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Why You Need More than a Diagnosis To Get Better

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It has been said that “Treatment without diagnosis is malpractice”.

And it is true that in todays’ practice of modern healthcare, diagnosis provides the over-riding foundation which directs both the type, amount and sequencing of treatment interventions.

Our obsession with diagnosis is evidenced by the explosion of diagnostic tests that are performed every year.

However, not only can the increase in CT and X-ray scans pose a health risk, they can be misleading. Consequently the surge in CT and MRI scans has failed to boost diagnostic rates.

And yet, even if CT, MRI and ultrasound scans did increase the accuracy of your diagnosis, this may not be enough to improve treatment outcomes.

The reason is because while x-rays and scans might tell you what the source of your problem, they do not tell you the cause. In other words, they give you the what, but not the why.

And although it is important to know which structure or tissue is the origin of your pain or problem, it is perhaps more important to know why. Because unless the cause of your ailment is corrected, your problem will always return even if you replace the injured body part.

I spoke about this phenomenon in my blog The Surprising Cause of Pain. In modern healthcare, we strive to name your diagnosis. That by putting a label on your condition, we can somehow better encapsulate, understand and manage your ailment. However, in so doing, we risk becoming blinkered to other possible sources, causes and implications of your injury.

Being given a diagnosis often gives the impression that it is just one tissue, one structure or one body part that is at fault, when in reality, it is often many tissues, structures and body parts that contribute to the cause of your physical problem.

A case in point is osteoarthritis. Osteoarthritis refers to inflammation and the subsequent breakdown of the surface covering of the bone ends at joints. What perhaps is not so well known is that along with this, the underlying bone begins to breakdown.

Bony projections (called osteophytes) form at the joint margins.

The membrane lining the inner part of the joint (synovial membrane) becomes inflamed and swollen causing excessive fluid to be secreted.

Joints become red and swollen.

The capsule and ligaments that hold joints together may become lax.

Muscles either spasm or become flaccid causing muscle imbalance and joint mal-alignment.

Nerves become hypersensitive and restricted.

Connective tissue (fascia) becomes taut and fibrotic.

Blood flow may be compromised.

The surrounding environment may become acidic.

Even your brain can become stressed, sensitized, reactive and magnifier of your pain.

And so the cycle of chronic pain begins and is perpetuated.

And this is not even to mention the incorrect motion in other parts of the body which may have led to the abnormal or excessive forces that caused the osteoarthritis in the first place.

The same goes for any injury whether it be a muscle strain, a joint sprain, disc injury, tendinopathy, bursitis or other condition.

I had a classic case of this a couple of weeks ago. Ann was suffering with intense inside right knee pain that came on “for no apparent reason” a couple of weeks before. So painful was Ann’s knee that I had to see her at home because she was unable to put weight on her right leg to walk.

Ann reported that she had had an MRI which revealed a burst Baker’s cyst (fluid filled sack behind the knee). This finding didn’t match Ann’s knee pain as a burst cyst would generally lead to pain, tightness and swelling behind the knee and Ann’s pain was on the inside just below the knee joint.

On examination, Ann’s right knee was indeed red, swollen and exquisitely tender on the inside of the knee just below the joint line. This corresponded to a different inflamed bursa (fluid filled sack called the Pes Anserine Bursa).

After applying cold packs and teaching Ann how to use crutches so that she didn’t weight bear on her right leg, Ann left to have another MRI for confirmation. This MRI revealed that she had a torn inside cartilage and this was the diagnosis that was given to Ann as a cause of her pain.

So Ann then underwent an arthroscope to “repair” this inside cartilage. To my surprise however, Ann returned to me two weeks later. Despite having an arthroscope, Ann’s pain hadn’t changed. In effect, the arthroscope may have corrected a condition, but this condition wasn’t the source of Ann’s pain.

On retrospect, I shouldn’t have been surprised, as again the MRI didn’t match Ann’s signs and symptoms; that of redness, swelling and intense pain just below the joint line on the inside of Ann’s knee over the area of this bursa.

Furthermore, on close questioning, it became clear that Ann’s knee pain was being caused by the way that she was sitting. So Ann was put on intense program to treat the inflamed joint tissues (synovium), fascia (connective tissue) nerves, muscles and bone surfaces. Ann was also shown how to sit and walk without aggravating her knee.

Two weeks later Ann left for overseas with minimal pain.

For the best, fastest, most complete recovery, it is essential that all the implications, complications and contributions to your ailment are adequately addressed, treated and resolved.

This is referred to as the Bio-Psycho-Social Model of Healthcare. It refers to the fact that the best outcomes will be achieved only when all the Biological, Psychological and Social factors have been taken into account and solved.

