Archive for category: Physiotherapy Column

What is Nerve Irritation?

Nervous tissue is designed to be able to smoothly glide in and around the interface of our muscular and skeletal systems. Our bodies are designed to move, therefore our nervous system needs to move with us. When there is nerve irritation, there can be restrictions to our normal freedom of movement. Therefore, physio can help with nerve irritation.

The nervous system underpins all our bodily functions, and one of its primary roles is that of protection – reacting to real or perceived threats that may compromise our safety – think about flight/fight/freeze reactions. It may be caused by stress responses, inflammatory processes, or points of restriction along adjacent tissue structures (e.g. tight muscles, stiff joints or a disc bulge as the nerve travels past or through).

Examples:

• Think about a sprained ankle – our body’s response is to protect it while the tissues are healing: we want to offload the joint, so our body will register pain if we try to overexert ankle movement.
• In today’s world, traditional forms of threat (like wild animals attacking you) are less common, but we still get stress responses to other things that can be physical or less tangible, like that caused by work/home life, relationships, etc. These forms of stress are just as effective as eliciting a protective response by the nervous system.

What Does Nerve Irritation Feel Like?

It can be different for everybody, and may include any one, or combination of:

• Pins and needles
• Numbness
• Sharp pain
• Shooting pain
• Radiating pain
• Tight muscles that don’t seem to release
• Headaches
• Heaviness, or weakness in muscles

Some of the most familiar, traditional examples of nerve irritation include sciatica and carpal tunnel syndrome.

How Can Physio Help With Nerve Irritation?

Assessment: gentle neurodynamic (“nerve movement”) tests to assess for nerve irritation. When there is no nerve irritation, our body is comfortable to move through its fullest ranges of movement, with no signs of “guarding” (muscles tightening to restrict this movement)

Following an assessment of spinal joints, your physiotherapist will tease out the most effective joint treatment for your body, where there will be repeated re-assessment to make sure treatment is making the most effective changes.

Treatment: may include a number of different modalities to reduce nerve irritation and, then to reduce the likelihood of recurrence. At Barefoot, we will also explore the reasons why there is nerve irritation – is it due to physical loads and postures, stressors, lack of hydration/nutrition, etc.

• Gentle joint mobilisation and muscle releases to reduce points of tightness and restriction in the body
• Motor control – how our body moves and what muscles are contributing to the movement to deload irritated structures and help with movement efficiency
• Postural/ergonomic setup as appropriate for the positions you hold your body – this may include sleep position, sitting position, standing position, or other postures that occur during the most common daily activities you perform
• A collaborative discussion with you regarding other potential related factors such as sleep quality/quantity, nutrition, hydration, emotional loads and stress, etc – see Brain Overload

If you have been experiencing pain, tightness, or other symptoms that may indicate nerve irritation you can click here or phone the clinic on 1300 842 850 to see one of our physiotherapists and get started with a comprehensive nerve assessment and treatment plan. If you enjoyed this blog you should check out our blog on What Is Nerve Pain.

Hey everyone it’s Dan from Barefoot Physiotherapy. I want to share my personal tips and experience with electric scooters. I scooter to work every day and have noticed that there are a few things you can do to keep your body happy while you are riding a scooter.

1. Top tips for riding a scooter

Safety:

• Make sure you have a helmet on and double check that your brakes and lights are working (especially if you are using a scooter that you are trying for the first time)
• Watch out for pedestrians and cars and try to avoid bumpy ground as I found that riding on bumpy or uneven surfaces is harsh on the joints and muscles as it causes more vibrations and it’s harder to control the scooter
• Wearing bright colours of a night time for visibility

Posture:

• Firm and steady grip around both handles, wrists not folded back or forward excessively.
• Neck and shoulders should be relaxed.
• Elbows approximately 90-120 degrees arms reaching out in front of you comfortably. Don’t lock your arms down or squeeze your arms onto your body.
• Trunk upright and keeping your back relaxed.
• Gently squeeze your glutes and keep your knees slightly bent(I know it’s very tempting to just lock your knees out, if you do a lot of the shock you feel will likely go through your joints more than your muscles).
• Keep one foot forward and turn your toes out approximately 20 degrees or whichever angle your hip feels most comfortable(Everyone has a different hip).
• If you feel like your outer hip bone area is feeling tight or uncomfortable try widening your feet apart more rather than having your feet right in front of each other.
• If you are riding for more than 10 minutes I would highly recommend switching the front foot with the back.

2. Best muscle releases when riding a scooter

• Foream muscles(wrist flexors) – they can become tight gripping the handles
• Thumb flexor/adductor release – probably more your right thumb depending on the scooter model, might become tight pressing the accelerator
• Lat release – Lats can get tight from tensing too much from
• Glute and deep hip rotator releases – Can get quite tight and sore from standing and stabilising your hip/body on the scooter
• Hamstring and quad releases
• Calf releases – lower body muscle might get fatigued and tight as they constantly adjust to balance your body.

