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Starting in Yarraman

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March 14, 2010

Beautiful Yarraman (from www.yarraman.net)

 

Blue Ribbon Physiotherapy will be starting on the 9th of April at Yarraman! We will be offering a weekly physiotherapy service from Dr Carr’s surgery at 20 Miller Street Yarraman. Every Friday we are looking forward to the chance to help people in the Yarraman/Blackbutt region who have often had to travel long distances to access physiotherapy in the past.

Our fees will be subsidised in this region because of the generous support of Dr Carr providing his rooms free of charge to help get a physiotherapy service into the region. We are grateful to Dr Carr and excited about the opportunity to work in the Yarraman area.

For those not familiar with the beautiful town of Yarraman check out

www.yarraman.net

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Deep water running

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February 27, 2010

I admit to being shamelessly biased about the benefits of hydrotherapy for the treatment of a large number of conditions. And when it comes to hydrotherapy some of the best results I see are from those who do deep water running. This form of running has no impact, and can have tremendous benefit in strengthening the core muscles in particular (so important in low back pain). A number of studies have found that deep water running is just as effective as treadmill running to improve fitness, but without the load on the joints. http://www.ncbi.nlm.nih.gov/pubmed/9407747

Initially when I started my hydrotherapy training, deep water running was mainly used by athletes to either use for cross-training along with other exercise, or for keeping their fitness while rehabilitating. However I found through working at the Wesley Hydrotherapy (now closed) that it was excellent for a large number of medical conditions. These included cardiac rehabilitation patients (because of the water pressure, there is improved cardiac output in water, so the heart rate doesn’t tend to rise as quickly ie the heart pumps out more blood rather than having to go faster -very good for those who have just had a heart attack although need to be carefully supervised and medically screened). We also started using it for people who had had strokes, arthritis and for weight management. It was also very effective for lymphoedema and swelling reduction, aided by the hydrostatic pressure and the moderate-to-vigorous exercise getting the circulation going.  I had clients unable to walk 50m due to arthritic pain who could work in the pool at intensities similar to treadmill running for an hour and a half. All without as much sweating, soreness and load on the joints!

There are a number of techniques for deep water running (best determined for you by your physiotherapist -often not easy to see your own technique) I find the easiest for most people to start with that supported by either a deep water running belt, or sitting on a noodle, breastroking movement with the arms and a cycle with the legs. The spine should be straight but not too straight (around a 10 degree forward lean is usually recommended) Another style is running with alternate arms and legs, in a more traditional “running” style. This can be achieved by imagining you are dragging a piece of paper behind you with your feet pointing and your hips fully extending (very good for gluteal strengthening). Cross country skiing is the same thing except the elbows and knees stay straight throughout (propulsion is achieved via turning the hands pushing with the palm each time) This one is quite hard to master but gives some of the best resistance by creating water movement in both directions. One of my favorites is “hands up” running, which as the name implies has the hands up and just using the legs. The equivalent for the upper body is “breastroke arms” where the arms breastrokes but the legs don’t move. The legs can be either bent (easiest) or out straight in front of you (hardest)

You are really only limited by your imagination and fitness/mobility level on what you can come up with. You can run with leg or arm weights, try tethered running (where a belt is tied to the wall and you run away from it), or run without a belt or noodle at all (very hard work! You do by pushing down VERY hard like you are climbing a ladder) You can alternate your speed, do interval training, endurance work -all tailored to your individual needs.

 If you have your legs too far out behind you though you will find it hard to stay straight and you will lean forward excessively (and this is why deep water running not great idea initially for those who aren’t that confident in the water because you need to be able to get yourself up off your tummy and either swim to the side or right yourself)

Pool noodles also known as "woggles"

The cheapest way to do deep water running is to just sit on a noodle (can get from many discount stores for around $3) These are fine for most people. When you start getting better at deep water running, or if you need additional back support, the deep water running belts are best. You will sit lower in the water than you do with the noodle, and there is also more of a tendency to lean forward, so you will also work harder than if you are on the noodle.