For optimal healing and recovery you must treat the muscle, the joint, the connective tissue and the nervous system.

You must correct the biomechanics, posture and movement patterns.

You must optimise the psychological and social environment to enhance recovery.

Yes, a diagnosis is important. But even more important is that the “diagnosis” given from an investigation such as an x-ray or scan is confirmed by a comprehensive assessment and professional clinical examination.

It is then critical, that all the information gained is used to devise a treatment strategy or Recovery Action Plan that treats and corrects both the source and cause of your problem.

This is the only way to achieve the best, fastest, most complete recovery possible.

If you would like any help with any aspect of Getting Better, Staying Better and Living Better, please don’t hesitate to call us here at Bodywise Health on 1 300 BODYWISE (263 994).

We would love to help you get back to living freely and without pain.

Wishing you the best of health and life.

Michael Hall
Physiotherapist
Director, Bodywise Health


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).

References available on request

Read more...

Arthritis Latest Research Gives You New Hope

Interview 008
 
 
If you suffer from Osteoarthritis or Rheumatoid Arthritis, recent research offers you new hope. 
 
New research published in the Journal Pain Practice, August 2017 indicates that it is inflammation and especially neuro-inflammation (inflammation of the nerves) rather than degeneration that is the cause of arthritis, especially osteoarthritis.
 
Inflammation is an immune response critical for healing. During this process, white blood cells are activated to break down and ingest damaged cells, thereby clearing the area for the laying down of new tissue.
 
The problem is that constant, long term irritation (greater than 6 weeks) from external forces (e.g. excessive physical loading) and internal forces (e.g. chemical / nutritional and psychological / stress / depression) can cause over-stimulation of your immune system so that it begins to breakdown undamaged or healing tissue, thereby impeding healing.
 
Nerves are like the communication and power lines in our body. They serve to give feedback to the brain (and spinal cord) as to what is happening from both inside and outside the body and then they provide the conduit for impulses to the body’s tissues (e.g. muscles) so that the body can respond.
 
Like power lines, they need to be able to mobile and to move as your body moves so that they don’t get tugged, caught or pressed on. If they do, then the result will be adverse reactions such as pain, pins and needles, numbness and even loss of power.
 
Nerves in particular can have a magnifying effect on the pain experienced with inflammation. Not only do they become over-sensitive to stimuli, they also become restricted in their mobility. This leads to nerve tension, irritability, soft tissue tension (e.g. connective tissue, muscle), joint restriction and stiffness and faulty postures and movement patterns, further perpetuating the problem.
 
Not only that, but your brain which initially acts as a receiver of pain then after about six weeks can become a transmitter of pain beginning and perpetuating the cycle of chronic pain.
 
However, what this new research means for you is that if you can reduce the inflammatory process, you may be able to limit and perhaps even turn around this destructive process.
 
How do you do that? Here are some tips.
  1. If your pain is consistently from certain physical postures, positions, movements or activities you need to:
  2. Avoid or at least change the way that you perform these behaviours so that they become non painful.
  3. Unload the structure which is hurting with tape, bracing, sling, crutches etc. to the point that stress has been alleviated.
  4. Apply a cold pack for 10-20 minutes (check the skin every 5 minutes for adverse skin reactions) and repeat at least 6 times a day for 3- 5 days. The emphasis on cold packs is especially important towards the end of the day.
  5. Depending on the severity and the irritability of the tissue (how much stimulus causing how much pain for how long it lasts), dictates how much movements is possible. The key is to keep movement pain-free, easy and not stressful for at least 1-2 weeks to remove inflammatory chemicals and aid healing.
  6. Specific neural mobility techniques and exercises may have a profound effect on increasing nerve mobility and reducing nerve irritability and inflammation.
 
Nutritionally you need to:          
  1. Eat complex carbohydrates and low GI foods. Reduce you intake of simple, refined carbohydrates such as anything with white flour and white sugar. Refined carbohydrates cause the hormone insulin to spike which causes inflammation.
  2. Reduce Omega 6 fatty acids such as animal fats as these are pro-inflammatory and increase Omega 3 fatty acids (oily fish, flaxseed 3 to 4 times each week) as these are anti-inflammatory. The ideal ratio is 4-2:1. The current western diet is about 20:1
  3. Avoid trans-fats that contain hydrogenated oils such as many fried foods, pastries, cakes, biscuits and margarine. These are inflammatory.
  4. Reduce the intake of your food which creates an acidic environment inside your body by reducing your intake of sugar, red meat and animal products, alcohol, coffee, soft drinks) and increasing your intake of vegetables (especially green) and filtered water (2 litres per day).
  5. Avoid any food which gives an inflammatory or allergic reaction. How do you know? Listen to your body. Any time you feel lethargic, irritated, “foggy”, tired or sleepy after a meal? Do your nails tongue, hair, teeth, eyes, skin, lips, mouth, muscles and stools have any adverse changes?
  6. Eat high quality protein (>0.8 gms/kg per day).
  7. To reduce inflammation and improve healing take a daily pro-biotic and fish oil 6-9 gms/day, 1 ½ teaspoons or 8 capsules or 1 quality krill oil capsule.
  8. For natural pain relief take quercetin 600-1000mg/day Rutin, Bromelin, Curcumin.
 
