Individualised treatment at Barefoot Physio

in

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

in

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

in

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?

in

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 with one of Brisbane’s best physio’s.

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

in ,

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

in ,

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

in ,

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

Physiotherapy Brisbane, Barefoot Physiotherapy

The Barefoot Physiotherapy Plan

in

Barefoot’s 10 step plan

Client’s will often ask us how we will best determine the cause of their symptoms or ask us what sets us apart from other physiotherapy clinics. Our answer is simple, our Barefoot Physiotherapy Treatment Plan.

Every client we see at Barefoot Physiotherapy is always approached with the same treatment plan, a 10 step process to help you get back to living your Barefoot Lifestyle. Now 10 steps may sound like a lot but I’m going to break them down so you can see how they can help you move and feel the best you can.  

Getting started

Whenever anyone comes to Barefoot Physiotherapy we always take the time to discuss their story, and work out what their individual goal of coming to us is (this is one of the best parts because we get to discuss goals and how you can be the best physical version of yourself possible). Our next stage is to always determine if other health professionals or any type of investigation is needed so we can reassure you that not only are you in the best place for your care, but that we are confident we have all the pieces to solve your puzzle.

Your first session with will include us testing to see if your nerves are involved in your condition. Our nerves run throughout our spine branching up into our neck, down to our fingertips and to the tip of our toes. If we determine that your nerves are restricted or you might hear us say ‘grumpy’ we will treat them and then teach you how to keep them happy. This way once our nerves are moving well, our muscles and joints will be able to move freely and it will help us make long lasting improvements to your muscles and joints.

Whole body holistic approach

Once we have made those grumpy nerves happy we will complete a full body assessment testing muscles, joints, movements and accompanying thoughts and worries. This will lead to us completing a systematic testing process to work out the primary cause of your condition, which we can then treat YAY!

Next we are at step 8 (nearly complete), it’s now time to teach you how to take care of the primary cause of your symptoms, with muscle retraining and self-treatment. We will then discuss booking you in for tune ups with increasing intervals to keep your body happy and keep you living your Barefoot Lifestyle.

If this all sounds great to you and 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.

Physiotherapy Brisbane, Barefoot Physiotherapy

Corticosteroid injections and Physiotherapy

in

Corticosteroid Injections

To get a Corticosteroid injection or not is a common question we as Physiotherapists are often asked by clients. As health professionals we always respond in a way that provides our clients with all the details and facts they need to know to help them make an informed decision.

Corticosteroid injections are essentially a very strong form of anti-inflammatory medication. They are administered by a medical practitioner and can be given into either a painful joint or muscle.

The evidence

The evidence surrounding corticosteroid injections show that they do provide some immediate pain relief, which is often a result of the local anaesthetic provided during the injection. However, it may then take the injections a few days  or weeks to start working and the effect generally wears off after a few months.  The best long term effects of Corticosteroid injections have been shown when the injection is administered in conjunction with ongoing Physiotherapy.

Injections and Physiotherapy

Corticosteroid injections can help facilitate your physiotherapy sessions by providing a reduction or elimination of the inflammation and pain in your joint and muscle. This allows Physiotherapy to progress through rehabilitation with less resistance, treating the underlying cause of your symptoms. However, our physiotherapist will often always recommend you start some anti-inflammatory oral medication if your symptoms require it as a way of calming the inflammatory process in your body and progressing treatment without the need for a corticosteroid injection.

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.

Muscle tightness

Why are my Upper Traps always tight?

in

It is a common complaint

One of the most frequent problems we see in the clinic, is people with tight shoulders. Given the prevalence of desk jobs, many consider tight shoulders just a fact of modern life. However we often find that tight upper traps are rarely the real issue and rather they are a symptom of the body being unhappy.

In particular, we find that tension in the upper traps is often present when there is neural irritation. Nerves should be able to move freely and easily through the body however they can get restricted. Nerves are quite sensitive and may get irritated by a variety of causes including tight neck joints, stress and sickness. When nerve irritation occurs, the brain switches on “protective mode” and creates a wide-ranging response, aimed at avoiding further aggravation. This protective response can include symptoms such as pain, numbness, pins and needles or weakness, as well as muscle tightness and movement restriction.

Why do they get tight?

Upper traps are one of the muscles that is often part of this protective response. Given their role in protecting the nerves, releasing them directly often won’t make lasting changes. It may give some temporary relief although sometimes it can result in an aggravation of symptoms.

So if you releasing the upper traps is not the answer, then what do you do? Treatment should be aimed at working out why the upper traps are tight and treating the underlying cause. By addressing the primary issue, the brain can then switch off (or decrease) the protective response and in turn, then upper traps should start to soften.

If you or someone you know is experiencing tight upper traps 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.