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What to do if you get injured

Knee RICE

By Michael Hall

There is no doubt that your treatment in the immediate 24 hours following an injury has the biggest impact on how long and how well it may take you to recover from an injury. Weeks and sometimes months can be saved from your recovery time if you receive optimal, acute injury management. So, if you want to achieve the best outcome, it is critical that you get this initial management right.  The following is a guide on how to get the best results.

The Bleeding Phase - Perhaps the MOST Important Phase of Healing

“The most important time in the treatment of acute soft tissue injuries is in the 24 hours immediately following injury”.1

When you injure soft tissues, the blood vessels are also often damaged. Blood then pools around the injured tissues causing swelling which stops oxygen exchange, leading to further tissue damage. This bleeding phase may last from just a couple of hours for less vascular tissues such as ligaments up to 24 hours from crush injuries (corked) to muscle.

Consequently, the most important thing that you can do at this stage is to reduce bleeding and swelling at the site of injury. The best way to do this is summarised in the letters PRICER and HARM:

Protection

Ice

Compression

Elevation

Referral

Protection

Protection of the painful or injured body part is essential to prevent re-injury. This can be best achieved through unloading or at least partially immobilizing the injured area through the use of taping, braces, slings, cam walkers and crutches. Even supporting your injured arm with the uninjured arm can work. Part of the value of using these aids is that not only will they stop you from aggravating your own injury, but they will also alert others to the fact that you are injured and therefore need to take care around you.

Rest

Following injury, you should cease activity to limit bleeding and swelling to reduce the size of the scar in injured soft tissue.2

Ice

Ice or cold treatment is used to slow cellular activity.3 It has been proven to reduce bleeding, inflammation and tissue death as well as accelerate early muscle regeneration.2,4,5 It has been our experience at Bodywise Health, that most people don’t achieve optimal results because the ice/cold pack are not cold enough.

For best results, place an ice or frozen gel pack in a damp tea towel and strap it in place with moderate compression. Check your skin every five minutes to ensure that there are no adverse reactions such as whiteness or crispiness of the skin. Remove the cold pack immediately if this occurs.

The most effective method for reducing pain immediately following an injury (ankle sprain) has been found with Intermittent ice (cold) application.6 This involves 10 minutes of ice, 10 minutes of rest and then 10 minutes of ice every two hours over the initial 24 to 48 hours.

More usually ice is applied for 20 minutes continuously every two hours for at least six hours following injury. 4,6,7

At Bodywise Health however, we have achieved faster recoveries and better results with applying ice for 15 minutes every one to two hours for two to five days or at least until the severe pain and inflammation (signs-heat, redness, swelling) have settled down.

Please note, ice should not be applied if you have impaired circulation or if you suffer from an allergy to cold. In addition, you must take care when applying ice as prolonged applications can cause ice burns and nerve damage.8

Compression

Compression not only supports injured tissue, it also reduces bleeding, swelling and scarring and aids healing by improving circulation. It should be applied during and after ice application from the time of injury for perhaps up to two to three weeks post injury. The compression bandage must be firm but comfortable and begun a hands breadth below the injury extending to a hands breath above the injury with each layer overlapping the previous layer by one half.

Elevation

Lifting (elevating) your injury above your heart is also minimizes bleeding and swelling.2 Elevating arm injuries is best achieved by using a sling or even the opposite arm. Likewise, leg injuries should be elevated above the pelvis by lying down and using a chair, pillow or bucket to raise the leg.

Referral

The greatest impact for limiting tissue damage and optimizing injury outcomes lies in the first three to five days following an injury. At Bodywise Health, we have found that the sooner we can assess and effectively treat an injury (i.e. same and / or next day), the better the repair, the faster the recovery and the better the outcome that people achieve, without exception.

In the first 72 hours after being injured, you must also avoid HARM-ful factors. These include:

Heat packs, heat rubs and hot baths (showers) as these will increase bleeding, swelling, tissue destruction and inflammation at the injured site.

Alcohol as it may mask pain, reduce muscle function and impede recovery.9

Running/moderate activity will cause further damage.

Massage/vigorous soft tissue therapy as this will also cause further swelling and bleeding.

There is no doubt that immediate, effective treatment is the best way for you to limit the financial, time, stress and opportunity cost of an injury. So if you want to save money, if you want to save time and if you want to get your life back as quickly as possible, make the most of this time. It could save you weeks and months of treatment.