Psychologically you need to:
Better manage stress so that you have a sense of control, of being in the moment, are sleeping well and are well connected with other people. 
 
It is beyond the scope of this blog to go into detail with management strategies. 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 arthritis can be painful and debilitating, this new research offers you hope. 
 
In particular, the concept of reducing nerve inflammation through nerve mobility techniques may provide a powerful treatment to restoring joint health.
 
If you are having or have had treatment for arthritis, ask your health professional to assess and treat your nerve mobility. It may just be the key to getting you better.
 
If you would like any help with any aspect of Getting Better, Staying Better and Living Better, please don’t hesitate to call us here at Bodywise Health on 1 300 BODYWISE (263 994). 
 
We would love to help you get back to living freely and without pain.
 
Wishing you the best of health and life.
 
Michael Hall
Director, Physiotherapist
Bodywise Health
 
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).
 
References available on request

 

 

Arthritis Latest Research Gives You New Hope

 

If you suffer from Osteoarthritis or Rheumatoid Arthritis, recent research offers you new hope. 

 

New research published in the Journal Pain Practice, August 2017 indicates that it is inflammation and especially neuro-inflammation (inflammation of the nerves) rather than degeneration that is the cause of arthritis, especially osteoarthritis.

 

Inflammation is an immune response critical for healing. During this process, white blood cells are activated to break down and ingest damaged cells, thereby clearing the area for the laying down of new tissue.

 

The problem is that constant, long term irritation (greater than 6 weeks) from external forces (e.g. excessive physical loading) and internal forces (e.g. chemical / nutritional and psychological / stress / depression) can cause over-stimulation of your immune system so that it begins to breakdown undamaged or healing tissue, thereby impeding healing.

 

Nerves are like the communication and power lines in our body. They serve to give feedback to the brain (and spinal cord) as to what is happening from both inside and outside the body and then they provide the conduit for impulses to the body’s tissues (e.g. muscles) so that the body can respond.

 

Like power lines, they need to be able to mobile and to move as your body moves so that they don’t get tugged, caught or pressed on. If they do, then the result will be adverse reactions such as pain, pins and needles, numbness and even loss of power.

 

Nerves in particular can have a magnifying effect on the pain experienced with inflammation. Not only do they become over-sensitive to stimuli, they also become restricted in their mobility. This leads to nerve tension, irritability, soft tissue tension (e.g. connective tissue, muscle), joint restriction and stiffness and faulty postures and movement patterns, further perpetuating the problem.

 

Not only that, but your brain which initially acts as a receiver of pain then after about six weeks can become a transmitter of pain beginning and perpetuating the cycle of chronic pain.

 

However, what this new research means for you is that if you can reduce the inflammatory process, you may be able to limit and perhaps even turn around this destructive process.

 

How do you do that? Here are some tips.

 

If your pain is consistently from certain physical postures, positions, movements or activities you need to:

1.     Avoid or at least change the way that you perform these behaviours so that they become non painful.

2.      Unload the structure which is hurting with tape, bracing, sling, crutches etc. to the point that stress has been alleviated.

3.     Apply a cold pack for 10-20 minutes (check the skin every 5 minutes for adverse skin reactions) and repeat at least 6 times a day for 3- 5 days. The emphasis on cold packs is especially important towards the end of the day.

4.      Depending on the severity and the irritability of the tissue (how much stimulus causing how much pain for how long it lasts), dictates how much movements is possible. The key is to keep movement pain-free, easy and not stressful for at least 1-2 weeks to remove inflammatory chemicals and aid healing.

5.     Specific neural mobility techniques and exercises may have a profound effect on increasing nerve mobility and reducing nerve irritability and inflammation.

 

Nutritionally you need to:          

1.     Eat complex carbohydrates and low GI foods. Reduce you intake of simple, refined carbohydrates such as anything with white flour and white sugar. Refined carbohydrates cause the hormone insulin to spike which causes inflammation.