3. Best exercises for scooter riding

• Everyone could benefit from more stability/endurance while they are on their scooter. When our muscles become more fatigued and tight we are more prone to injury. To prevent this from happening we should strengthen up our muscles(especially our lower limb muscles). Here are some exercises that target balance, lower body strength and endurance and also help you in certain situations.
• Side hop for emergency exit/getting out of the way of a car
• Single leg Squat with emphasis on eccentric control for safely stopping the scooter when the brakes don’t work properly.
• Tandem stance(one foot in front of the other) with eyes closed, on an even surface next to a wall (not on the scooter) for better balance and stability on scooter
• Double leg glute activation in standing or Single leg hold at wall to increase glute activation and endurance

Hopefully some of the tips above help you optimise the way your body feels when riding an electric scooter. Sometimes our surroundings are quite unpredictable and we might have landed funny. If you do start feeling pain in your foot or knee please book in with one of our Barefoot Physiotherapists for professional assessment and treatment.

If you enjoyed this blog please check out our blog on How to do a great squat or Getting into Exercise.

The widespread benefits of gentle aerobic exercise are well known – improved heart health, improved sleep quality, improved mood, the list goes on. The current recommendations are for 30 minutes, 5 times a week (and 2 days of strength or resistance training). So what do you do if you aren’t able to make it that far? Many people would do a 30 minute walk without a second thought, but if you are recovering from an injury, illness or period of de-conditioning for any number of reasons you may very well need a structured return to walking plan.  

Steps for return to walking 

1. Understand that everyone is different and respecting where your body is at. Every body is different and has been through its own unique journey and challenges and some have been through a lot more than others. So respecting wherever your body is at right now and working within your limitations (rather than doing what you ‘think’ you should be doing) is essential. 

2. Mindset: it is easy to feel like going for a 5-10 minute walk is not achieving anything or even worth doing, especially if you’ve previously had a higher level of activity. However, if that is your current level of capacity, that’s exactly here you want to start. The only way to progress from there is to make a start. Shifting your mindset to see the importance of consistency and knowing that what you are doing is valuable and working toward progress is key. This might include getting dressed in your ‘workout’ clothes or putting on your joggers. Small behaviours that help reinforce that we are about to exercise .

3. Establish your comfortable baseline: You want to work out how far you can comfortably walk without getting flared up (ie no increase in pain/symptoms, no big drop in energy). This is how you can gradually build your tolerance rather than the “boom/bust” cycle of walking too far, getting flared up and having to take a week off before you can try again.  

4. Make a plan – once you establish your baseline, you can use the below table to help you work out which level is suitable. Eg if you can walk for 5 minutes, but 10 minutes is too far – choose level 2. If you can comfortably do 15 minutes, choose level 6.  

Plan for return to walking

Summary of Return to Walking

The goal is to build up your walking pace so that you get the cardiorespiratory benefits without irritating anything. Adding the second walk in often speeds up progress, however if you don’t have time or ability to do that, then that is ok. You only want to change one thing at a time (eg pace or time). This means you may stay on a level for a while and work on getting your pace quicker or you can work through the levels and then work on your pace. It’s totally up to you, and your body. 

If you have specific questions about goals for return to walking program, talk to your health professional. Here at Barefoot Physiotherapy, we would love to help you with your goals.  Book in to see one of the team today.

Nerve pain is a common condition affecting many people. It can result in significant discomfort and impact on daily life if not treated. It can be the result of a number of causes, may of which can be improved with physiotherapy. What does nerve pain feel like? Nerve pain or nerve irritation can present with a variety of symptoms.

• Tingling or pins and needles sensation – can be anywhere but commonly in the leg or arm
• Burning sensation – can be felt anywhere in the body but especially in the leg or arm
• Weakness – muscles may feel weaker or tasks may feel like they require more effort than previously
• Heaviness – arms or legs may feel heavy to move
• Change in skin sensation or numbness– reduced sensation anywhere in the body
• Feeling of tight muscles that does not improve or gets worse with stretching
• Headaches – there are many causes of headaches, but they can be the result of nerve irritation. [[ See here for our blog on headaches]]
• Sharp or shooting pain
• Achiness in a muscle or joint
• Restricted or unco-ordinated movement – very limited movement or feelings of clumsiness (in the absence of other medical conditions)
• Radiating arm or leg pain – pain that feels like it starts at either the top or the bottom of the arm or leg and radiates along the limb
• Buttock or shoulder blade pain

Causes of Nerve Irritation

Nerve irritation can be caused by muscle or joint problems or more serious conditions. Nerve problems that can be treated by a physio include:

• Sciatica – pain from the sciatic nerve that may start near the lower back or buttock and travel down the back of the leg including the calf and foot
• Radiculopathy – a nerve entrapment at the nerve root when it exits from the spinal cord through the spinal joints. This can occur in the neck or lower back and may involve sensation changes, weakness or pain can present anywhere along the path of the nerve including the arm or leg
• Piriformis syndrome – involves the sciatic nerve as it runs through the piriformis muscle. Often results in buttock and or leg pain
• Carpal tunnel syndrome – involving the median nerve at the inner wrist, where tight muscles or swelling can make it difficult for the nerve to move freely. This is a common condition in computer workers and pregnant women.

