Physiotherapy for Pain Management

Here’s a great article from our Industry Body explaining the current situation with Codeine becoming prescription only, and how Physiotherapy for Pain Management can be an effective treatment option.

With codeine becoming a prescription only drug from February, a large number of Australians will be seeking alternative ways to manage their pain.

National President of the Australian Physiotherapy Association, Phil Calvert said, ‘The good news is that physiotherapy is proven to provide effective pain relief, which treats rather than simply masks the underlying cause of pain.’

‘We appreciate that restricting access to codeine may cause anxiety for people who suffer an injury. So we want them to know that physiotherapists help people to manage their pain and recover movement with great success, without the use of addictive drugs.’

Research has shown that the relative level of pain that is experienced by someone can be influenced by a range of factors including their emotions and social environment. This means that pain can be a very complex issue to successfully treat.

‘There is no one size fits all approach in assessing and treating someone’s pain. So physiotherapists are practiced in considering a range of factors that may be contributing to the pain. We’ll talk with patients about their lifestyle goals and introduce an appropriate treatment including exercise programs, joint manipulation and mobilisation,’ said Mr Calvert.

What to expect from a physiotherapy consultation:

  • Your physiotherapist will perform a physical examination and find out more about your history and any other factors that may be contributing to the pain.
  • In most cases of acute pain (the period in which an injury is expected to heal), the pain will settle as the tissue heals. Your physiotherapist will explain the nature of the injury and normal healing times. They may provide early treatment, but in many cases advice regarding self-management strategies, including gentle exercise, will be enough to help resolve the pain and return you to full function.
  • In situations where the pain has become chronic (generally more than three months – longer than normal healing times), assessment and management may be more complex. Things other than tissue damage may be contributing to your pain, which your physiotherapist will investigate. In complex situations other specialists may also form part of a wider treatment team.
  • At all stages of pain management, physiotherapists will work with you to encourage self-management, remaining active as appropriate and avoiding a reliance on medication.

If you’re experience pain or difficulty with movement that may cause pain, please don’t hesitate to get in touch with us.  Here’s a BLOG of ours to read, If you’d like some simple exercises to assist with pain management: http://www.barefootphysiotherapy.com.au/easy-exercises-keep-healthy-active-age/

 

Easy exercises to keep you healthy and active as you age

For many people, aches and pains have become a normal part of their life, especially as they age. However, it doesn’t matter if you’re 7 or 77, pain is not a normal part of life, and should be something that you take seriously. This includes general aches and stiffness from your daily life!

Here are some exercise and body management tips to keep you happy, healthy and moving beautifully through life!

  • Keep moving!
    • Studies have shown people who stop moving are more likely to experience stiffness and pain. Now this movement is a little more than just pottering to the kitchen and back. This means you should be getting out of the house and moving around. Some good activities you could try are; heavy gardening, a half-hour brisk walk, riding a bike for 30 mins or more, team sports, or even dancing!
    • Moving gets the blood flowing and joints lubricated. So not only should this movement help with any pain that you are already experiencing, but it will also help to prevent the onset of stiffness and pain!
  • Deep breathing and muscle relaxation
    • If your muscles are tense, then they are not going to be happy and they will send pain signals to your brain. So how do we relax muscles without going to the physiotherapist or for a massage?
    • Deep Breathing Exercises;
      • Make yourself comfortable (lying down or sitting in a chair)
      • Loosen any tight clothing
      • Start to listen to your breathing in its natural pattern, without changing anything
      • Place your hand on your stomach, and start breathing in through your nose and out through your mouth.
      • Imagine that you are breathing down into your hands, letting your belly move in and out with your breaths
      • As you breathe out, imagine all your tight muscles are relaxing away all their tension
      • Continue for 3-5mins
    • Regular exercise can also help the back pocket. A few studies have shown in the older population, those who exercise spend less time and money on things such as doctors, and hospital visits…because overall they are generally healthier people.

Lastly, if you are experiencing pain on a daily basis and can’t seem to find relief, make sure you seek help. You can always give your physiotherapist a call, if you don’t have one you can make an appointment with one close by, or book in to see your GP.

