yoga

Accumulative Strain Flare ups

Years of full-time dance, hip surgery as a teenager and a semi-recent auto-immune diagnosis means that every so often my body goes a little bit haywire and throws out a variety of physical symptoms (a flare up) that impact my day to day activities. Yes, your physio can be sore too! The nature of our work means that we are physically and mentally active for the majority of the day. Which all adds to that accumulative strain we talk about in sessions.  As a physio and ex-dancer I have the benefit of knowing my body reasonably well. And the nature of accumulative strain means that we can tip over the threshold to symptoms with a seemingly minor event.

What do we do?

So how do physio’s manage accumulative stain flare ups? Firstly – have a good team in place!  Have all your strategies ready to go (or know who you can turn to to ask for help). That may be a partner or friend, physio, GP, PT, dietician, massage therapist – the list goes on! For me my auto-immune flare up presents as moderate to severe neural irritation in one arm. This is not super helpful with my job. Firstly we make sure my physio appointments are booked closer together to treat all of the things we already know make my body happier. I also get super strict with my food. I do this by avoiding things that cause more inflammation in my body and eating more of the things that make me feel good. As well as making sure I get more sleep. And making sure I have the opportunity to lie down/do my releases throughout my work day.   This is why we are always asking questions about other things in your life – it all makes a difference!

Physiotherapy Brisbane

How to think about it

Context is key.  Especially in accumulation strain flare ups or brain overload situations. We are always looking at the big picture.  There may be an activity that isn’t amazing for a particular body part but the overall mental/social/physical benefits mean we still want to include it but with modifications or extra releases.  For example, when my hip is really cranky it doesn’t like walking for more than 15 minutes but it will tolerate cycling a bit better.  The benefit for my whole system of being outside with gentle movement is worth having to do an extra long release session pre and post cycling.  As your physio (and general cheer squad) we’ll always be asking you questions and teasing out info to help you make similar choices if needed.

Physio brisbane

You can find out more about accumulative strain here (Read more).  If you have questions or need some help about creating a team or modifying activity ask your physio. Book in by calling 1300 842 850  or online at  http://www.barefootphysiotherapy.com.au/book/start/

Barefoot Physiotherapy Brisbane example of a shoulder self release clients can do at home.

Muscle releases at home

At Barefoot Physiotherapy we love meeting new clients and helping kick start them of their health journey. For most clients it is important to be completing their own exercises and muscle releases between appointments to maintain improvements. In a session with a Barefoot Physio we will do a head-to-toe assessment to work out what muscles need to be released to help improve your movement quality and reduce muscle tension. Completing these muscle releases daily is ideal as this will help to ensure you are consistently reaping the benefits of happy relaxed muscles.

Benefits of keeping your muscles happy are:

  • A reduction in muscular spasm and pain
  • Increase or maintain movement range of the muscle
  • Helps with post exercise recovery
  • Reduces tension pain such as headaches
  • Preventing injuries!
  • Happy muscle and joints = happy nerves 🙂

How often do you need to do your homework?

It is important to work out a way of fitting your muscle releases into your daily routine, so that they can be easily completed with the least amount of fuss. As a guide we recommend setting 10 mins aside to work through your release list. However, the ideal amount of time for you could be more or less depending upon where you are at on your health journey. Your physio will help you work out the ideal amount of homework for you!

Tips to fit releases into your routine:

  • Dedicate the ten minutes at a certain time of day as ‘me time,’ a good way of setting your body up to happily complete all your daily tasks.
  • Think about the various positions you complete your releases, this way you can conveniently fit them into parts of your day. For example: Sitting – you can do them during the ad breaks while watching your favourite TV show. Standing – during a study/work from home break against the wall. 
  • Keep any tools you need in an easily accessible spot, so there are no barriers for you to quickly fit a session of releases in. Make sure your foam roller, lacrosse ball or spiky ball are not hidden in a faraway cupboard.
  • Use visual cues to help you remember to do your releases: i.e. a post it note on your fridge or computer screen or a daily alarm/alert.
  • Importantly keep a list of your muscle releases handy this way you can easily access what ones you need to do. If you ever need help on how to complete them you can also follow this link, to read more about them on our website.