If you are injured and would like to know what is the best and fastest way to get better, please call 1 300 BODYWISE (263 994) for your FREE assessment and advice.

I hope that this helps.

Kind regards,

Michael Hall

Please note:

• Rebates are available through your private insurance extras cover;

• For complex or chronic conditions, you may qualify for the EPC (Enhanced Primary Care Program) allowing you to receive 5 allied health services each calendar year with a referral from your GP.

For more information, please call Bodywise Health now on 1 300 BODYWISE (263 994).

Further information and advice can be accessed through:

  1. Sports Medicine Australia at http://sma.org.au 
  2. The Australian Pain Management Association at http://www.painmanagement.org.au
  3. The Australian Physiotherapy Association at www.physiotherapy.asn.au/DocumentsFolder/Advocacy_Position_Pain_Management_2012.pdf
  4. Arthritis Australia at http://www.arthritisaustralia.com.au
  5. The Victorian Arthritis Association at http://www.arthritisvic.org.au

References

  1. Brukner and Khan and Colleagues. Clinical Sports Medicine. McCraw Medical. 4th Edition, 2012.
  2. Jarvinen TAH, Jarvinen TLN, et al. Muscle Injuries: optimizing recovery. Best Prac Res Clinis Rheumatol 2007;21(2):317-31.
  3. Bleakley C, McDonough S, MacAuley D. The use of ice in the treatment of acute soft tissue injury. Am J Sports Med 2004;3(1)251-61.
  4. Bleakley CM, O’Connor S, Tully MA et al. The PRICE study (Protection, Rest, Ice, Elevation): design of a randomized controlled trial comparing standard versus cryokinetic ice applications in the management of acute ankle sprain(ISRCTN13903946) BMC 2005;33(5).745-64
  5. Jarvinen TAH, Jarvinen TLN, et al. Muscle Injuries biology and treatment. Am J Sports Med 2005;33(5)745-64.
  6. Bleakley C, McDonough S, MacAuley D. Crotherapy for acute ankle sprains: a randomized control study of two different icing protocols. Br J Sports Med 2006;40(8):700-5
  7. MacAuley D. Ice therapy: how good is the evidence? Int J Sports Med 2001;22(5):379-84
  8. Moeller JL, Monroe J, McKeag D. Cryotherapy-induced common peroneal nerve palsy. Clin J Sport Med 1997;7(3):212-16
  9. Suter PM, Schultz Y. The effect of exercise, alcohol or both combined on health and physical performance. Int J Obes 2008;32(S6):S48-52.
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Probably THE most important factor in reducing your mechanical pain

Posture Pain

Gravity is the enemy. Have a look around you and you will see its force. People stooped, heads forward, rounded shoulders and curved backs.

Now think about the tasks that you do every day. You sleep, you sit, you cycle, you drive, you work at a computer, you cook, you clean, you do almost everything in a bent forward position. You may even stand and walk in a slightly forward leaning position.

Is it no wonder then that if you look at people who are in pain or old, that they are stuck there?

Your posture is one of the most important factors in determining not just your physical health, but also how well you feel, how young you look and how well you are able to perform every-day tasks.

Poor posture is related to tension headaches, upper and lower back pain, shoulder pain, hip pain, knee pain, foot pain, myofascial pain, you name it. It is also associated with depression and responsible for the forward stooped appearance that we see in so many elderly people.

With such far reaching consequences, fixing your posture is one of the quickest and easiest ways of not just helping you recover from physical pain, but of avoiding and preventing it in the first place.

What is posture and in particular, what is good posture?

Posture “refers to the relative arrangement of segments of the body” (Norkin & Levangie 1983). Ideal posture may be defined as “that state of muscular and skeletal balance which protects the supporting structures of the body against injury or progressive deformity”. Under such conditions, your “muscles will function most efficiently and the optimum positions are afforded for the thoracic and abdominal organs.” (Posture Comm of Am Academy of Orthopaedic Surgeons 1947.)


Categories of Posture
As mentioned, posture may also be divided into two categories: static and dynamic posture. Static posture refers to the arrangement or alignment of the body parts whilst the body is at rest, whilst dynamic posture refers to this alignment during movement.

Static posture will therefore directly affect dynamic posture or in other words, the starting position for any movement must affect the precise alignment of the parts during that movement. By definition therefore, good static posture is a prerequisite for good dynamic posture as precise maintenance of correct alignment during movement cannot occur, if the body parts are not correctly aligned in the first place.