What is powerlifting and how can it benefit you?

When the words ‘powerlifting’ or ‘powerlifters’ come to mind you might think of big burly men pushing stacks of iron and devouring mountains of food. But, as I have found from my own personal experience, this isn’t really the standout feature of powerlifting and certainly isn’t a necessity when incorporating it into your fitness regimen. In this article I will be discussing exactly what powerlifting is, how it compares to other training styles and will point out some of the positives of this style of training in particular.

What is powerlifting?

Powerlifting is a sport which focuses on getting as strong as possible in the three primary lifts, also known as ‘the big 3”. The deadlift, squat and bench press. These exercises form the foundation of powerlifting training and the first focus for anyone new to the sport is to learn how to do each movement with appropriate technique. Once the technique has been mastered, then the focus can shift to lifting as much weight as possible whilst maintaining good technique.

Since the goal of powerlifting is to lift as much as possible, powerlifting workouts involve low reps (generally 2-4 repetitions per set) with high percentage of maximal weight and long rest periods between sets (3 minutes or longer).

 

Bodybuilding, in comparison, uses higher rep ranges (often >8 reps per set) which is better suited to increasing muscle size (hypertrophy) rather than power. This is also very different to the programming found in high intensity interval style (HIIT) gyms that have become popular in recent times. So why would someone like to train this way?

As a novice to powerlifting these are the benefits I’ve enjoyed so far:

  • The simplicity: almost the whole body is trained in just three lifts! This also means I can easily remember whether I am ready for another session of either deadlifts, squats, or bench press.
  • The functional component: the big 3 lifts each require action of multiple joints and muscles and increases the strength of the entire body. Squatting is essentially getting in and out of a chair, deadlifting is picking something up off the ground and bench press helps with everyday pushing and pulling movements
  • Better connection with my body: each training session pushes me to my limits! I have to focus hard to ensure my brain talks to my muscles effectively to get maximum recruitment of all the right muscles for the lift I’m working on. I’ve found that by pushing my nervous system to its limits I am feeling stronger rapidly. This type of strength is known as neuromuscular strength and refers to the brain having improved communication with your muscles. Improved communication with muscles can contribute to Injury prevention
  • Powerlifting has a unique way of motivating you that likely stems from its simplicity. Many people will tell you – there is just something really satisfying in seeing the numbers of each lift increasing. I feel motivated to persevere to keep going and increase the weight that I’m able to lift in each exercise.As a final note, make sure that whatever exercise you choose, it is something you enjoy doing. If you are stuck in an exercise rut, then powerlifting might be the right thing to spark your enjoyment and motivation. Make sure you tell your physio if you are starting any new exercise and ensure your body is moving well to avoid injuries. At Barefoot we can develop a plan to get you back to exercise and even ready to try powerlifting if that is your personal goal.

Want to learn more about powerlifiting? Or book an appointment at Barefoot? Click the link here. Physio Alistair

Basketball. . . the game, performance & recovery!

Barefoot Physio Cam is our ‘go-to’ guy to discuss all things Basketball. He has played professional basketball for several years and loves to chat about the best way to keep your body happy before, during and after the season! This blog will be centered around some of the things you can do to help with game performance and recovery.

Pre-Game

Before a game there are two things that are very important; nutrition and hydration. Both of these factors play an important role in your ability to perform during the game. Lack of pre-game nutrition has been shown to distract players during the game, and poor pre-game hydration has been shown to decrease shooting percentage.

So what to eat pre-game?

It’s a good idea to have your last substantial meal around 3-4 hours before tip-off, and then if you need to have a snack you can do so around 1-2 hours before the game.

Your pre-game meal should contain carbohydrates for energy, and a small amount of protein to protect you against hunger during the game. A couple of ideas might be a chicken salad wrap, pasta with beef mince in a tomato-based sauce.

Now your pre-game snack should be something that is light, low in fat (making it easy to digest) and full of carbohydrates for energy! A good option would be yoghurt with fruit salad or a piece of toast with vegemite on it. If you’re the type of person that doesn’t like having solids before a game, another good idea for your snack would be to have a fruit smoothie instead.

