All posts by Paul

It is with a heavy heart that after 30 years we close the clinic doors for the first time as the pandemic affects our country.

We do what we do because we want to help people. We are blessed to have such an amazing team and the most wonderful patients that have supported us since day one. The support of the government will allow us to keep this super team together and more importantly keep us all safe.

We will use this time to grow stronger as a team and do whatever we can to continue to help those around us. As soon as this is over and the time is right for us to return to work – we will be there to help you, motivate you, improve you and get you back to doing what you want to do.

Unfortunately, it is no longer safe to offer face to face appointments at present, however we are already consulting via video conferencing and for now there will be no ACC surcharge and private consultations will be $40.

If you wish to make an appointment simply call us on 04 499 3504 and Ed will sort it out.

We apologise to all of you who were due to see us this week and the month to come, we will be contacting all our patients individually, as soon as possible, to see how we can continue to help you. If you have any issues in the next few weeks, please do not hesitate to contact us and we will do whatever we can to help on 04 499 3504 or email us info@ccphysio.co.nz

Until we see you all again – stay safe, be kind and look after each other.

Love and best wishes,
All of the team at Central City Physiotherapy Clinic

Spring has sprung and it’s the time of year where the masses head to their gardens.  Most of us perceive gardening to be a relatively gentle activity.  However danger may lurk behind every bush and in every bed.

The reality is that at the first sight of blossom most of us get a rush of blood to the head.  We get into our gardens like there is no tomorrow.  Many of us suffer as a consequence.

A & E Clinics, Doctors and Physiotherapy rooms are full of these weekend warriors.

More often than not, it’s a case of too much too soon.  We spend the winter in our physical cocoon only to roar into a full day of heavy labour in the garden come spring.

Back injuries occur with prolonged stooping, bending and lifting.  Shoulder strains from over reaching and pulling stubborn weeds.  Tendonitis, tennis & golfers elbow from overuse on the secateurs.  The list is never ending.  There are a number of simple strategies that can not only reduce the risk of injury but make the job easier and more enjoyable.

Pre Season Training

• Prepare these muscles and joints prior to the spring clean up.  A simple aerobic, walking and light resistance programme started a month before spring will help condition the muscles to the work ahead.
• Warm up and stretch prior to picking up the tools.  Gardening is not unlike other forms of exercise, a simple 3-4 minute warm up (especially on cold days) and stretch helps prepare the muscles and joints for activity.

Planning

• Plan to spread the load over a few sessions or days or take regular breaks from the heavier work to carry out lighter work.
• Avoid high repetition for prolonged periods.  Pruning is the classic example, with many a gardener experiencing tendonitis from a few hours on the hand secateurs.
• Plan regular breaks from the heavier work to hydrate or just step back and contemplate the work done to date.

Tools

• Garden tools come in a variety of shapes and sizes.  Pick a tool with a handgrip that fits your hand.
• Long handled tools require less trunk bending reducing the risk to your low back.
• When in doubt use the loppers over the secateurs.
• Wheelbarrows are a fantastic tool but remember you don’t have to fill it to overflowing.

Raised Beds & Soil Structure

• Raised beds are a wonderful option for reducing the need to bend, lowering one risk of back injury.
• Regular mulching of the soil allows for reduced weed growth and easier pulling of weeds.
• Regular soil conditioning, especially for clay based soils, helps to loosen the soil structure making for easier digging and weed pulling.

Weeding

• It is pretty hard to beat a long handled hoe for removing weeds.  Most weeds are easily lifted by scraping the top 1-2 inches minimising the need to break up the deeper soil.
• Avoid jerking to pull weeds especially those long grasses with deeper root structure.
• Avoid constant gripping, overpowering the grip and end range joint positions, especially at the wrist.

Lifting

• Reduce the load and make a few more trips.
• Plan the lift and lift to the plan.  Most lifting injuries occur from poor planning.
• Bend at the hips not the low back.  This is the simple reason weight lifters rarely have problems with their backs.
• Lift with a wide, stable base, keep the spine straight and tighten the abdominal during the lift.
• Before and after lifting arch backwards 3-5 times.

Safe gardening.

Mike Stewart is a Physiotherapist at the Oamaru Physiotherapy Clinic.  He has Post Graduate qualifications in Manipulative Physiotherapy and Sports Medicine and is a registered Physiotherapy Acupuncturist

Source:  Oamaru Physiotherapy Clinic written by Mike Stewart and Michelle Sintmaartensdyk

Gradual Process Injuries

Gradual process injuries are those which occur over time.  They may occur over a week or even over a year.  They are sometimes called Occupational Overuse Syndrome [OOS] and earlier were called RSI.  However these terms do not really describe the injury.