But why is posture important?
Posture is important because:

1. It determines the amount of stress on the different tissues and systems of the body which directly relates to the development of pain syndromes and injuries, and also,

2. It determines effectiveness and efficiency of movement and therefore the influences the performance levels of all physical tasks.

Essentially, good posture thereby minimises the abnormal or excessive stresses on the body and optimises the performance of all physical tasks.

2 Postural Patterns in Life
You have 2 postural patterns in life.Posture photo

1. A bending, turning inward pattern. Have a look at people who stoop (e.g. image on the left). The head is forward, the chest is depressed, the shoulders  are rounded, the upper back curvature is increased and hips are bent and the person looks old and stooped.

2. A straightening, turning outward and opening up of your body. In contrast with the image on the left, the person on the right is upright. They look tall. Their head is in line with their shoulders, their chest is lifted and their back has a normal S shaped curve.

Typical Faulty Postures and Related Pain Syndromes
If good posture minimizes excessive or abnormal forces, poor posture exacerbates abnormal or excessive stresses leading to many and varied physical conditions. Some of these include:

Head forward posture (ear lobe in front of shoulder)
- Headaches
- Neck pain (due to disc bulges, facet joint irritation)
- Osteoarthritis of the neck
- Vertebral artery signs such as dizziness, blurring of vision and ringing in the ears

Rounded shoulders and increased mid back curve
- Thoracic spine and rib pain
- Upper back muscle strains
- Shoulder pain
- Decreased rib expansion and therefore limited breathing

Flat back posture
- Low back pain with sitting, bending etc.

Increased low back inward curve
- Low back pain with walking, standing etc.

Turning in and Bent Hips
- Hip osteoarthritis
- Buttock pain (Gluteus Medius Tendinopathy; Trochanteric Bursitis)
- Knee pain (Knee cap pain, Knee arthritis)
- Ankle pain (sprains)
- Foot pain (Plantar Fascitis)

What is good posture and how is it assessed?
The standard way for postural alignment to be assessed is by using the plumb line test where the alignment of the body in standing is assessed in relation to a plumb line positioned above the body (Muscle Testing and Function by Kendall and Kendall).

From the side, a plumb line placed just in front of the outside ankle bone should pass through:
- ear lobe
- bodies of the cervical vertebrae
- tip of the shoulder
- divide the chest in half
- bodies of the lumbar vertebrae
- slightly behind the hip joint
- slightly in front of the knee joint
- slightly in front of the outside ankle bone (lateral malleolus)

From the front, the plumb line should divide the body into two symmetrical halves. The head, shoulders and hips should be level, and also the hip, knee and ankle joints should be equidistant from the line of gravity.

A caveat to this, is that Kendall and Kendall in Muscle Testing and Function state that it is normal for a person’s for the dominant side shoulder to be lower and for the dominant side hip to be higher. Consequently, for this to occur, a scoliosis must be present. They state that the reason for this is due to the increased muscle bulk and the asymmetry of limb usage of one side compared to the other.

Can you do anything to improve your posture?
Absolutely! First and foremost, before deciding whether any intervention is necessary let alone whether it is going to be of benefit, an accurate and comprehensive evaluation must be performed. This obviously will involve an assessment of postural alignment, but also it must take in account other factors such as the habitual postures and movements, as well as an assessment of muscle bulk, tightness and strength, joint mobility, balance and coordination.

Posture Pro – A great tool for assessing posture and bodily stress.posture-pro2
At Bodywise Health, our computerized posture assessment tool called Posture Pro not only gives you an accurate, objective measure of your posture, but it also is able to calculate the stresses on your neck, back, shoulders and legs, and whether they are abnormal or not.

It is a great predictor of whether you will suffer from an injury or pain in any of these areas. Reducing, stopping and preventing your pain often then goes hand in hand with correcting your posture.

Correcting your posture may involve more than just sitting and standing up straight
Correcting your posture and the abnormal stresses involved is a simple matter of using “hands on” techniques to loosen specific stiff joints and tight muscles, whilst using precise strengthening exercises to “shorten” lengthened, weak muscles. In effect, your muscles are used like guywires as the exercises effect is to muscle bind you back into better alignment.

Once gained, this new mobility and strength can then be incorporated with better awareness (reinforced with postural taping), to ensure that correct posture becomes a habit which is maintained over time.