Along with making sure that all your nutritional needs are met, it is also important to ensure your hydration levels pre-game are going to hold you through the game. It is recommended that you consume around 300-600ml of fluid 3-4 hours before the game, slowly. While avoiding caffeinated drinks, as they have a diuretic effect. Then a further 200-400ml of fluid within 2 hrs of tip-off.

Warm up

Your pre-game warm-up can consist of many different things, although there are a few key aspects that are recommended to be apart of the warm-up.

Light cardio – jog/skip forward and backward

Footwork drill – shuffle/carioca

Dynamic stretch – hip/hamstring, quads/calves

Balance drill – single leg balance +/- passes

Light strength – pushup, bodyweight squats

The combination of these drills allows the body to gradually increase in mobility and temperature, decreasing the risk of injury, and improving initial game performance.

In Game

Play hard. Make plays on both ends. Shoot with confidence! And enjoy the time spent competing – it’s such a quick game, sometimes as a spectator it can be hard to keep up!

Cool down

This aspect of the game is often overlooked, but is just as important for your performance as the warm up. An effective cool down allows the body to cool down slowly and prevent injuries in the future.

  • Light cardio – jog back to a walk
  • Dynamic stretching – arms and legs
  • Muscle releases – foam roller or lacrosse ball
  • Static stretching

Post game

After the game, the most important thing to is replace the fluid and electrolytes that were lost during the game. The most accurate way to know how much fluid was lost is to weigh yourself pre- and post-game, however, most people don’t do this because it takes too much time. An easier way to get your fluid intake right, is to consume twice as much fluid post-game as your did pre-game. The post-game fluids should also contain an element of sodium, to help replace the sodium that was lost in sweat during the game.

So now you have more understanding of how you can get out there and play to win, with a healthy body. Stay tuned for more Basketball blogs!

Do you enjoy playing basketball? Leave a comment below to let us know what you favourite sport is!

Climbers . . . this ones for you!

Following the warmer weather ( and the rain finally clearing up) it seems like a great time to discuss shoulder injury and pain in climbing now that the conditions seem just right! Physio Kirsten is an avid climber, when she isn’t treating our incredible clients you will most likely find her on a rock wall somewhere, or scaling the cliffs at Kangaroo Point in Brisbane. 

Kirsten has given us her top tips for climbers, and sat down to let us know about shoulder injury and how physiotherapy can help.

One of my favourite things about treating climbers is that we are super keen on figuring out why things are happening and how we can self treat ourselves to keep climbing. 

Where does shoulder pain come from?

With shoulder pain there are several things to consider. We always want to assess the neck and thoracic spine as pain can commonly originate at these areas. Looking at both the spine and shoulder positioning with movement and climbing often will highlight a dysfunction in the movement. This dysfunction at the joints can lead to nerve irritation or compound soft tissue injuries of the muscle, tendons or labrum.

Treatment for Climbing Shoulder Injury/ Pain

Often treatment will involve the physiotherapist treating the joint dysfunction, nerve irritation, the soft tissue injury and work on correcting the dysfunctional movement.

There are some common areas that frequently need physiotherapy treatment in climbers. In general we need to treat some area in the neck and thoracic joints with manual therapy, strengthen the rotator cuff, middle and lower traps, serratus and lats as well as lengthen the pecs, biceps and lats and train appropriate neck and shoulder positioning for climbing and belaying.

Strengthening antagonist muscles and training should be done in good positioning and control so that:

1. when climbing in not the most ideal positions at least some of the positioning training will transfer and

2. We aren’t overloading ourselves in poor positions leading to injury

Treatment areas and proper cueing are very specific to the individual and often we as climbers deal with some level of pain until it gets to the point we can’t continue climbing. The key to quick recovery is catching the issue early, booking in with a professional who can assess where and what your pain is coming from and start treating what is specific to you.