We can help with teaching Muscle Releases if you need

If you or someone you know is experiencing any muscle joint or possible nerve irritation please contact us. We can determine if it is a musculoskeletal issue before having to see a GP. We are open 5 days a week and a couple Saturdays a month. We have early and late appointments available. Please call us at 1300 842 850 or Click here to book an appointment.

Injury management

What its like to have an injury

By Caitlin Sargent:

As a physio I, along with many of my clients, expect I would rarely suffer injuries. As an elite athlete though it is kind of considered part of the deal. While it would be nice to always prevent all injuries, the nature of everyone’s lives is that at some point we are often going to accumulate too much strain and experience some degree of stiffness, pain or injury. It may be a slow gradual onset of tightness and discomfort when sitting in front of the computer or, as in my case, it may be a hamstring tear whilst competing at State Championships in front of a crowd.  And yes there is photo evidence.

Race injury
Photo credit: Casey Sims. Mid race Hamstring tear

Acute injury management

Most people are familiar with basic injury management – relative rest (ie don’t do the things that hurt), ice to reduce the inflammation and reduce the pain, compression to minimise swelling and aid in blood flow, elevation again to minimise swelling in the area. What does not often get discussed as part of this process, is the psychological management. “Where did this come from?” “How long will it take to get better?” “Will I ever be the same again?” “Is this going to impact my ability to work?”… The thoughts and questions can be an unhelpful spiral.

Sometimes, being a physio in these instances is helpful – for example, my lower back had been tight that week so I was not entirely surprised when I felt my hamstring tear. However as a physio I also felt irresponsible and embarrassed that I had ignored what I thought was a minor tightness and let it become a far more significant injury. It is important to know, that all kinds of thoughts and emotions are normal when experiencing an injury. However getting caught up in them, is usually not helpful (and can actually make our pain worse). Almost all injuries will make a full recovery and if you follow medical/physio advice, a majority of common injuries will be noticeably better in 2-6 weeks.

Injury management
Cross training

Physiotherapy management

Given my profession, I am somewhat biased – however I truly believe that good physiotherapy management and care can significantly speed up the recovery time for injuries. In my own case, after my hamstring tear, I had physio multiple times a week for a number of weeks. Given that the sciatic nerve runs through the hamstring, there was significant nerve irritation and early stage (first 10 days) treatment focused on this. Once the nerve irritation was settled down, we were able to do a fully body assessment and testing which found that T11 (a mid-back joint) made the most improvements to my hamstring length, hamstring strength and lower back range of motion. While it was frustrating to have my running training hampered, it was very comforting to see objective improvements happening in each session – giving me confidence that I would be able to return to training soon. I was able to modify my training to maintain as much fitness as possible, whilst also not impeding my recovery.

I have experienced a variety of injuries during my time as an athlete and I can confidently say it never gets “easy”. There are always frustrations, worries and negative thoughts. However I have found that by putting my energy into what I can do to get better (getting enough sleep, doing my self-releases, avoiding aggravating activities) and focusing on what training I can do (rather than what I can’t do) – I am able to minimise the impact of those negative thoughts. It allows me to see the injury as just another challenge in the life of an athlete – an opportunity for growth that will make me a better athlete, human and physio.

Injury recovery
Back on the hills

Individualised treatment at Barefoot Physio

Treatment Direction Tests and Individualised Treatment

Every body is different in its experience of movement and load. People have different postures, different exercise/activities, different injury history with different compensation strategies and different daily load from life, based on occupational demands, sleeping positions and much more. As a result, no two bodies are identical or present in the same way. In fact, two people can present with the same symptoms but with very different tight muscles and joints. Consequently, they improve with quite different treatments. So, how do we know what works for you?

Here at Barefoot, we do a whole body assessment of each individual to get a really clear picture of where their issues are, looking for which muscles and joints are tight, which muscles aren’t working as well as they could be and what movements are limited. See here to learn more about our whole body approach. We then take this information and use it to perform treatment direction tests.

Treatment Direction Tests

What are treatment direction tests (TDTs)? It is a simple testing process that allows us to narrow in on what the most effective treatments are for each individual. We take the information gathered in the full body assessment and systematically trial treatment to these areas whilst doing a movement, to see which muscles or joints make the most improvements.