2.     Reduce Omega 6 fatty acids such as animal fats as these are pro-inflammatory and increase Omega 3 fatty acids (oily fish, flaxseed 3 to 4 times each week) as these are anti-inflammatory. The ideal ratio is 4-2:1. The current western diet is about 20:1

3.     Avoid trans-fats that contain hydrogenated oils such as many fried foods, pastries, cakes, biscuits and margarine. These are inflammatory.

4.     Reduce the intake of your food which creates an acidic environment inside your body by reducing your intake of sugar, red meat and animal products, alcohol, coffee, soft drinks) and increasing your intake of vegetables (especially green) and filtered water (2 litres per day).

5.     Avoid any food which gives an inflammatory or allergic reaction. How do you know? Listen to your body. Any time you feel lethargic, irritated, “foggy”, tired or sleepy after a meal? Do your nails tongue, hair, teeth, eyes, skin, lips, mouth, muscles and stools have any adverse changes?

6.     Eat high quality protein (>0.8 gms/kg per day).

7.     To reduce inflammation and improve healing take a daily pro-biotic and fish oil 6-9 gms/day, 1 ½ teaspoons or 8 capsules or 1 quality krill oil capsule.

8.     For natural pain relief take quercetin 600-1000mg/day Rutin, Bromelin, Curcumin.

 

Psychologically you need to:

Better manage stress so that you have a sense of control, of being in the moment, are sleeping well and are well connected with other people. 

 

It is beyond the scope of this blog to go into detail with management strategies. 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 arthritis can be painful and debilitating, this new research offers you hope. 

 

In particular, the concept of reducing nerve inflammation through nerve mobility techniques may provide a powerful treatment to restoring joint health.

 

If you are having or have had treatment for arthritis, ask your health professional to assess and treat your nerve mobility. It may just be the key to getting you better.

 

If you would like any help with any aspect of Getting Better, Staying Better and Living Better, please don’t hesitate to call us here at Bodywise Health on 1 300 BODYWISE (263 994). 

 

We would love to help you get back to living freely and without pain.

 

Wishing you the best of health and life.

 

Michael Hall

Director, Physiotherapist

Bodywise Health

 

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).

 

References available on requestArthritis Latest Research Gives You New Hope

 

If you suffer from Osteoarthritis or Rheumatoid Arthritis, recent research offers you new hope. 

 

New research published in the Journal Pain Practice, August 2017 indicates that it is inflammation and especially neuro-inflammation (inflammation of the nerves) rather than degeneration that is the cause of arthritis, especially osteoarthritis.

 

Inflammation is an immune response critical for healing. During this process, white blood cells are activated to break down and ingest damaged cells, thereby clearing the area for the laying down of new tissue.

 

The problem is that constant, long term irritation (greater than 6 weeks) from external forces (e.g. excessive physical loading) and internal forces (e.g. chemical / nutritional and psychological / stress / depression) can cause over-stimulation of your immune system so that it begins to breakdown undamaged or healing tissue, thereby impeding healing.

 

Nerves are like the communication and power lines in our body. They serve to give feedback to the brain (and spinal cord) as to what is happening from both inside and outside the body and then they provide the conduit for impulses to the body’s tissues (e.g. muscles) so that the body can respond.

 

Like power lines, they need to be able to mobile and to move as your body moves so that they don’t get tugged, caught or pressed on. If they do, then the result will be adverse reactions such as pain, pins and needles, numbness and even loss of power.

 

Nerves in particular can have a magnifying effect on the pain experienced with inflammation. Not only do they become over-sensitive to stimuli, they also become restricted in their mobility. This leads to nerve tension, irritability, soft tissue tension (e.g. connective tissue, muscle), joint restriction and stiffness and faulty postures and movement patterns, further perpetuating the problem.

 

Not only that, but your brain which initially acts as a receiver of pain then after about six weeks can become a transmitter of pain beginning and perpetuating the cycle of chronic pain.

 

However, what this new research means for you is that if you can reduce the inflammatory process, you may be able to limit and perhaps even turn around this destructive process.

 

How do you do that? Here are some tips.

 

If your pain is consistently from certain physical postures, positions, movements or activities you need to:

1.     Avoid or at least change the way that you perform these behaviours so that they become non painful.

2.      Unload the structure which is hurting with tape, bracing, sling, crutches etc. to the point that stress has been alleviated.

3.     Apply a cold pack for 10-20 minutes (check the skin every 5 minutes for adverse skin reactions) and repeat at least 6 times a day for 3- 5 days. The emphasis on cold packs is especially important towards the end of the day.

4.      Depending on the severity and the irritability of the tissue (how much stimulus causing how much pain for how long it lasts), dictates how much movements is possible. The key is to keep movement pain-free, easy and not stressful for at least 1-2 weeks to remove inflammatory chemicals and aid healing.