Nutrition and Pelvic Health

A lot of pelvic health issues (Women’s health / Men’s Health) are tied in some degree to the digestive system. When you think about the postures you take when you have an upset tummy, the strain your pelvic floor muscles take when you are having difficulty with a bowel movement and the close proximity of the pelvis and digestive system you can see why.
Therefore, in conjunction with musculoskeletal assessment and treatment, nutrition and gut health should also be addressed when looking at pelvic floor pain and/or dysfunction ie// prolapse, stress incontinence, urgency, back pain, pelvic floor pain, pubic pain, SIJ pain, Scrotal pain.

Does Nutrition Play a role for you?

1. Are you getting enough nutrients in your diet? Are you absorbing them?
– You should be eating 8-10 fruit and veg servings
– Eating in a stressful environment, on the go or while talking can inhibit absorption
– Chewing less than ~20-40x can inhibit absorption nutrients, reduce feeling of fullness and minimise normal hormonal responses
– Certain medications can change absorption
How this affects you physically: muscle spasm, fatigue, tight-ropey muscles

2. Are your stomach and intestines working as they should?
– Are you producing enough stomach acid to help digest food?
– Signs you aren’t: bloat/belch following a meal, feeling overly full, undigested food in stools
– Changes in intestinal permeability meaning not just good things getting out ‘leaky gut’

How can this affect you physically? You may feel bloating and gas which can leave you feeling yucky, and cause us to hold ourselves in bad positions to combat this “icky” feeling. This also can hypersensitize our body.

3. Do you have gut inflammation?
Chronic stress and pain can lead to low digestive enzymes as energy to make these is directed elsewhere. It also activates hormones that can lead to an inflammatory response. This inflammation in the gut can then propagate musculoskeletal symptoms further.

What to Do:
Assessment and treatment for prolapse, stress incontinence, urgency, back pain, pelvic floor pain, pubic pain, SIJ pain, Scrotal pain should include:
– Seeing a nutritionist to tackle this component of the picture
– See a physiotherapist/s who can perform a physical assessment of your condition.

At Barefoot we are a musculoskeletal physiotherapy clinic who looks at your whole body to fix the problem. We will look at your muscles, joints and nerves and together we can work towards stronger a stronger pelvic floor.

Want to learn more or book in to see the Barefoot Physio team? Click here.

Standing Desks

With recent reports about the hazards of prolonged sitting, standing desks are increasing in popularity. Standing desks have shown to be particularly beneficial for people with lower back, hip or pelvis pain and even improve return to work outcomes. However many people report more discomfort and fatigue in their legs with a standing desk and certain health conditions (such as varicose veins) are better suited to sitting.

It is important to note that sitting at work still has a role to play. In fact, a 2 minute walk every 20 minutes can be enough to reduce glucose levels in the body and hence reverse some of the negative health effects of sitting. If you want to learn more about ideal sitting posture see our previous blog here

To help you navigate the standing desk world, we have put together our top tips below.

  1. Ensure you are standing in a good position
    While a standing desk may seem like the answer to certain aches and pains, it will be no better for your musculoskeletal health if you are not in a good position. Ever stood at a concert for a few hours and felt worse afterwards? If you are going to spend extra time standing during the day, it is important to take the time to identify your ideal position.Fatigue at a standing desk is shown to be higher in those who slouch. Similarly, we know that standing too upright can also cause certain muscle and joint problems. So how do you know what the right position is? Well your body will actually tell you! Below are some good general guidelines to follow
  • Maintain a neutral spine. This means maintaining your 4 natural curves. This position minimises stress on your spine and helps prevent injury and will look slightly different for different people
  • Keep your head upright and in line with your shoulders
  • Shoulders should be relaxed back and down –  the muscles on top of your shoulders should be soft
  • Don’t ‘lock’ lock your knees out – you should keep a gentle bend in them
  • Avoid leaning backwards or forwards – your lower back muscles should be soft and relaxed


  1. Introduce gradually

Just as you wouldn’t go from doing no running training, to suddenly doing a marathon, it is important to gradually increase your body’s tolerance for standing. If you are not used to standing all day, suddenly changing from 8 hours of sitting a day to 8 hours of standing can cause a variety of issues. It is recommended to start with just 5-10 minutes of standing at a time and build up to 20-30 minute blocks. When beginning, total standing time in the day should aim to be no more than 2 hours. Compression stocking, inner soles and supportive shoes have been shown to help alleviate feelings of leg fatigue.