Our goal is to not push into pain, but rather be guided by what range of motion can be comfortably achieved. For example we might be trying to improve shoulder mobility – so while you lift your arm up in front of you, we trial releases to the areas we found were tight during our body assessment. This might be a shoulder muscle, a back joint or even a leg muscle or ankle joint glide. The body will show us, which of these areas is the most effective to treat by increasing the pain-free shoulder range of motion.

Treatment and Self-treatment

Once we have done this testing and know which areas make the most improvement, we focus our treatment on that area. We will also give you homework (if that’s what you want) to help keep your body happy. By narrowing the treatment area down through testing we can ensure that the homework or self-releases we are giving you are time efficient and effective!

Full body assessment

Why we use a Full Body Assessment at Barefoot Physiotherapy

At Barefoot Physio we treat the whole person, not just the specific injury that brought you in.  In physio we are often told to “look at the joint one above and one below”.  This means if you come in with knee symptoms, your hip and ankle will also be assessed and potentially treated.  The Barefoot Treatment Plan goes one further and assesses your whole body in our ‘full body assessment’ in order to find where the restriction and cause of compensation is coming from.  This includes assessing your nerves, muscles, joints and movements to gain a ‘snapshot’ of your individual body.

What is it?

A full body assessment gives us a list of significant findings in your body (or what we call 3’s).  Significant findings may include movements such as hip flexion (bringing knee to chest) or cervical rotation (turning head); muscles such as your bicep or gastrocnemius (calf); or joints such as your talocrural (ankle). We are feeling for points of higher muscle tone (like a “trigger point”), or joints that don’t glide as smoothly as they can.  Similar to our neurodynamic tests, we measure movements ranges to “R1” or the first point of resistance where your body starts to show signs of being unhappy in this movement via muscle guarding.

What do we tend to find?

As we complete our scan (full body assessment), it regularly reminds our clients of previous injuries or issues that may have been symptomatically resolved but are still presenting with lingering restriction or altered loading patterns. For example, a client may present with hip symptoms in their squats at the gym but a full body scan brings up an old shoulder injury that still niggles occasionally that they haven’t thought relevant. All of this adds to the picture of the accumulation of strain on your body. We collaborate with our clients in both isolating areas of interest in the body but also to then prioritise our findings for treatment. We then use our treatment direction tests (TDTs) to narrow to what is relevant and important for your body.  Once we’ve narrowed it down we can effectively treat, retrain and strengthen a handful of areas and keep your whole body happy.

More reading next week!

For more about TDT’s (treatment direction tests that help us work out what is most important to treat) watch out for our blog next week! If you’re interested in booking a session you can here

Dry Needling

Why we use Dry Needling

At Barefoot Physiotherapy we utilise a variety of techniques to help reduce pain and decrease muscle tightness. One of these techniques is called Dry Needling.

Why we choose Dry Needling?

It has numerous positive immune effects:

  1. It helps stimulate local endorphin release (which helps relieve pain) and it can increase blood flow to the symptomatic area.
  2. It has a pain gating mechanism – which essentially helps to introduce a new sensation to a painful area, over riding the original painful stimulus.
  3. Increased levels of white blood cell activity which helps stimulate the production of antibodies to improve function in inured areas.

Trigger Points

Dry Needling also helps to ‘break up’ trigger points. Trigger points can be tight/ tender spots in your muscles which can feel like a knot or ropey band to touch.  In order to improve the function of muscles it is important they are operating at their best length/ strength and power. We can use dry needling to help release these trigger points through a process of encouraging calcium re-uptake.  

  1. Our Muscles have two types of filaments which allow them to contract and relax with movement.
  2. Calcium is released on contraction and then there is a re-uptake component to help the muscle relax.
  3. If the calcium is not properly reabsorbed in the process it can cause a trigger point to form.
  4. Needling into the trigger points helps to reset this process and allow the calcium process to restart, therefore releasing the trigger point.

Is Dry Needling safe?

Dry needling is a very safe procedure when completed by an experienced therapist who will always be sure there are no contraindications to using the technique with a client. At Barefoot we have undergone high level specific dry needling training and continue to refine our skills in constant training sessions.