Quick tips on improving your static posture
In the meantime, some quick tips for immediately improving your posture include:
1. Stand “tall”, lifting from the top of your head and from the middle of your chest;
2. Sit with a lumbar roll cushion in the small of your back and relax backward;
3. Strengthen the muscles that hold you up against gravity.

Quick tips on improving your dynamic posture
1. Learn to squat on each foot, keeping your knee over your second toe and without holding on;
2. Progress this to stepping down a step keeping your knee over your second toe;
3. Progress this to hopping, running and cycling keeping your knee over your second toe;
4. Run in a slightly bent forward position.

These posture improvement strategies will have the effect of lengthening your spine and stopping your body from “giving way” under the long term ageing effect of gravity.

Correcting your posture in this way is one of the quickest and best ways that you can permanently reduce your pain and improve your health. I hope that this helps.

Until then,

Best wishes,

Michael Hall
Director
Bodywise Health

For more information on how Bodywise Health can help you to improve your posture so that you may prevent chronic neck and back pain, please call Bodywise Health on 1 300 BODYWISE (263 994).

Please note:
• Rebates are available through your private insurance extras cover;

• For complex or chronic conditions, you may qualify for the EPC (Enhanced Primary Care Program) allowing you to receive 5 allied health services each calendar year with a referral from your GP. For more information, please call Bodywise Health now on 1 300 BODYWISE (263 994).

 

 

 

 

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How to Prevent Injury and Perform at Your Best

Running Image

I was at the Ironman Triathlon over the weekend and whilst I have great admiration for each competitor’s drive and self-discipline, I was amazed at how many people had terrible posture and poor movement patterns. Many of the cyclists had excessive curvature of their back, inadequate hip bending and their knees were turned inwards close to the bar. Many of the runners also were hunched over, with excessive turning in of their knees and turning out of their feet.

Injuries waiting to happen

In effect, all these people are just injuries waiting to happen. Why? Because the one thing that most determines if you will suffer from a physical injury is your technique. Your technique for swimming, your technique for cycling, your technique for running, walking, standing, sitting, everything.

The way to know if your pain is due to a posture or movement habit

These are the sorts of pains and physical problems that come on for no apparent reason. They just seem to appear and you can’t quite put your finger on it as to why. Any physical problem that has come on out of the “blue”, is likely to be due to a faulty posture or movement habit.

You see, it is not often what you do but how you do it that will cause you pain and problems. Poor technique doesn’t just lead to poor performance, it leads to injury as the excessive or abnormal stresses generated cause cellular irritation, inflammation, pain and tissue breakdown.

The problem for you is that many of these techniques are habits, ingrained in you from the day you were born. Most of the time you don’t even know that you are doing them.

Think about it. Many people have devices which record how many steps they take, with the target being 10,000 steps a day. How many times do you move your head, bend over, cross your legs, lean forward, sit down and stand up? Thousands upon thousands of times. And how long do you spend looking at computer screens, TV screens and smart phones? Potentially, hours upon hours.

What you may not realise is that many of the positions and movements you do each day, you do every day, in the same way, at the same speeds, in the same directions. These are called habits and you have been doing then since the day dot. They are part of your very fibre, bound up in the very way that you perceive yourself and the world around you. They are also as unique to you as your voice and fingerprints.

Poor habits = Poor health, Good habits = Good health

Now, can you imagine if you do each of these activities in a slightly “faulty” way. Perhaps you sit at a computer leaning forward, or turn your head to look at the computer screen which is off to one side. Perhaps people approach you from one side or you find yourself twisting one particular way time and time again.

If you are a gardener, builder or cyclist, it has been proven that you will finish up with a flattened lower back (Claus 1996). In other words, your body will adapt to your daily activities, much the same way that an athlete’s body will adapt to their training program. In effect, your body will reflect not just what you do, but more importantly how you do things.

Magill and associates (1992) showed that if you stretch a soft tissue (e.g. sit slouched) for 20 minutes that it takes longer than 40 minutes for full recovery. And yet, we may hold certain, “stretched” positions for hours (e.g. gardening), over-stretching tissues and never letting them recover. Is it no wonder that these tissues develop over stretch weakness that may then lead to over-stretch strain (tearing of fibres)?

