Archive for category: Physiotherapy Column

Running technique

If you ask any running coach or physio how important good technique is, you’re sure to open up a real can of worms. While there are certainly some elite athletes with unusual running technique, I believe that correct form plays a role in both injury prevention and performance enhancement.

So what does good running technique look like?

• Overall posture – typically, we’re aiming for the same optimal alignment that we’d look for in any task. That is, a neutral spine, shoulders over hips, feet under hips. The only difference in running is that we are also wanting a slight forward lean to encourage the forward momentum. This forward lean should come from the ankles
  
• Leg cycle – running stride should be driven by hip movement. The upper thigh should swing upwards to initiate the stride, with the knee and ankle following through. The foot should then hit the ground underneath the hip. If the foot lands in front this changes the running action from a “push” to a “pull” which is less efficient and a higher risk of injury.
  
• Pelvis control – to avoid wasting energy (and unnecessarily loading other structures like your lower back), we also want to see a stable pelvis in all directions. That is, there should be minimal movement of the pelvis forward to back or side to side.
  
• Foot position – the foot should stay dorsiflexed (ie toes up) throughout cycle. When the foot hits the ground, ideally it’s the middle to front of the foot that makes initial contact, not the heel
  
• Arm drive – focus should be on driving the arm back (often people think of pulling the arms up in front). Legs will copy what the arms do – so important that arm drive stays square (not across body)

Some of these technique points, like arm drive, can be easy to modify and make an immediate and noticeable improvement. However others, like pelvis stability, might be more challenging and also require strength training or consistent technical work (such as drills) to achieve lasting change. If you are interested in improving your running or making yourself more injury-proof, book in with one of our physios today.

As an expectant mother you may be experiencing various discomforts; whether this is baby number one or three your body will be constantly adapting over the course of your pregnancy. If you are experiencing  any pain or discomfort associated with pregnancy or have any questions about your changing body, you may benefit from a prenatal physiotherapy consultation. Barefoot Physiotherapy can help you address your symptoms and be as comfortable as possible throughout your pregnancy with our leading pregnancy physio services.

What to Expect at a Barefoot Prenatal Physiotherapy Appointment:

1. Your Physiotherapist will address your individual concern and determine whether Physiotherapy is your best course of treatment or if your GP or Obstetrician needs to be consulted.
2. If your pain or discomfort is musculoskeletal in nature we will then run through our Barefoot Plan; to work out the cause of your symptoms.
3. The Barefoot Plan includes testing for any nerve irritation, movement restriction, muscular tightness or joint stiffness.
4. We don’t do any internal examinations; we have thorough assessment techniques that we use. And if we deem that an internal examination is necessary, we may refer you to a trusted colleague.
5. After an assessment your Physiotherapist will develop a treatment plan; which will likely consist of a combination of hands on treatment, exercise prescription or modification and advice and education.
6. Dependent upon what trimester you are in, your session may also include a pelvic floor external assessment and if needed instruction on how to increase your strength control to prepare your body for childbirth. This could include exercises, breathing control and extra support options i.e. tummy tights.
7. At the conclusion of your appointment we will email you a summary of  your session with your home exercise program and any education to help you manage your symptoms at home, between appointments. If you have any questions or concerns between your sessions your Barefoot physiotherapist will be contactable by email or the clinic phone.

What to do next:

If this sounds like the type of Physiotherapy you are searching for please don’t hesitate to reach out. If you or someone else is experiencing  pain or discomfort associated with pregnancy we can help assess and determine your best course of treatment. Book in with Barefoot today by calling us on 1300 842 850 or using the book online link on our website.

Rheumatoid Arthritis

When considering rheumatoid arthritis physio, there are a number of different types of arthritis, but they all are characterised by inflammation of joints. The type of arthritis most people are familiar with is osteoarthritis (OA). OA can occur in one single joint or multiple joints, is typically experienced in older populations and features loss of cartilage. Past trauma may be a contributing factor, but is not always present. By comparison, rheumatoid arthritis (RA) is an autoimmune condition. Autoimmune conditions are when the body’s immune system mistakenly attacks its own tissue. In the case of rheumatoid arthritis, the lining of the joint is the target. Eventually most of the joints in the body will become affected if rheumatoid arthritis is present. While the two conditions are quite different, they can both benefit from physiotherapy.

Symptoms of rheumatoid arthritis

• Swollen, sore, warm joints
• Usually the same joints are affected on both sides of the body
• Often stiffest in the morning or after prolonged inactivity (think sitting down for a few hours)
• Typically starts in smaller joints (eg fingers and toes) and progresses to involve larger joints (eg hips, knees, shoulders)
• Fatigue
• Periods of ‘flare’ and ‘remission’ – autoimmune conditions often go through waves alternating between being more active, resulting in worse symptoms and then settling down where symptoms may be relative minor
• Over time, the bones can also be affected and result in the joints visibly changing shape

Rheumatoid Arthritis Physio & Treatment

While there is no cure for RA, there are a number of treatments that can help slow the progression of disease and also ease the symptoms. Best management of RA will involve a rheumatologist (doctor specialising in autoimmune and musculoskeletal conditions) as well as physiotherapy. Medical management largely focuses on medication – including drugs to moderate the immune system as well as anti-inflammatories. Physiotherapy can help in a variety of ways. Hands on treatment is targeted at improving range of motion and reducing pain. Exercise prescription is aimed at increasing functional capacity – this can involve a combination of gentle strength exercises and general low impact aerobic exercise such as walking or hydrotherapy. Physio is also important for education and empowering people to understand their condition so that they can self-manage. Self-empowerment is central to Barefoot’s way of treating and is particularly important for long-term conditions like RA. We can help with learning ways to adjust tasks to unload certain joints, how to self-pace exercise and when to rest.