5.     Specific neural mobility techniques and exercises may have a profound effect on increasing nerve mobility and reducing nerve irritability and inflammation.

 

Nutritionally you need to:          

1.     Eat complex carbohydrates and low GI foods. Reduce you intake of simple, refined carbohydrates such as anything with white flour and white sugar. Refined carbohydrates cause the hormone insulin to spike which causes inflammation.

2.     Reduce Omega 6 fatty acids such as animal fats as these are pro-inflammatory and increase Omega 3 fatty acids (oily fish, flaxseed 3 to 4 times each week) as these are anti-inflammatory. The ideal ratio is 4-2:1. The current western diet is about 20:1

3.     Avoid trans-fats that contain hydrogenated oils such as many fried foods, pastries, cakes, biscuits and margarine. These are inflammatory.

4.     Reduce the intake of your food which creates an acidic environment inside your body by reducing your intake of sugar, red meat and animal products, alcohol, coffee, soft drinks) and increasing your intake of vegetables (especially green) and filtered water (2 litres per day).

5.     Avoid any food which gives an inflammatory or allergic reaction. How do you know? Listen to your body. Any time you feel lethargic, irritated, “foggy”, tired or sleepy after a meal? Do your nails tongue, hair, teeth, eyes, skin, lips, mouth, muscles and stools have any adverse changes?

6.     Eat high quality protein (>0.8 gms/kg per day).

7.     To reduce inflammation and improve healing take a daily pro-biotic and fish oil 6-9 gms/day, 1 ½ teaspoons or 8 capsules or 1 quality krill oil capsule.

8.     For natural pain relief take quercetin 600-1000mg/day Rutin, Bromelin, Curcumin.

 

Psychologically you need to:

Better manage stress so that you have a sense of control, of being in the moment, are sleeping well and are well connected with other people. 

 

It is beyond the scope of this blog to go into detail with management strategies. 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 arthritis can be painful and debilitating, this new research offers you hope. 

 

In particular, the concept of reducing nerve inflammation through nerve mobility techniques may provide a powerful treatment to restoring joint health.

 

If you are having or have had treatment for arthritis, ask your health professional to assess and treat your nerve mobility. It may just be the key to getting you better.

 

If you would like any help with any aspect of Getting Better, Staying Better and Living Better, please don’t hesitate to call us here at Bodywise Health on 1 300 BODYWISE (263 994). 

 

We would love to help you get back to living freely and without pain.

 

Wishing you the best of health and life.

 

Michael Hall

Director, Physiotherapist

Bodywise Health

 

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).

 

References available on requestArthritis Latest Research Gives You New Hope

 

If you suffer from Osteoarthritis or Rheumatoid Arthritis, recent research offers you new hope. 

 

New research published in the Journal Pain Practice, August 2017 indicates that it is inflammation and especially neuro-inflammation (inflammation of the nerves) rather than degeneration that is the cause of arthritis, especially osteoarthritis.

 

Inflammation is an immune response critical for healing. During this process, white blood cells are activated to break down and ingest damaged cells, thereby clearing the area for the laying down of new tissue.

 

The problem is that constant, long term irritation (greater than 6 weeks) from external forces (e.g. excessive physical loading) and internal forces (e.g. chemical / nutritional and psychological / stress / depression) can cause over-stimulation of your immune system so that it begins to breakdown undamaged or healing tissue, thereby impeding healing.

 

Nerves are like the communication and power lines in our body. They serve to give feedback to the brain (and spinal cord) as to what is happening from both inside and outside the body and then they provide the conduit for impulses to the body’s tissues (e.g. muscles) so that the body can respond.

 

Like power lines, they need to be able to mobile and to move as your body moves so that they don’t get tugged, caught or pressed on. If they do, then the result will be adverse reactions such as pain, pins and needles, numbness and even loss of power.

 

Nerves in particular can have a magnifying effect on the pain experienced with inflammation. Not only do they become over-sensitive to stimuli, they also become restricted in their mobility. This leads to nerve tension, irritability, soft tissue tension (e.g. connective tissue, muscle), joint restriction and stiffness and faulty postures and movement patterns, further perpetuating the problem.

 

Not only that, but your brain which initially acts as a receiver of pain then after about six weeks can become a transmitter of pain beginning and perpetuating the cycle of chronic pain.

 

However, what this new research means for you is that if you can reduce the inflammatory process, you may be able to limit and perhaps even turn around this destructive process.

 

How do you do that? Here are some tips.

 

If your pain is consistently from certain physical postures, positions, movements or activities you need to:

1.     Avoid or at least change the way that you perform these behaviours so that they become non painful.

2.      Unload the structure which is hurting with tape, bracing, sling, crutches etc. to the point that stress has been alleviated.