Your body will follow the path of least resistance. This means that the muscles that you use more will get stronger, whilst those that you move less will get weaker.  Its the same for joints, as those that you move most will get more mobile, whilst those that you move less will get stiffer.  This reinforces and perpetuates the joint mal-alignment and muscle imbalance.  It also causes compensation to occur, often at the least desirable joint, in the least desirable direction, leading to pain and dysfunction.

“Hands- on” treatment techniques whether they be from a physiotherapist, chiropractor, osteopath, massage therapist, acupuncturist, are essential as they "loosen up" specific stiff joints and tight muscles.  However, "hands on" techniques will generally give just short term relief as they generate just short term changes in joint mobility and soft tissue tension, thereby alleviating symptoms for the time until the tissues become irritated again. Likewise, corrective exercise alone will generally give just medium term relief as while they may correct muscle imbalance, they won't correct the posture or movement which is causing the actual problem. To achieve long term, sustained relief, you must correct the posture, movement or activity which is causing the problem. 

How to fix these problems for good

To turn these problems around, the first thing you need to do is become aware. Listen to your body. How does it feel as you do or just after doing a particular activity? Does it feel abnormally tight, stiff, tender or achy? Does it grate, lock, click or give way? All these are signs that an activity may be doing you harm and are often a precursor to symptoms. These signs are to be distinguished from normal exercise muscle soreness which should last about 24 hours and indicates that your soft tissues are adapting to the exercise “stress”. Pain longer than this, probably means that you have exercised too hard and / or have sustained some sort of tissue damage.

So what is good technique?

Good technique refers to the optimal alignment and function of all the body systems, structures and tissues so that the highest level of performance is achieved and a person’s physical, psychological and spiritual health is enhanced.

5 Tips for achieving good technique

  1. Listen to and work with your body. Become aware of what feels good and what doesn’t feel good. Use mirrors or other biofeedback tools to check your form and stop the activity when you notice that your technique has become “faulty”. Make adjustments and then test to assess what works and what doesn’t work. Then keep doing what works and refine the process through practicing to improve everything that you do.
  2. Become informed by reading books, blogs and articles. Watch films that educate you in how to perform better. Attend seminars or join groups that have the same values, goals and interests.
  3. Get an assessment. You don’t know what you don’t know. In other words, you may have no idea that the way that you are doing something is potentially causing your body and health damage, let alone detracting from your performance and results.
  4. Get a coach. Whether it be by yourself or with a group, a qualified coach who is knowledgeable, competent and has a track record of results will be able to help you avoid technique and training mistakes that may lead to injury.
  5. Use equipment and training techniques that enhance your health and performance.

Your technique determines everything. Poor technique pretty much will guarantee you injury. Good technique will not only minimize your chances of suffering from an injury, but also means that you may swim better, cycle faster and run easier. So not only will you spend less time on the injury sidelines, you will have more fun doing what you love.

I hope that this helps.

Next week, I will share some quick and easy tips on how you avoid the most common injuries and / or if you are injured, how to recover faster from them.

Until then,

Best wishes,

Michael Hall

If you are concerned about your physical and nutritional health and would like to reduce or prevent pain, please call Bodywise Health on 1 300 (BODYWISE) 263 994 to book your FREE Physical or Nutritional assessment.

Please note:

Rebates are available through your private insurance extras cover;

For complex or chronic conditions, you may qualify for the EPC (Enhanced Primary Care Program) allowing you to receive 5 allied health services each calendar year with a referral from your GP. For more information, please call Bodywise Health now on 1 300 BODYWISE (263 994).

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The Real Cause of Most Pain Syndromes and How to Prevent Them

back-pain-mainBy Michael Hall, 

With health statistics on so many fronts screaming crisis, it is no wonder why so many people throw up their hands and say that it is all too hard. Key findings from the First Results 2011-12 Australian Health Survey reveal that of the national health priority areas, the top long term health conditions experienced in Australia were:

  1. Arthritis – 3.3 million people (14.8%)
  2. Mental and behavioural conditions – 3.0 million people (13.6%)
  3. Asthma – 2.3 million people (10.2%)
  4. Heart Disease – 1.0 million people (4.7%)1

The prevalence of overweight and obese people over 18 has risen from 56.3% in 1995 to 61.2% in 2007-08 to 63.4% in 2011-12. This is of grave concern as obesity is linked with inflammation as fat cells (adipocytes) release inflammatory signalling molecules (adipokines)2. The result, obese adults are five times more likely to have high triglycerides (a predisposition to cardiovascular disease), seven times more likely to have diabetes and four times more likely to display signs of liver disease than normal weight adults.