  1. Pick the right desk

There are lots of different options and brands on the market, so it can be difficult to tell which desk is right for you. Key things to look for are:

  • Easy to move up and down (if its too difficult or requires a lot of physical exertion, then you either won’t move your desk often enough or you may hurt yourself moving it)
  • “Set and forget” – programmable sitting and standing height. This allows you to take the time to set up the correct height for your body once, then easily move between sitting and standing set-ups without having to re-check your posture each time
  • 10 year motor warranty
  • Can rise to more than 1200mm
  • Large enough to comfortably fit monitor, keyboard and forearms on
  1. Your best position is your next position!

Ultimately, the best option for you is to regularly change position. This is why if you are going to invest in a standing desk, it is important to get one that can easily change from sitting to standing and back again. Likewise, it is important to ‘move around’ in your standing position – this includes having a foot rest to alternate legs with for different posture options.

If a standing desk does not seem right for you (or you’re just not ready to take the plunge yet), then looking for ways to move more during the day is a really good starting point. This includes having ‘walk and talk’ meetings, a central printing station that you have to get up and walk to or taking the stairs (instead of the elevator) as much as possible. All are great ways to move more and keep your body happier!

  1. See your physiotherapist

Every body is different and the demands of every job are different too. That is why seeing your physiotherapist for a thorough assessment of your nerves, muscles, joints, posture and physical work demands is the best way to get personalised, specific treatment and advice for you. You do not need to have any symptoms to have as assessment. It’s like getting your car serviced to prevent a breakdown! If there is any strain building up in your body, we can help teach you how to reduce the strain and prevent it becoming a more significant problem.

Want to learn more, or book in for an appointment? Click here.

Top tips for keeping you body happy at work!

Top 5 tips for those who are sitting at their desk all day.

If you are an office worker chances are you have come across or experienced first hand the pains of sitting for too long. While a typical desk job may seem to expose the body to little physical strain, prolonged sitting can wreak havoc on the body. The reason for this is that we are meant to move. Our anatomy and biology is set up for us to walk, stand, squat, twist, pull, push and a whole lot more. As the saying goes, “if you don’t use it, you lose it”. In this case sitting all day causes us to lose our mobility. Muscles become tight and weak, our posture changes, and we become stiff and sore. To remove the risks of prolonged sitting check out our list of top things to do to maintain your mobility and move well regardless of the demands of your job.

  1. Perform an audit of your workstation setup

Often making a few changes to your workstation can cause you to form good posture without having to even think about it. Here’s some common faults and fixes for your workstation setup.

Common faults with workstation setup:

  • Chair too low → looking up at monitor
  • Monitor too low → looking down at monitor
  • Desk too low or seat too high → hunched over keyboard

Fix these with:

  • Chair at proper height → eyes are level with top of monitor
  • Hands comfortably at keyboard → shoulders are not rounded
  • Monitor at correct height → neck in neutral position

Want to learn more about how to setup your workstation? Click here.

 

Optimise your sitting posture:

often when we think about posture, it can seem overwhelming, often you are left with one question . . . What is the right way to position my body?

To ensure that the curves of the spine are maintained: roll your pelvis forward until you achieve a very slight curve in the lower back, sit up a little straighter through your mid/upper back, and check that the position of your head isn’t too far forward of back. It should feel nice and balanced over the rest of your body.

The next step is to get used to what being in this position feels like so you can adjust your position without thinking about it too much. After this you must form a habit of getting into and maintaining this position. To form a habit it is helpful to have habit triggers. Every time one of the following occurs hold your good posture for 5-6 deep breaths or until you forget about it:

  • You get an email
  • You answer or hang up the phone
  • You take a sip of water
  • You set your desktop background to a picture of someone with good posture and do what they do when you see it.
  • You set a reminder on your phone to notify you that its time to practice your posture habit.

Remember the most important point is that the body is made to MOVE. Even though we have outlined a perfect posture position above, remember that it’s always good to change positions often.

Regularly change your position throughout the day.

Been sitting for an hour? Why not stand for the next half hour? Or even kneel? The point is to do something different and to put your joints in a different position.