As a general guide for you on what you can expect Dry Needling shouldn’t have a sustained sharpness or stingy sensation but it can and should feel dull, achy, grabby or warm.  After a session of needling your muscles may feel a bit sore and it is advised you avoid any intense physical activity in the first 24hrs to help them continue to relax.

If you have any further questions about Dry Needling make sure to ask your Physiotherapist and we will be happy to answer any of your queries.  Please call us at 1300 842 850 or Click here to book an appointment.

Physiotherapy Brisbane, Barefoot Physiotherapy

When do I need to rest?

A common question we hear after a pain flare up or acute injury is “so, should I rest for a while?”.   The exact answer will depend on the injury but usually it’s either “no” or “yes, but only for a few days”. 

Using a back flare up as an example – we’ll recommend to our clients to take it easy for a few days, resting in comfortable positions (but changing positions every 45-60 mins), using anti-inflammatories and heat as appropriate, and to stick with gentle and short walks around the house. This does not mean to lie on the couch 24/7! The main goal is to let the body calm down a bit, ideally this also includes a few physio sessions close together. 

Next step

Once this acute episode has settled somewhat then we want to slowly reintroduce movement.  This is done in a graduated way so your body can recognise this movement as non-threatening, therefore not triggering the protective response.  Our brain and body is super clever and will go into protective responses (such as bracing with all movement) that are useful in the short term, but end up being detrimental longer term.  Your physio will work with you to determine the amount or type of activity, with variations of your favourites the first to be added back in!

What we want to avoid is the “boom/bust cycle” which cycles us between lots of activity, flare up and drastic reduction of activity, symptom decrease then straight back into lots of activity…. The reintroduction of movement is a great opportunity to include a variety of movement options.  Sticking with the example of a back flare up – we’ll start with gentle walks, glute releases then retrain glute activation, pelvic tilts to encourage segmental lumbar movement etc. While ideally we get back to our usual activities without any hiccups along the way, it’s important to remember that even if we do have up’s and down’s it doesn’t mean that we are back to square one or that things will never improve.  It just means we may need to dial activity or load back a little, have more regular physio, stay at the current level of activity for a bit longer, or maybe have a few days again at near total rest.

If the injury involves tissue damage, such as a ligament sprain or bone fracture, then the timeframe looks a little bit different and will often require a slightly longer period of rest than the example above, but it’s a similar process.

Any questions reach out

If you’ve got any questions about how to manage an injury with rest and return to activity, or to stop it from happening again – give us a call  at 1300 842 850 or Click here to book an appointment.

Yoga Physio and Props – get the most out of your practice!

Written by Catherine – Yoga Physio

As both a physio and a yoga teacher I can honestly say one of the best things you can do for your yoga practice is to use props!  It’s a legitimate game changer. It’s common for teachers to make suggestions of using a block or bolster throughout a yoga class, but often it’s a bit more difficult to work out exactly how or why you should be using them, especially as we have more and more access to online classes!

The best things about using props is that they change your environment to suit your body and your yoga pose, rather than contorting your body to suit the environment.  We already know that all bodies look and move differently, why should we then expect everyone to be able to come into the same position in a yoga class? As we do more and more in our homes, it’s important to listen to your body.  You’ll get much more out of your practice (in all facets) if you’re not constantly fighting against your body!

A couple of examples (with home prop variations included):

Downface Dog (Adho Mukha Svanasana): Roll up the back of your mat or have a rolled towel to tuck under the heels so that you can soften the calf stretch/ankle dorsiflexion plus make it a bit easier to soften the knees out of a full hamstring stretch.

Yoga physio
Downface dog with prop

Triangle Pose (Trikonasana):  Use a block or a study shoe box under the front hand, either on the inside or the outside of the leg.  This helps to support the torso while also changing the amount of trunk rotation, hip flexion/rotation/abduction required and decrease the likelihood that you just sink into the front knee/shin.

Yoga Physio
Triangle with prop

Warrior 3 (Tuladandasana): Use blocks, or shoeboxes, or a sturdy stack of textbooks under the hands for a bit of extra support and height for the torso before starting to hover or lift the hands.  It also means if you over balance you won’t fully fall out of the pose.  You can also try a standing variation where hands can rest of the wall, or edge of the couch. Nail the glute and core activation with a bit of extra support.