Since the mapping of the human genome, there has been increasing hope that advances in genetic treatments may offer the greatest potential to our overcoming many of these chronic illnesses and pain syndromes. And with so much publicity being focused on genetic research as being the solution to our health problems, there may be tendency to think that we are just a product of our genes and that there is nothing that we can do to avoid the illnesses or injuries that afflicted our ancestors.

Yet, studies of identical twins have revealed that though people may have identical genes, the injuries and illnesses they experience may not necessarily be the same. How can this be if people have the same genetic profile? There must be other factors and control levers at play that influence the expression of genes. Research is beginning to uncover that the expression of genetic traits is due to complex, multitude of factors one of which is not only a person’s environment but the way that they perceive and interpret their environment. This means that people can and do have the possibility of influencing their health for better or for worse.

Intimately associated with our perception of our environment is our brain and body’s relaxation or healing response or our “fight or flight” response. In an environment of safety, love, nurturing and appropriate challenge, freedom and confidence predominate, which leads to better relaxation, sleep, digestion, growth, repair and expansion of our physical, mental and spiritual capacities. It is an anabolic or building up process of our minds, bodies and life.

With the “fight or flight” response, fear is the predominant emotion, as blood is shunted away from our gut to the muscles so that we can fight or flee. In addition, our immune system is mobilised to prepare us for injury. This process is called inflammation. The purpose of the immune system is to defend the body against attack by foreign bodies (e.g. viruses or bacteria) or act like a demolition company to clear a site of damaged tissue and debris so that new tissue can be laid down. In other words, it is a catabolic or breaking down response. Whilst this response is important in the short term for survival and healing, over the long term, a hyperactive, dysfunctional immune system will wreak havoc on our ability to stay healthy as normal tissue is “attacked” and our bodies become at war with themselves.

The characteristics of inflammation are constant often throbbing pain as well as heat, redness, swelling and night pain with the classic example of an inflammatory reaction being a mosquito bite. This in effect is the basis for most pain.

The stimuli which can lead to an inflammatory reaction can be grouped into three categories, those of:

  1. Mechanical stimuli
  2. Nutritional stimuli and;
  3. Psychological stimuli.

However, all of these categories have one thing in common; the applied stimuli which leads to inflammation is either excessive or abnormal and therefore beyond the body’s physiological ability to adapt.

There are four factors which dictate whether a stimulus might be excessive. These are:

  1. The intensity of the stimulus;
  2. The number of times the stimulus is applied (or volume);
  3. The duration of the stimulus;
  4. The recovery time between stimuli.

If any one of these variables by themselves or combined present a force that is over a tipping point, then an inflammatory reaction and pain will occur. The purpose of pain is to alert us to the need to change or stop the behaviour so that we can avoid further risk of injury. Taking away the pain with a pain killer may be doing us more harm than good as it is taking away the very mechanism that protects us from further danger.

The reason most people don’t get better is not because their body can’t heal, but because they keep aggravating their “injury”. Stop them from aggravating their “injury” and generally their problem will heal and their pain will reduce. Unfortunately, this is often easier said than done particularly in a society where we are progressively becoming less in tune with our body’s needs and “masking” or band-aiding issues is promoted ahead of dealing and working through problems.

Still, whether they be physical, nutritional or psychological stressors, if you can identify what the excessive or abnormal forces are and you are able to reduce these to within normal physiological limits, then you may be able to achieve a permanent reduction in your pain. The three areas of life in which you can do this include:

Biomechanical / Physical Pain
What differentiates mechanical pain from biochemical pain, is that it is related to certain body postures, positions or movements. Change your posture, position and / or movement and you will change your pain response.  This is in contrast to biochemical pain which is often constant, throbbing and unrelated to any movement or position.

Fixing mechanical pain is often relatively easy if the postural and movement patterns which cause and alleviate pain are consistent. Once the aggravating activities are identified, then eliminating inflammation and pain is simply a matter of changing the way person moves so that they don’t irritate the damaged tissue or structures.

Mechanical pain that is inconsistent raises the prospect that biochemical irritation and perceptual issues may be playing a role. And whilst this type of mechanical pain is harder and often takes longer to alleviate, it is still possible to achieve a substantial reduction in pain by reducing inflammation and tenderness with cold therapy, using “hands on” techniques to reduce soft tissue and joint tension and then unloading the irritated tissue / structure so that it can heal.