Don’t have this option? Get up go for a short walk to refill your water bottle, make a tea, go to the bathroom. You could even try marching on the spot, rolling your shoulders in circles, or doing a couple yoga moves. The takeaway from this is that there a million +1 ways to move your body and you must move it away from the position you have been spending a lot of time in.

Ideally change your position every 20-30 minutes but another useful technique is to listen to your body, i.e. is it starting to feel stiff? Are you starting to twist and move around in your seat to find a better position? If so, it’s time for a break. Get up and move or change your work position.

  1. Move often

 This can take the form of formal exercise, gardening, going for walks, anything really. If your body can handle regular movement/exercise it will develop better resilience to the strain that lengthy desk work can have on the body. Plus you’ll reap the numerous other health benefits of exercise.

  1. Get a thorough assessment from your physiotherapist

At Barefoot Physiotherapy, we assess your nerves, joints, muscles and movements to measure the amount of strain you have built up in your body. You do not need to have any symptoms or conditions to have this assessment; think about it like going to the dentist for a check-up to prevent something happening! If there is any strain building up in your body, we can help teach you how to reduce the strain and prevent it coming back again. Want to learn more or book an appointment? Click here.

Stretching vs Releases

Ever had a tight muscle that doesn’t seem to budge no matter how many stretches you do? It’s so common at Barefoot to have new clients tell us ” I stretch my ** tight muscle ** all the time and it still feels super tight” . . . so why is this happening?

Alot of tight muscles often have palpable “knots” and “triggers” in them. These are specific areas of contracted muscle within the entire muscle belly. To target these specific “hard or ropey” spots it is more effective to perform muscle releases (using a ball, pocket physio, foam roller, dry needling or trigger point massage) rather than doing a stretch. When you “muscle release” this allows for sustained pressure on a trigger point, at a specific angle held for around 90 seconds for 2-3 different spots per muscle group.

Muscle Releases

Muscle releases can still be performed if your muscle is tight due to nerve irritation, however stretching should definitely be avoided. It is difficult to know whether you have nerve irritation or not until it is tested by a qualified Physiotherapist. If you have consistently stretched a muscle correctly for >3 days and you’ve had no change, then you’ve tried doing muscle releases and there is still no change, then it is likely that there could be nerve involvement. Luckily at Barefoot this is something we test and specialise in, so if you need to get this checked click here to book an appointment.

Stretching can be effective if you have an entire muscle group that is notably tight and is not originating from nerve irritation. If this is the case, it is important to hold your stretches for a minimum of 60 seconds each using the correct technique to have the desired effect. If you do not know the correct technique, a Physiotherapist can help teach you.

So how will this help your muscles & body?

  1. Your muscles will feel “good” when relaxed at rest.
  2. Your injuries will be prevented
  3. Allows you to maintain full motion of your joints
  4. Allows full strength by having full range of motion
  5. Your recovery will be quicker after exercise!
  6. Your muscle soreness will be reduced
  7. Happy muscles & joints = happy nerves!
  8. Sports performance will be improved
  9. A reduction in headaches
  10. To stop us feeling old & creaky!
When and How?

Practicing muscle releases or stretches everyday is ideal. We recommend you set aside a minimum of 10 minutes a day to work on the areas that make the biggest difference to your body.  If you have a few areas to work on, you have had a big day at work or you are exercising at a high level, we would recommend 20-30 mins. If you aren’t sure what areas need to be released in your body to help you perform better, a Barefoot Physiotherapist will do a head-to-toe assessment to work out where you need to focus on for your body.It is normal to feel some discomfort during these releases and it should stop as soon as you release the pressure. If it doesn’t, please notify your Physiotherapist to find out why. Remember to breathe while you do your releases! Breathing in & out deeply will help relax the muscle contraction and speed up the releasing effect.

Be aware of your position while you stretch/release. Our brain always likes to take the easy option, so it will sometimes sub-consciously put us in the position where we get the least resistance. This doesn’t help us achieve the flexibility we are after. Posture and technique are key to sustaining a good stretch on a muscle. Want to know more? Check out the rest of our post here.