Features of our AquaJogger running belts

Aqua Jogger deep water running belt

  • Resilient closed cell foam won’t absorb water, dries quickly, and resists chlorine damage.
  • Patented contoured design supports and strengthens the lower back.
  • Soft, flexible foam narrows at the waist for comfort and freedom of movement.
  • Easy-to-operate quick-release buckle ensures a hassle-free fit.
  • Active has a custom-woven non-elastic web belt
  • The AquaJogger design tones the abdominal muscles without doing a single sit-up due to the continual use of abdominal muscles to maintain correct posture.
  • To accomodate different body shapes, belt can be worn upside down or with the foam in front of the body.
  • Soft, durable, and comfortable

    • COST - $65 See our equipment page on how to order

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    Contour pillows for neck pain

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    February 27, 2010

    Low Profile pillow

    Pillows are a very individual thing. People often try lots of pillows before finding the right one for them. The trouble with cheaper pillows is that they are too flexible and our neck can get into all sorts of bad positions during the night as we move around.

    Contour Pillows are designed to mold your neck into a neutral (neither looking up or down) position (see the pictures and have a look at how the spine strays straight on the pillow) This can be very effective in helping neck and back pain (since the spine is very connected poor position of the neck can influence the lower back as well). And changing your pillow is a much cheaper idea than changing your mattress! It is recommended to change your pillow every 1-2 years.

    http://www.healthpress.us/4-key-benefits-of-contour-pillows/

    Low profile -With optional neck support heights of the front and back edge rolls, this “Low Profile” pillow is overall 2.5cms (1″) lower than the companion “High Profile” pillow.

    This lower contour should best suit smaller framed people who sleep on their side, or most people who sleep on their back. With your head in the contour and your neck positioned on the raised edge roll you are provided with the best therapeutic support and with the ideal posture for correct spinal alignment

    High Profile – This higher profile is best suited for medium or larger framed people who sleep on their side. (Back sleepers should be on a lower pillow). With your head in the contour and your neck positioned on the raised edge roll you are provided with the best therapeutic support and with the ideal posture for correct spinal alignment.

    NOTE -There is no guarantee that a contour pillow will improve your neck/back pain. However it is worth a try if you wake with a stiff/painful neck in particular. I have found over the years that the Denton brand works for the majority of those with neck/back pain, but as I said at the start, pillows are a very individual thing.

    Cost -$77 See our equipment page for details

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    Coming soon – Physiotherapy Equipment Sales

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    February 26, 2010

    Pic by Franklin Dattein

    In response to many enquiries about equipment sales, and the difficulty of our patients sourcing equipment themselves from Brisbane, we are pleased to announce that we will soon be selling physiotherapy equipment from our website. We plan to start with TENS machines, leg weights, theratube, and back and posture braces, as well as exercise balls. Stay tuned for more details.

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    Proudly Supporting Charlie’s Angels Horse Rescue

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    October 29, 2009

    Blue Ribbon Physiotherapy is proud to announce its support of Charlie’s Angels Horse Rescue.

    Based in south-east Queensland, Australia, Charlie’s Angels not-for-profit organisation rescues and rehomes horses that have been abused, neglected abandoned or are homeless. In particular, they strive to rescue horses from “dogger” sales (horses bound for slaughter to be either pet food or horse meat exported to the likes of Europe and Japan).

    Blue Ribbon Physiotherapy offers all financial members of Charlie’s Angels Horse Rescue a 20% discount on services. Members should present their membership card to claim your discount.

    Go to the Charlie’s Angels website to read all about the benefits of becoming a member of this worthy cause.

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    How hard should you exercise? Part 2: The Talk Test

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    June 5, 2009

    How hard should you exercise?

    It’s not as easy to answer as you think. What does ‘hard’ mean? What does ‘easy’ mean? These are all relative terms. One person might find doing twenty minutes of walking ‘hard’ while another might find climbing a mountain ‘hard’.

    In part 1 we looked at heart rates as a way of measuring how ‘hard’ you should exercise.

    Part 2 is much simpler. No maths or calculators required! It’s The Talk Test. Simply put when you finish your exercise you should still be able to talk without gasping or straining. That’s it. Simple :)

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    How hard should you exercise? Part 1: Maximum Heart Rate

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    May 14, 2009

    So you want to exercise but are unsure just how hard you should push it? There are three ways. The first of these (and possibly most talked about) is Maximum Heart Rate.

    Maximum Heart Rates (approximate) land and water

    Age      Max     80%max                  60%max

    20        200      160 (150 water)   120 (110 water)

    30        190       152 (142 water)    114 (104 water)

    40        180       144 (134 water)    108 (98 water)

    50        170       136 (126 water)    102 (92 water)

    60       160        128 (118 water)     96 (86 water)

    70       150        120 (110 water)    90 (80 water)

    80       140        112 (102 water)     84 (74 water)

    Anything over 60% Max is considered Fat Burning exercise. For Fitness work, about 75%-80% Max HR is considered optimal.