Book in with Barefoot Physiotherapy

If you or someone you know has RA, we would love to help with their management. Book in with Barefoot today by calling us on 1300 842 850 or booking online.

We are often asked by clients “how does dry needling work?”. Dry needling is a treatment technique that can be used to improve function of a muscle or decrease pain felt in the body. Dry needling can be used to initiate an immune response and change activation of nerve fibres.  

What Is Dry Needling?

Dry needling is a practice used by allied health professionals that have been specifically trained in this technique. Dry needling is named as such to contrast with other types of “wet” needling, think injection of medicine or a tattoo needle.

Dry needling works by using a very thin, single use needle inserted into the body at specific locations depending on what the goal of treatment is. Western Dry Needling focuses on the release of muscle, ‘trigger points’ by inserting the needling directly into the targeted muscle. Eastern Dry Needling in directed by the understanding of meridian or energy lines to treat systemic issues.

The physiotherapists at Barefoot Physiotherapy primarily use western techniques though occasionally eastern techniques are used to support treatment as well.

What Does Dry Needling Do?

You may be wondering “what does dry needling do?”

Dry needling works to alter and improve our body’s capacity to move comfortably. It reduces tension in the muscle by changing the length of muscle fibres. It can decrease overall sensitivity of a muscle or body part. Dry needling can be used to decrease joint stiffness and increase joint movement. It can also be used to calm the overall nervous system of a body, decreasing the stress response that occurs on a mental and cellular level.

So, How Do Dry Needles Work?

How Does Dry Needling Work?

Dry needling works via five main effects:

• Peripheral (local) effects: initiates a local inflammatory response and release of local endorphins; increases local blood flow; causes a twitch and release response of muscle fibres via changes to calcium channels in the muscle fibres.
• Segmental (at the spinal cord) effects: pain gating where information from the needle insertion overrides other information from the area; enkephalin (endorphin) releases which acts as an internal Panadol osteo.
• Extra-segmental (at the brain) effects: releases serotonin, adrenaline and endogenous opioids to reduce pain felt in the whole body.
• Sympathetic effects: needling can stimulate the autonomic system and change sympathetic output.
• Immune effects: can support regulation of the immunoinflammatory process by release of endogenous opioids.

When to Use Dry Needling:

And when to use dry needling?

Dry needling can be used for a variety of injuries or concerns. Your physiotherapist may use this technique to help reduce swelling after an acute injury. It can reduce muscle spasm in a semi-acute flare up (e.g., back pain). We can use dry needling to assist in reducing headaches and stress. Dry needling techniques can be used to encourage tissue healing with persistent injuries such as a hamstring tendinopathy. It can be useful in reducing pain and swelling in knee osteoarthritis.

Dry needling is one of many techniques that we use at Barefoot Physiotherapy for the best management of your care. It may be used in addition to joint mobilisations, muscle self-releases and strengthening exercises.

How Does Dry Needling Help Chronic Injuries or Pain?

Dry needling for chronic injuries or pain uses a slightly different approach to dry needling for tight muscles. In chronic injuries or pain, we are wanting to have more systemic changes from our needling techniques. In this instance, we may use more gentle techniques where the needles are left inserted for a longer period of time. We may also use more traditional eastern techniques to support certain systems of the body. We can use eastern techniques with a western framework to provide a variety of stimuli to the area of focus without overwhelming the system while still changing the input to certain joints or muscles.

How Long Does Dry Needling Take to Work?

The timeframe for how long dry needling takes to work changes depending on the reason for using and the technique used. We are often asked, “how does dry needling work with different techniques?”

Pecking techniques where we seek a muscle twitch work immediately and continue with an increase local blood flow for an hour post treatment. A twitch response corresponds with immediate changes to muscle length. Sustained insertion of a dry needle can begin to make changes in as little as 1-10 minutes. Chemical reactions initiated via the insertion of the needle continue to last for up to 48 hours post treatment. You may need multiple sessions utilizing dry needling to gain the full benefit.

Is Dry Needling Painful?

We are often asked if dry needling is painful. There is often a little pinch or “mosquito bite” on the insertion of the needle. As the needle moves into the targeted area of muscle you may feel a dull ache, a slight grab or even a muscle twitch (involuntary muscle activation). The ache will usually subside after the needle has been inserted for a few minutes. Your physiotherapist will be communicating with you during this process. There is a small chance of ongoing sharpness or a zapping sensation. If this is the case the physiotherapy will alter the position of the needle. At Barefoot Physiotherapy we stay in the room with you while the needles are inserted and can adjust or answer questions at any time.

Book In with Barefoot for Dry Needling Today

Hopefully this blog has helped you gain a better understanding of dry needling and how it can be used. If you have questions about using dry needling as a component of your treatment, ask your physiotherapist. Book in with us today by calling us on 1300 842 850 or using the book online link on our website home page.