All posts in Headache

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.

We provide injury management for everyone wanting fast, effective help to return full activities.  We spend extra time to ensure complete recovery and prevention of recurrence to keep you at peak performance so you enjoy life to the full- because your body deserves the best of care.

 We know you have a choice.  Choose us for:

1. Perfect central city location.
2. Experienced team to treat a full range of injuries and conditions.
3. Easy to get appointment times to suit.
4. Seen on time, every time.
5. Information on your progress from visit to visit.
6. All appointments 30 minutes.

Winter is certainly here and for those of you who injure   out in the cold remember that hopping into a      hot bath           once you get home is likely to make matters worse not  better, especially if there is acute inflammation- better to stick to the RICE program (Rest, Ice, Compression,  Elevation).

If you are waiting for your injury to go away don’t wait more than 5 days or you may end up with more problems as a result of poor healing or compensation patterns.

Always best to get some advice from one of our team of Physios- even if you only need a couple of sessions, we can tell you how to get the best resolution of the problem.        

Ensuring your body gets the best of care- so you can get the best out of life.

 Here are some tips to help ensure a successful, speedy resolution.

For all appointments call 04 499 3504.

Does work give you a pain in the neck and back?

With the huge reliance on technology in the workplace an increasing number of people are working for long hours in relatively fixed positions, performing repetitive movements while working hard to meet deadlines.  Common problems are aching felt in the neck, shoulder, upper and lower back, wrist and elbow joints and in some cases pain, numbness and pins and needles felt in the arm and/or hands.  These symptoms can signal the onset of OOS (Occupational Overuse Syndrome) also called Repetitive Strain Injury (RSI), which may include damage to tendons, muscles, nerves and other soft tissues from repeated physical movements over time.

Make sure you pay attention to your posture both at home and at work, especially when using your computer.

Physiotherapy Can Help!

A physiotherapist with knowledge in ergonomics and work related conditions can perform an individual work station assessment.  Recommendations will be given such as the correct seating and workspace layout to prevent such conditions happening.  Risks will be identified and advice given on correct posture, height of the desk and chair, position of screen, mouse and keyboard.

Guidelines for healthy computer use

Start Moving and Stretching:  Get up from your work station for a short stretch or walk around to promote blood flow to fatigued muscles every hour.

Variety:  Add variety to your tasks.  Take every break as an opportunity to go for a short walk, exercise and relax.  Try to vary your tasks.

Reduce Strain:  Make sure you are sitting correctly with your back supported.  Speak to us about ways to ensure you are sitting in the best possible position.

Talk to your physiotherapist:  This pain and discomfort can be prevented, but if symptoms do occur, early intervention is the best form of treatment.  If you are experiencing regular or increasing discomfort while sitting at your computer, take early corrective action.  A physiotherapist will listen to your problems and concerns, and will enquire about your activities and life style.  They will then examine you, and discuss these findings with you.  Following this, together you will work out a plan of exercises and stretches, and importantly look at changes that can be made to prevent the problems, especially to avoid recurrence.

As in the fairy tale, the same shoe does not fit all feet. Shoe size is of course critical, but there are a number of other factors that need to be considered when purchasing shoes. In this article I will discuss the function of the foot, problems that may occur, and how choosing the right type of shoe can make all thedifference to normal foot function.

Most people are familiar with the terms “flat” and” high arched” feet.  In medical terms the flat foot is generally known as a pronated foot and the high arched foot as a supinated foot. Variance in degrees of pronation and supination is common between people and may occur from one foot to the other. The terms pronation and supination also describe the variable position the foot travels through with normal weightbearing. As we walk the foot moves through varying degrees of pronation and supination to allow our feet to adapt to changes in terrain, and the position required as the foot moves from striking the heel on ground contact to pushing off with our toes as we take a step. Pronation allows the body to absorb shock when it lands. When running, the heel takes the equivalent of five times your body weight on heel strike. This force is dissipated throughout the body. Supination is required to lock the foot when pushing off. This provides power in order to walk and run faster.

Most people can adapt for minor differences from the ‘ídeal’ foot posture but from time to time we all

get sore, achy, tired feet. There are a number of factors that can cause pain around our feet.

Changes in foot wear, the surfaces we stand or run on and activity levels are common factors seen when reviewing problem feet. An excessively pronated foot means that various tissues within the foot may be placed under greater stress with resultant pain in the arch, heel or into the achilles area and may be a factor in the development of a “bunion”. Likewise an excessively supinated foot is less able to absorb load and may be a factor in foot pain. Our foot posture can also influence a number of other areas in our body.  Shin, knee, hip and spinal pain can result from alterations in foot posture and function.

Correct choice of footwear is important. As there are many so different types of shoes on the market today it can be very confusing when deciding on which shoe to choose. Sports shoes are available in control and neutral designs to accommodate different foot needs. It is important to get the right shoe for your foot posture to ensure the maximum support for your foot.  Talk to your Physiotherapist or sports shoe retailer about issues you may have, and get advice on which shoe is right for you. In some cases an additional insert or orthotic may be required to assist with alteration in foot posture.

Selecting the right shoe does not always mean you have to buy the most expensive model .Generally the

more expensive models tend to have more stability control which will make a significant difference if your foot requires that control. Shoes are also designed for different function and it is important that you use the correct shoe type for your activity. Running shoes need to provide control and stability in a different plane than a court or squash shoe. Your sports shoe retailer will be able to advise you on what shoe is best suited for your needs. If you experience foot or leg problems, seek advice from your physiotherapist or a good sports shoe retailer before selecting your next pair of shoes.

Duncan Drew is a Physiotherapist at the Oamaru Physiotherapy Clinic .He is a credentialed McKenzie Physiotherapist and has a special interest in Sports injuries and Spinal conditions. He has played Cricket at National level and was a member of the successful North Otago Team who recently secured the Hawk Cup 

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