3.     Apply a cold pack for 10-20 minutes (check the skin every 5 minutes for adverse skin reactions) and repeat at least 6 times a day for 3- 5 days. The emphasis on cold packs is especially important towards the end of the day.

4.      Depending on the severity and the irritability of the tissue (how much stimulus causing how much pain for how long it lasts), dictates how much movements is possible. The key is to keep movement pain-free, easy and not stressful for at least 1-2 weeks to remove inflammatory chemicals and aid healing.

5.     Specific neural mobility techniques and exercises may have a profound effect on increasing nerve mobility and reducing nerve irritability and inflammation.

 

Nutritionally you need to:          

1.     Eat complex carbohydrates and low GI foods. Reduce you intake of simple, refined carbohydrates such as anything with white flour and white sugar. Refined carbohydrates cause the hormone insulin to spike which causes inflammation.

2.     Reduce Omega 6 fatty acids such as animal fats as these are pro-inflammatory and increase Omega 3 fatty acids (oily fish, flaxseed 3 to 4 times each week) as these are anti-inflammatory. The ideal ratio is 4-2:1. The current western diet is about 20:1

3.     Avoid trans-fats that contain hydrogenated oils such as many fried foods, pastries, cakes, biscuits and margarine. These are inflammatory.

4.     Reduce the intake of your food which creates an acidic environment inside your body by reducing your intake of sugar, red meat and animal products, alcohol, coffee, soft drinks) and increasing your intake of vegetables (especially green) and filtered water (2 litres per day).

5.     Avoid any food which gives an inflammatory or allergic reaction. How do you know? Listen to your body. Any time you feel lethargic, irritated, “foggy”, tired or sleepy after a meal? Do your nails tongue, hair, teeth, eyes, skin, lips, mouth, muscles and stools have any adverse changes?

6.     Eat high quality protein (>0.8 gms/kg per day).

7.     To reduce inflammation and improve healing take a daily pro-biotic and fish oil 6-9 gms/day, 1 ½ teaspoons or 8 capsules or 1 quality krill oil capsule.

8.     For natural pain relief take quercetin 600-1000mg/day Rutin, Bromelin, Curcumin.

 

Psychologically you need to:

Better manage stress so that you have a sense of control, of being in the moment, are sleeping well and are well connected with other people. 

 

It is beyond the scope of this blog to go into detail with management strategies. 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 arthritis can be painful and debilitating, this new research offers you hope. 

 

In particular, the concept of reducing nerve inflammation through nerve mobility techniques may provide a powerful treatment to restoring joint health.

 

If you are having or have had treatment for arthritis, ask your health professional to assess and treat your nerve mobility. It may just be the key to getting you better.

 

If you would like any help with any aspect of Getting Better, Staying Better and Living Better, please don’t hesitate to call us here at Bodywise Health on 1 300 BODYWISE (263 994). 

 

We would love to help you get back to living freely and without pain.

 

Wishing you the best of health and life.

 

Michael Hall

Director, Physiotherapist

Bodywise Health

 

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).

 

References available on request

 
 
Bodywise Health
364 Hampton St
Hampton, Victoria, Australia, 3188
 
Read more...

The Surprising Cause of Pain

low-back-pain

When treating physical pain, there is one question that is rarely asked and even more rarely answered. Why? Why have I got back pain? Why have got neck pain? Why have I got knee pain? Even if a diagnosis is made and it is known to be the source of pain, no one ever asks “Why is my disc painful?” Why is my tendon painful? Why do I have arthritis?

Every day people tell me that they have been told that they have an injured tissue or structure and that they need to have medication, a cortisone injection, denervation, surgery or other passive technique in the hope that these interventions will solve your problem.

But unless you know why these tissues and structures have become painful, then your chances on getting permanent pain relief are at best remote. It is like putting a band-aide over a cut and then you keep cutting the area. You have simply “masked” the pain for a short time. Once the “effects” of the intervention have worn off, the structures will become painful again as you keep aggravating the damage or irritated tissue.

This point was born out in a research article titled “Effects of manual therapy and exercises targeting the hips in patients with low back pain” that was published in the Journal of Evaluation in Clinical Practice, January 2017.

This article indicates that low back pain and hip pain are becoming increasing associated and that together they cause greater pain at each site than if the back pain or hip pain existed in isolation. As yet, it hasn’t been determined which causes which. In other words, does low back pain cause hip pain or hip pain cause lower back pain.

But perhaps more importantly, what has been found is that treating and freeing up the hip has resulted in reduced lower back pain.

The bigger issue that this raises is the concept of regional interdependence. This means that even seemingly unrelated parts of your body can cause pain and injury in other parts of your body.