Sometimes nerve irritation is caused by disc bulges in the spine. Physiotherapy can still help in the management of this type of nerve pain but it may be accompanied by other treatments including medication, injections or sometimes surgery.

Nerve problems can also be caused by medical conditions such as peripheral neuropathy, multiple sclerosis, stroke and motor neurone disease. While these conditions may also benefit from physiotherapy treatment, medical care is the start point for their management.

Physio treatment for nerve pain

As with most musculoskeletal conditions, physiotherapy for nerve pain should take a multimodal approach – that is, it should include a variety of treatment types. Assessment and treatment should aim to address the underlying cause. At Barefoot Physio, we have specific and sensitive tests that will give us the information to guide our treatment. Treatment for nerve irritation may include:

• Advice and education – understanding what is causing your nerve pain, what activities you may want to avoid in the short term and knowing that most nerve pain will improve is key. The better you understand pain, why it occurs and what in your body is driving it the better your recovery will be
• Manual therapy – gentle mobilisations of the joints where the nerves come out of the spine. ‘Neural interface treatment’ (treating where the nerve interacts with other tissues such as muscles and joints) is aimed at reducing the sensitivity of the nerve in a non-aggravating way. It can also include muscle treatment along the path of the irritated nerve. There are specific gentle nerve tests physios can use to help ensure your body is getting the treatment it needs
• Posture – learning ideal postures and positions for your daily activities (sitting, sleeping, standing, driving) can be helpful for avoiding further aggravation and promoting recovery and minimising the risk of future problems
• Holistic strain management – understanding that pain is not just caused by tight muscles and in fact all kind of “strain” can contribute to the brain producing pain is very important. Looking at your sleep, hydration, stress, nutrition, medical conditions and other factors is an important piece of the puzzle for addressing your nerve pain. No two bodies are the same and your back pain is unique to you

If you are suffering from nerve pain or think you might have nerve irritation, click here to book in to see one of our physios today. If you’d like to read more on Nerve Pain Management follow this link.

Walking your dog is a great form of exercise, no equipment needed; just you and your legs and off you go. Just as walking is a great form of exercise for us, a regular walk is also important for the health of your dog. It helps to maintain physical health, and also be stimulating for their senses as they check out the sights and smells in the environment. Like any form of physical activity, we want you to best take care of your body. This will help limit the chance of niggles/injuries impacting the ability to participate in your (+your furry friend’s) favourite activity! Here are our top tips for walking your dog.

Tip 1 when walking your dog: Make sure you have all your gear!

• Hat & sunscreen
• Water (for you and your dog). Don’t forget a container they can drink out of too
• Wear Appropriate footwear for yourself
• Don’t forget some bags as you may need to clean up after your dog
• Dog treats to reward for good behaviour!

Tip 2 when walking your dog: Consider both your own capacity and that of your dog

Is YOUR body up to doing a 30 minute walk, even if your dog is keen to do that? Don’t fall to “paw pressure” ; it is important to pace yourself, even if your furry friend wants to keep going. You can gradually build up your time and distance! (for an example of gradually building up the time on your walking program – see here).

Similarly, maybe your dog isn’t up to as long of a walk as you might be – they might be a little older and not have the same capacity as a puppy. You may need to go for a slightly shorter walk if they tag along with you

Tip 3 when walking your dog: Training your dog to walk well

Consider your pet’s personality and level of obedience. If they tend to be highly excitable, try to stick to an area that may be less busy with other people, dogs or other wildlife. This will minimise the risk of them pulling or jerking the leash, resulting on strain on your body and theirs.

Training your dog to walk beside you rather than pulling ahead can open you up to other stimulating environments for you both to experience safely.

Tip 4: Holding the lead

It is best to avoid wrapping the lead around your fingers or wrist to avoid the potential for crushing your hand if your dog pulls on the lead.

Holding the lead with two hands can provide more control. As a result this leads to less strain through your shoulders and neck than holding with only one hand.

For more personalised advice on our top tips for walking your dog book in with us online here, or call 1300 842 850. One of our friendly team at Brisbane’s Best Physiotherapy clinic would love to see you and provide additional tailored advice to get you out walking and having fun with your dog.