If you have specific niggles going on in your practice that adjustments and props still don’t cut it  give us a call at the clinic on 1300 842 850 or Click here to book an appointment.

Increasing running

Increasing running with Caitlin Sargent

More time for running

With gyms closed and exercise options somewhat reduced compared to normal, a lot of people are turning to running for their endorphin dose. Running is a great form of exercise, with the added bonus of getting some vitamin D and some seeing some fresh scenery. However, there is such a thing as too much of a good thing. A sudden rise in running volume can lead to injuries, so I’ve put together my suggestions for how to safely increase your running.

Gradual approach

Progressive overload is a term used in exercise to describe how we can safely get the body to adapt to new stimulus. It is generally accepted that a 10-20% is safe, but also effective in increasing fitness. This is often a lot less than people imagine – if you were previously running 3km, then an appropriate increase would 300-600m in one run. It also applied across the whole week – so if you were previously running 5km twice a week and wanted to add another run in, a total volume increase of 2km would be appropriate. So you might consider a 5km and two 3km runs.

If you haven’t been running, I would start with a maximum of 2 runs per week. Depending on your existing level of fitness and strength as well as past exercise experience, you may find you adapt to this quite quickly and can increase your frequency quite quickly. If you have little or no past running experience, it is a good idea to start with a run/walk option. Eg Run for 1 minute, walk for 1-2 minutes x 5. As you progress you can increase the continuous running time and then decrease the rest time (until you are running for 5-10 minutes straight!)

Don’t forget about Strength!

It is easy to get focused on running, especially when gyms are closed and the lure of outdoor training is so high. However running is a high load activity on the body- it is essentially repetitions of single leg squat jumps one after another. Ensuring you have adequate strength and endurance in your leg muscles (in particular glutes and calves) is important for helping prevent injury, as well as improving performance. Strength training for running doesn’t need big heavy weights. When done correctly, body weight exercises like step-ups, lunges and squats (ideally single leg ones) are all great for training up strength and control in running muscles.

Rest days!

Most important of all – allow your body rest and recovery time! 1-2 days of either total rest or gentle walk/yoga is very important for keeping your mind and body happy and healthy

If you’d like to know more or ask Caitlin questions feel free to contact the clinic on 1300842850 or email hello@barefootphysiotherapy.com.au

Cooking pasta

Hobbies and your body – Physio tips to take care of yourself

More time at home can mean more time for hobbies

With many of us spending more time at home, we’re seeing people able to engage more with their hobbies (or even taking up new ones). It’s great to see creativity and passion being nourished like this. While the brain loves being engaged in an activity to the point of losing track of time, often the body feels otherwise. Awkward positions and long periods of sitting are just some of the reasons we may find ourselves more sore as we spend more on our hobbies.

“Hobbies” covers a very wide spread of activities, however many of them are done in some variation of sitting, so that is what this blog will focus on. If you love to cook or bake – there’s a whole other blog about that here.

How you can take care of your body

  1. Think about your set-up
    There is usually another component to hobbies other than just ‘sitting’ – either leaning over a desk – drawing/puzzling /sewing or with something in hand – knitting needles, crossword book or a digital tablet. It is important to keep in mind how these other elements are affecting our posture. A few things to keep in mind
  2. If you are leaning over a table – try to keep your chin tucked in to reduce the amount of strain on your neck. If you have easy access to an adjustable table (like a drafting table with a changeable angle), this is another way you may be able to ease the load on your neck
  3. Try to keep your elbows tucked in – its very easy to let your arms rest out to the sides, especially if they’re engaged in activity. However, this tends to result in extra work for your shoulder muscles so aim to keep your elbows relaxed by your side.
  4. Take breaks
    Bodies are designed to move, so long periods in any one position often result in stiffness or aches. If you know your hobby often makes you lose track of time, then try setting a timer to get up and move every 30-60 minutes. Depending on your hobby, you can also try changing positions – eg sitting, standing, reclining on the couch/armchair.

If your body is sore and stopping you from spending more time on your passions, book in to see a physio to get to the root of the cause and help customise your hobbying posture! You can book online with a Barefoot Physiotherapist here