    60% MaxHR exercise – You can do this comfortably for 5-10 minutes at a time. You should feel that you are working at moderate pace (i.e. couldn’t go all day!) but not overdoing it (i.e. you can do this speed for most of your workout).

    80%MaxHR exercise – This can usually only be done comfortably for about a minute at a time (i.e. should feel tired and can’t go any more after about a minute. You shouldn’t be exhausted! You should recover from ALL exercise within a minute and still be able to carry on a conversation.

    Please Note: These are the Theoretical Maximum Values. This will vary if you are on certain medications, have a genetic condition, heart/respiratory problems etc. You should check with your doctor and/or physiotherapist to see what the desired HR for you is before attempting more vigorous exercise. It will also change with depth of pool/temperature etc.

    The Maximum HR is less is water. This is because there is:

    1. Better heat dissipation in water
    2. Reduced gravity and load on body and heart, so improved return of blood to heart
    3. Water compresses body and aids blood vessels with blood transportation
    4. Increased pressure assists oxygen absorption in water.

    There is a difference of 0-15 beats with HRs in water, so for these above maximum values you can take off about 10 for water exercise to get your water maximum (see number in brackets).

    Stay tuned for Part 2 of this article!

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    Hydrotherapy and your spine

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    April 29, 2009
    Your spine is made up of 24 vertebrae, which are separated by ‘discs’, plus the fused vertebrae of the sacrum and the coccyx. The main jobs of your spine are to protect the spinal cord (which runs down through the middle of the spine), provide support and structure to the skeletal, and to provide flexibility so that you can bend over and turn around.
    The spinal discs have a strong fibrous outer layer to give structure and support, while still allowing movement between the vertebrae, and a jelly like substance inside to absorb shock. Nerves from the spinal cord exist the spinal column at specific points.

    Sometimes, the spaces between the vertebrae (the discs) become narrower and stiffer. This can result in pain (as the nerves have less space to move in, and the jelly-like substance absorbs less shock) and stiffness (because there is less flexibility in the vertebral joints).  

    Hydrotherapy can help relieve these symptoms. As you float in the water, your ‘weightlessness’ helps to open up the spaces between your vertebrae, easing pressure on the nerves and loosening stiff joints. The warm water is also very good for improving circulation, and relaxing spasm in muscles around the spine. The water is a very effective place as well to re-train and strengthen the spinal muscles, particular the core muscles. This is often not possible to do due to load and pain out of the water.

    There hasn’t been a lot of good quality research into hydrotherapy and low back pain, but I can tell you from countless numbers of patients I have treated with low back pain that it can be very effective.

    http://www.aquatictherapist.com/index/2009/01/low-back-pain-and-aquatic-therapy-a-sweet-combination-say-researchers.html

    In my experience hydrotherapy isn’t a cure-all for low back pain but it can be a very effective starting point where land exercise is difficult to manage. Hydrotherapy can also then be used as an ongoing back management tool along with other forms of treatment. You will still need to do exercise out of the water as well.

    Contact us if you wish to investigate your spine or hydrotherapy further. We are here to help!

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    Ankle sprains

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    April 7, 2009
    Ankle joints and feet are the link between your body and the ground. If the ankle twists as the foot hits the ground, particularly during a fall, this may cause a sprain. Physiotherapists provide advice and treatment to speed up healing and restore full performance.

    What is Ankle Sprain? The ankle joint is made up of four bones. The shape of each bone helps to make the joint stable. Stability around the joint is increased by the ligaments, which are bands of strong connective tissue that prevent unwanted movement. When the ankle twists, the ligaments usually prevent the joint from moving too much. An ankle sprain occurs when one of the supporting ligaments is stretched too far or too quickly, causing the ligament’s fibres to tear and bleed into the surrounding tissues. This bleeding causes pain then swelling.

    What Should I Do After a Sprain? In the first 24 to 72 hours after injury, use the R.I.C.E. method:

    • Rest: Take it easy, but move within your limit of pain.
    • Ice: Apply ice for 15 minutes every 2 hours. This helps control pain and bleeding.
    • Compression: Firmly bandage the entire ankle, foot and lower leg. This reduces swelling.
    • Elevation: Have your ankle and leg well supported, higher than the level of your heart. This reduces bleeding and swelling. If there is still swelling and pain after 24 hours, visit your local physiotherapist or doctor.