As long as the lesion is then protected from re-injury, there is no mechanical reason why it can’t repair. There are however nutritional and psycho-social reasons why a person may not get better which brings us to….


Biochemical / Nutritional Pain
It stands to reason, that if your body is to heal and be healthy, it needs the building blocks to make the necessary tissue for healing and repair. Without the essential nutritional elements, no repair is possible. What is shocking in this day and age, is that not only are many people not getting adequate nutrients for repair, but that their diet is actually sabotaging their health and healing response.

Let me explain.

What you eat can cause inflammation and lead to inflammatory diseases that include everything from pre-mature ageing, allergies, chronic pain, osteoarthritis, diabetes, fibromyalgia to Alzheimer’s disease, cancer, osteoporosis, depression, heart disease and more2. A diet of highly processed and refined carbohydrates, that is too low in omega 3 fatty acids (optimal ratio of omega 6 to omega 3 fatty acids is 2:1 to 4:1) and anti-oxidants and contains allergens and reactive foods or toxins will lead to inflammation and eventually pain. And a diet that is deficient in nutrients can cause specific health problems such as vitamin B12 deficiency which can lead to burning neuropathic pain.

So how do you know if you have a food allergy, reactive food or poor diet that may be causing inflammation? By listening to your body and taking note of any clues that it might be giving you. How do you feel after a meal and is your body displaying any signs of nutritional deficiencies? For example, do you feel lethargic, irritated, “foggy”, tired or sleepy after a meal? Do your nails have white markings (possible zinc or B6 deficiency), horizontal ridges and grooves (possible vitamin B or protein deficiency) or yellow vertical lines (possible deficiencies of keratin, calcium, magnesium, zinc, or sulphur). And what about your tongue, hair, teeth, eyes, skin, lips, mouth, muscles and stools? All these areas of your body can display specific, easily detectable signs that indicate your diet is lacking nutrients that may be leading to poor health, inflammation and pain.

The best place to start is with an assessment, especially if you are at all worried that your diet may have deficiencies that may be affecting your health adversely either now or in the future. Remember, many diseases show up only after years of neglect and could so easily have been prevented with strategies such as having more:

  1. High quality protein (at least 0.8gms for every kilogram of a person’s body weight);
  2. Oily fish (at least 3-4 meals per week);
  3. Complex carbohydrates by substituting wholemeal bread for bread for wholegrain sourdough or white rice for brown rice;
  4. Fruit and vegetables to supply antioxidants and alkalize your body;
  5. Filtered water (at least 2 litres daily, not with a meal if you are over 40) and less coffee, alcohol or soft drinks;
  6. Taking a probiotic daily as well as other supplements as indicated to correct any nutritional deficiencies and to enable your body to begin the journey back to full health.

These are just some of the many other quick and easy diet changes that can make a massive difference to your health. For more information or for an assessment, call us here at Bodywise Health on 1300 BODYWISE (263 994) and will be deighted to assist you and provide you with any additional informationthat you may want.


Emotional / Psychological Pain
Yes, how you think and what you feel can cause inflammation and pain. As Dr Craig Hassard says in the film The Connection, “If your brain is happy, then your body is happy”.3

Whilst the link between mind-body health has been recognised for more than 50 years, the past 10 years has seen an explosion in learning and evidence that indicates just how strong this link is.

What is fascinating is that it is NOT your reality, but how you perceive and interpret your reality that determines your health.

Research by Dr Lorimer Mosely at Oxford University using mirror therapy has shown that displaying a person’s healthy, normal hand has led to a reduction in inflammatory signs and symptoms of their affected hands by chronic regional pain syndrome. And projecting normal walking legs of amputees has eliminated their phantom pain.4,5

Emotions such as fear, anger, despair and sadness have so many far reaching consequences for your health. In life, they are absolutely appropriate when matched to the appropriate situation or circumstance. They can be absolutely critical for self-preservation in enabling you to adapt and survive when challenged by real threats to your safety and health. They often operate at an instinctual and reflex level as they are under the control of a more primitive area of our brains, the amygdala.