The symptoms or what you feel vary from person to person.  Pain may be felt in one part of the body one day and in another the next.  Tingling and numbness may also be felt.  Stiffness is another symptom.

How do they occur?

They can occur from muscles and joints being held in one position over a period of time or tight muscles which over time eventually pull on tendons.  For example, holding the neck in one position while at work is enough to put tension on the structures supporting the neck and thus cause pain.  Running without stretching afterwards will cause the calf muscles to tighten over time, causing tension on the achilles tendons and eventually pain.

Constant tension on any soft tissue structures can cause a breakdown of the tissue which causes pain.

Examples of these injuries are shin splints, low back strain, tennis elbow, wrist and forearm pain, neck and shoulder pain.

How can physiotherapy help?

The sooner you see a physiotherapist the sooner your pain will be reduced.

• The tight muscles need to be stretched again and loosened.
• The tight nerves need to be stretched.
• The joints which have been tightened causing a restriction in movement need to be moved and the range of movement restored.
• Muscle imbalance needs to be corrected.  Sometimes the working muscles become so strong the other supporting muscles become weaker.  This is referred to as a muscle imbalance.
• Posture needs to be improved.
• Advice will be provided on preventative action in the future to reduce the chances of this occurring again.

IF YOU EXPERIENCE PAIN, FIND OUT WHY IT IS OCCURRING.  PHYSIOTHERAPISTS CAN HELP YOU OVERCOME AN INJURY AS QUICKLY AS POSSIBLE.

It’s the time of year when many players in all sporting codes take to the field. Some of these players will suffer a knock to the head or face, or fall heavily and sustain a concussion. Confusion exists as to what a concussion actually is and how it should be managed. Can someone be concussed if they haven’t lost consciousness? Should they be allowed to play on? And how long before the injured player can safely resume sport?

Concussion is a relatively frequent injury arising as a consequence of contact sport or falls, and is often poorly understood and managed. The outcome of repeated or poorly managed traumatic head injury can be serious and long term. This is particularly true for children and adolescents who may return to sport too early following a concussion, and who may suffer long term physical and learning consequences as a result.

Concussion is defined as a disturbance of brain function as a consequence of a direct or indirect blow to the head. It results in a variety of non- specific symptoms (such as those listed) and often does not involve a loss of consciousness. Concussion should be suspected in the presence of one or more of the following

–          Symptoms (headache) or

–          Physical signs (such as unsteadiness) or

–          Impaired brain function (confusion) or

–          Abnormal behaviour

Any athlete with a suspected concussion should be REMOVED FROM PLAY, medically assessed, monitored for deterioration (i.e. should not be left alone) and should not drive a motor vehicle.

(Taken from SCAT2 –Sport Concussion Assessment Tool).

These symptoms may last for a short time only, but if present, indicate that the player should not return to play.

Most (80-90%) concussions resolve within 7-10 days, although this time frame may be longer in children and adolescents. Recovery requires physical and “cognitive” (activities requiring brain concentration and attention) rest. This may mean some days off school or work and refraining from activities such as text messaging and playing video games. More serious concussions may require specialised medical testing and retesting to determine recovery and return to activity timeframes. It is important to realise that previous concussion makes you more susceptible and vulnerable if you receive a further injury. Return to sport before concussion symptoms have completely resolved puts you at risk of suffering a serious or potentially life threatening consequence if you suffer a further injury.

Return to sport will vary between individuals and be determined by the extent of the injury, whether this is the first episode of concussion, and how rapidly symptoms resolve. Current ACC and NZRU guidelines recommend a minimum of 3 weeks stand down from sport after concussion. This period should allow sufficient time for the resolution of symptoms in most concussions. However, should symptoms persist after this period of time further medical advice should be sought before return to sport.

The guidelines outlined in the following table (from Consensus Statement on Concussion in Sport: the 3rd International Conference on Concussion in Sport held in Zurich, November 2008, Br J Sports Med 2009;43:i76-i84 P McCrory , W Meeuwisse , J Dvorak , M Aubry , M Molloy , R Cantu ) provide a stepwise progression to guide return to sport. The player should proceed to the next level of activity only when he/she experiences no symptoms at the previous level. If symptoms are present the player should drop back to the previous level.  The player should not return to contact sport until completely symptom free. This is especially important for children and adolescents, and the time frame for recovery in these players may be longer than for adults.