    Your chances of a full recovery will also be helped if you avoid the H.A.R.M. factors in the first 48 hours.

    • Heat: Increases swelling and bleeding.
    • Alcohol: Increases swelling and bleeding.
    • Running or exercise: Aggravates the injury.
    • Massage: Increases swelling and bleeding.
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    Sleep Apnoea

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    March 13, 2009

    In private practice I have seen a lot of people that come in for a treatment on another area, and tell me they feel tired, lack energy and have trouble losing weight. It often turns out that they are suffering from sleep apnoea and don’t even know it! Read the following article to find out more.

    SLEEP APNOEA

    Sleep apnoea means your breathing stops while you sleep.  It’s estimated that about 5% of Australians suffer from a sleep disorder called sleep apnoea. While sleeping, the muscles of the throat relax to the point of blocking the airway above the voice box. Breathing stops, for between a few seconds and up to one minute, until the brain registers the lack of breathing (or a drop in oxygen levels) and sends a small wake-up call. The sleeper rouses slightly, typically snorts and gasps, then drifts back to sleep almost immediately. In most cases, the person suffering from sleep apnoea doesn’t even realise they are waking up. This pattern can repeat itself hundreds of times over every night, leaving the person dogged by sleepiness and fatigue.

    Degrees of severity

    The full name for this condition is obstructive sleep apnoea. Another rare form, called central sleep apnoea, is caused by a disruption to the nerve messages sent between the brain and the body. The severity of sleep apnoea depends on how often the breathing is interrupted. The following averages can be used as a guide:

    • · Normal – less than five interruptions an hour.
      · Borderline – 5 to 15 interruptions an hour.
      · Mild sleep apnoea – between 15 and 30 interruptions an hour.
      · Moderate sleep apnoea – between 30 and 50 interruptions an hour.
      · Severe sleep apnoea – over 50 interruptions an hour.

    Other symptoms of sleep apnoea

    • People with significant sleep apnoea have an increased risk of motor vehicle accident and may have an increased risk of heart attack and stroke. In the over 30s age group, the disorder is about three times more common in men than women. Some of the associated symptoms include:
      · Day time sleepiness, fatigue and tiredness
      · Waking up tired/dry throat in morning.
      · Poor concentration
      · Irritability and mood changes
      · Impotence and reduced sex drive is sometimes reported.

    Causes of sleep apnoea

    • Obesity is one of the most common causes of sleep apnoea. A loss of around five to 10 kilograms is often enough to dramatically reduce the severity of the disorder. Other contributing factors include:
      · Alcohol, especially in the evening, which relaxes the throat muscles and hampers the brain’s reaction to sleep disordered breathing.
      · Certain illnesses, like reduced thyroid hormone or the presence of a very large goitre.
      · Large tonsils.
      · Medications, such as sleeping tablets and sedatives.
      · Nasal congestion.

    Treatment options

    Treatment for sleep apnoea relies on changes to lifestyle, including losing weight and cutting down on alcohol. Any contributing medical condition, such as low production of thyroid hormone, needs to be corrected. One treatment available is a mask worn at night that keeps the back of the throat open by forcing air through the nose. This is called ‘nasal continuous positive airway pressure’. However, many people with sleep apnoea find the mask not helpful or difficult to tolerate.

    Another treatment is the use of a mouthguard which, when properly made, is effective for sleep apnoea up to 30 interruptions of breathing per hour. Mouthguards are also used in severe sleep apnoea if the person cannot tolerate the mask. They work by holding the jaw in a forced forward position.

    Where to get help

    • Your doctor
    • Sleep disorder clinic.

    Things to rememeber

    • Sleep apnoea occurs when the muscles of the throat collapse during sleep, blocking off the airway above the voice box.
    • Around one in four men over the age of 30 have some degree of sleep apnoea.
    • Treatment includes weight loss and cutting back on alcohol.
    • Presence of daytime sleepiness may distinguish simple snorers from sleep apnoea, but a sleep study will confirm either way.

    If in doubt whether you have sleep apnoea, talk to your doctor! A lot of people have sleep apnoea and don’t know it. It can literally be life-changing when properly treated!

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