As physios, we know that stiffness of your ankles, knees and hips as well as tightness and weakness of your leg muscles can cause back injuries such as disc bulges, arthritis and stenosis. Why? Because stiffness in your leg joints will cause you to twist in your back every time you squat, get out into/out of the car or on/off a low chair.

Likewise, weakness in your leg muscles will mean that instead of squatting, you will bend at your back every time you need to reach low or pick something off the floor. This is not to say that you shouldn’t bend at you back. It is to say that you shouldn’t bend so much and that bending at your back hundreds if not thousands of times a day because you can’t squat will eventually lead to a back problem.

The more that these incorrect movement patterns become practiced, the more that they become habits leading to muscle imbalances, joint mal-alignment, joint irritation, stiffness and eventually more pain.

A quick scan test to see if your legs might be contributing to your back pain is a Squat Test. Stand with your feet pointing directly forwards, hip width apart. You should be able to squat all the way down to your heels and not allow your feet to turn outwards. If you can’t then this test is indicating that your leg joints are either stiff or your leg muscles are weak. This means that every time you get in / out of a car, or on / off a seat, you are likely to be compensating at your back.

Other commonly associated areas of your body that can cause pain include excessive turning in of your hips causing knee and foot pain, a stiff mid-back and weakness in your leg muscles can causing elbow and shoulder pain or poor hearing and vision leading to neck pain.

This is because one area of your body will try and compensate for other areas of your body that may not be doing their job optimally and it is these areas of compensation which so often become painful as they are trying to perform functions that they are not designed to do.

Another way of beginning to understand what the cause of your pain is, is to identify what you are doing or what have you just done when your pain comes on.

Are you sitting, getting out of the car, gardening or putting on shoes and socks, in which case it maybe bending and / or the way that you are performing these activities which are likely to be the cause of your pain. Or are you walking, in which case it may be arching your back or something to do with placing weight on your legs that may be the cause of your pain.

Then we get to be detective. What is it about these activities and the interactions of your body which is causing your pain? Are your calves so tight that they pull you backwards as you stand, causing you to bend slightly forwards to compensate and it is this constant slight bend forwards that then causes a disc bulge which leads to your lower back pain?

What’s even more frustrating is that these faulty ways of “being” have become such ingrained habits that you may have no idea that they are doing you harm until it’s too late and you are injured and in pain.

Many people will say that their parents had the same problem or that they were born this way. And it is true that you may have unique physical structural characteristics that may cause problems. One long leg, excessively arched or flat feet, twisted, bowed or knock kneed knees, turned in or out legs, an excessively curved or flat back, tall pelvis, a wide pelvis and / or wide shoulders, pigeon chest and so on, all have particular physical effects that can lead to pain and loss of function. Some might need a structural solution such as orthotics, bracing or worse-case scenario, surgery.

The way that you then perform your daily activities will often make the effect of these “variations” worse. This is because it takes awareness, discipline and perseverance to correct the detrimental effects of these physical forces on your body.

As your body follows the path of least resistance, it is so much easier to “go with” these forces than to oppose them. This means that not only will any negative effects be perpetuated, they will worsen over time making a chance of complete recovery more and more remote.

However many times, even these physical variations and incorrect movement patterns can be adequately addressed with “hands on” treatment, movement correction and physical training.

“Hands on” treatment by itself however, is not intense enough to create any sort of lasting improvement as it causes just a short term change in soft tissue tension levels and joint mobility.

In addition, exercise training by itself is also inadequate, because it is not specific enough to create change or increased mobility at the specific areas which have become stiff.

And finally, posture and movement retraining by itself is also inadequate because joints may be too stiff or unstable and muscles may lack the strength, endurance, co-ordination and control for ideal postures and movement patterns to be adopted in the first place.

To achieve permanent pain relief and sustained improvement in your ability to live pain-free and without limitation, requires a program of “hands on” techniques, corrective rehabilitative exercise and optimal posture / movement pattern retraining.

And yet, this program will also be adequate, if it is not intense enough to change the excessive or abnormal mechanics and the postural movement habits that have created them, permanently.

Treatment / training once a week is simply not going to be intense enough. There are at least 167 other hours during the week, when all the benefits from treatment can be undone.

It takes at least 4 weeks for your muscles to get stronger and at least 3 to 6 weeks for you to develop new, correct posture and movement habits. treatment / training must therefore be at least 2 to 3 times a week for at least 4 to 6 weeks to get a result. But the beauty of this approach, is that once you have achieved an improvement, it is more likely to be permanent.

Not only does this mean that you will prevent further flare-ups and the possibility of re-injury, you will actually perform every day movements better, with more freedom, strength, control and confidence as well as with less fatigue.