However, these emotions are meant to be turned on and then turned off. Problems arise when they become switched on so often by situations such those involving relationship difficulties, financial pressures and time constraints, that they become prolonged and "normal".  This then leads to a heightened state of tension, a hypersensitive nervous system, a less effective digestive system and a dysfunctional immune system and eventually to inflammation and pain. An example of this is depression which has a major inflammatory component.

The good news is that these emotions and thought processes can be overridden with hard work. Research has shown that the anteromedial portion of the prefrontal cortex (at the front part of the brain that deals with episodic memory, reasoning, attention, multitasking, task sets, decision making, cognition and processing of self-referenced information) can override the more reflexive, innate thought and behavioural processes.

There are many specific psychological therapies that can help people overcome inappropriate, instinctual mental and physical responses to everyday situations. A common denominator of successful approaches in achieving long term, sustained, independent improvement, is the active involvement of a person in their treatment along with the support and empowerment of an appropriately qualified health professional (psychologist etc. registered with The Australian Association for Cognitive Behaviour Therapy), with additional support as needed (e.g. family, friends etc.). Some of these approaches include:

1. Cognitive Behavioural Therapy;
2. Stress inoculation;
3. Stress desensitisation;
4. Meditation (Mindfulness, Emptying, Transcendental);
5. Relaxation training;
6. Biofeedback;
7. Neuro-Linguistic Programming (NLP).

It is beyond the scope of this blog to go into detail with each of these therapies. Suffice to say that if you are feeling stressed, out of control, not coping and or things are affecting adversely your everyday life then seek help from your GP or a qualified psychotherapist.

Whilst these different therapies, may use different techniques, their common purpose is to:

1. Empower you to reinterpret previously perceived stressful events in a more appropriate way and;
2. Impart knowledge and skills so that you can more effectively deal with and respond to these “stressful” situations in a healthier way.

These approaches also have in common the practice of techniques that interrupt your everyday thoughts followed by the active repetition (and learning) of better and more beneficial responses. Research has indicated that it takes about 300 to 500 repetitions to learn a new habit.6 However, to unlearn, correct and then re-learn a habit has been estimated to take about 3,000 to 5,000 repetitions.7 However long it may take you to learn how to initiate your own relaxation or healing response, it has been found that the more involved, engaged and emotionally connected you are with your responses, the faster and more complete your recovery.

Please understand that everything that you think, say and do, is a habit and a result of neural and immunological programming that has occurred both innately and via experience. Recovery lies with the fact that you can learn, grow, adapt and change in response to your changing world and circumstances.

Yes, it will take hard active work to change your “unhealthy” physical, nutritional and psychological habits and replace them with healthier ones, because in effect in so doing you are changing the neural programming that goes with each habit. To change a habit takes at least a month of reinforcing a new habit to such a degree, that it becomes the default, instinctive, reflex neural pathway and habit. It requires active involvement and commitment of a person as well as outside support, education, instruction, coaching, home-work and accountability. You are much more than just the product of your genes, your parent’s history or even your perceived “story” about yourself. Each and every day is your opportunity to forge a new path for your health and your life. Good luck in your journey.

If you are concerned about your physical and nutritional health, and would like to know if you have any deficiencies which may need correction, please call Bodywise Health on 1 300 263 994 (BODYWISE) to book your FREE physical health check or nutritional assessment.

For more information on how Bodywise Health can help you to overcome your pain, please call Bodywise Health on 1 300 BODYWISE (263 994).

Please note:

  • Rebates are available through your private insurance extras cover;
  • For complex or chronic conditions, you may qualify for the EPC (Enhanced Primary Care Program) allowing you to receive 5 allied health services each calendar year with a referral from your GP. For more information, please call Bodywise Health now on 1 300 BODYWISE (263 994).

Additional References:

1. Australian Health Survey, First Results, Australia, 2011-12
2. Chadwick V. Mcphee R. Ford A. a Practical Guide to Clinical Nutrition for Allied Health Professionals. May 2014
3. Harvey S. The Connection Mind Your Body 2014
4. Moseley G. Distorted body image in complex regional pain syndrome. Neurology 65 September 2005
5. Moseley G. Effect of sensor discrimination training on cortical reorganisation and phantom limb pain. The Lancet Vol 357 June 2001
6. Schmidt, R. Motor Learning and Performance 2nd edition. Champaign, IL:Human Kinetics, 2000.
7. Chek, P. Primal Pattern Movements. A Neurodevelopmental Approach to Conditioning, 2003

 

 

 

 

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