smart in your management and seek the right advice. Try understand your body and listen to what it needs or doesn’t want. But also know with a positive attitude & good support, the good days will outweigh the bad.

Now get out there and enjoy every possible adventure!

 

by Hayley Rawson – Massage Therapist at Redfern Physiotherapy and Sports Medicine