Even better, you will have increased your capacity for living, giving you a reserve capacity that will enable you to perform unfamiliar activities or to keep going safely when physically challenged.

Whilst this approach does take more effort, time and work than passive approaches, the benefits of being set free to live without limitation and without the need for medications, injections or surgery are worth it.

Until next time, Stay Bodywise,

Michael Hall
Physiotherapist
Director Bodywise Health

Reference:
Bade M, Cobo-Estevez M, Neeley D et al. Effects of Manual Therapy and Exercise Targeting the Hips in Patients with Low-Back Pain – A Randomized Controlled Trial; Journal of Evaluation in Clinical Practice 2017; 23(4): 734-740. doi: 10.1111/jep.12705. Epub 2017 Jan 27.

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How To Make Your New's Resolution Stick

 

 Pilates 1 02



Ah yes, January 3 and probably most people have already failed in their New Year's Resolutions. If your one of them, don't be disheartened. You are working against the forces of neuro-anatomy, neuro-physiology, neuro-psychology, physical forces and both overt and covert social pressure.

There is no doubt that as we start the New Year, many of you have the best intentions to make this year better than the last. To lose weight, get fitter, become more organised, be more effective and enrichen your relationships, might be just some of your hopes for this year.

And yet, even with the best of intentions, you need to know is that will-power by itself often won't work. Why? Because for however many years that you have been alive, you have been reinforcing nerve pathways in your brain, physical and physiological adaptations in your body as well as social and environmental constructs that will all work to maintain the status quo. Even your self-perception holds you back. The exponential growth in lap-band surgery is a testament to this.

You see, your brain and your body don't have delete buttons. You can't simply just erase memories and start again. Your thoughts, words, actions, experiences and perceptions, all leave a trace "memory". As I so often say in the workshops that I present, you are a reflection of the way that you live. You reflect not just what you do but how you do it. In many ways, we are manifestations of our habits. So to change a habit we essentially have to change ourselves. Not easy to do.

As a physio, I know that many aches, pains and physical problems that people suffer is a result of incorrect postures and faulty movements habits that people have been doing all their lives. These lead to excessive or abnormal forces on body tissues and structures, creating micro-trauma which leads to tissue irritation, inflammation and tissue breakdown or degeneration.

I know that if I ask someone to stand differently or move differently, I have "Buckley's" chance of them doing what I have asked. They can may be do it for a day or two but not forever. And yet, if I am to help someone achieve a permanent pain relief or a permanent improvement of their health status, this is what needs to happen.

One of my key learnings is that pain is the potent driver of human activity. You see it all the time. What do you do if you have hurt your leg? You limp. And if you limp for long enough, even if your leg gets better, you will continue to limp. Essentially, limping has become the way that you walk. So how do I stop you from limping? I teach you how to walk correctly with crutches so that you never learn to limp in the first place.
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This principle of pain to drive change can also be used to your advantage. To help correct posture and movement, I tape people. This not only supports the injured tissue, hastening healing, but also makes it uncomfortable to stand or move incorrectly. The new correct posture and movement then creates new behaviours which begin to forge new neural pathways in your brain. If the new, correct behaviours can then be reinforced over the next four to six weeks they can become lifelong habits, enabling you to experience less pain, better performance and greater energy, for the rest of your life!

So the question is, as you begin the year full of hope of keeping your New Year's resolution, what is your "tape"? What is your pain and how do you use that to your advantage? Is it the threat of the loss of your health, the loss of relationships, the loss of time, the loss of your ...? Is it that you will be held to account by your accountability partner, whether that be a family member or friend?

Whatever your "tape" is, it always pays to take stock of where you are at, so that you can measure and track your improvement over time. Your improvement then becomes your reward and serves to motivate you, creating a groundswell of momentum propelling you towards your goal.

To help you determine your baseline physical health status, we are offering FREE Physical Examination for the month of January.

If injury or pain is holding you back from beginning your quest for better health, then we will throw in an injury assessment for FREE. So what do you have to lose except another year of your life not living to your full potential?

Call 1 300 BODYWISE (263 994) to book your FREE Injury and Physical Assessment today. It might just be the best New Year's Resolution that you could make.

We look forward to helping you get your life back.

Until next time, Stay Bodywise,

Michael Hall
Physiotherapist, Director
Bodywise Health

Please note:
* Yes, Bodywise Health is open throughout the holiday period;

* Rebates are available through your private insurance extras cover;

* For complex or chronic conditions, you may qualify for the CDP (Chronic Disease 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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Bodywise Health

364 Hampton St,

Hampton

Victoria. Australia 3188

03 9533 4257

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