Dietitian, Dublin 6, Caoimhe McDonald

Take control of your IBS don’t let it control you – By Caoimhe Mc Donald

Dietitian, Dublin 6, Caoimhe McDonald

“Take control of your IBS don’t let it control you”   

Irritable bowel syndrome (IBS) is a chronic and relapsing bowel disorder. It affects up to 20% of adults and adolescents as well as children. It is 1.5 times more common in women than in men.  Symptoms include:

Dietitian, Dublin 6, Caoimhe McDonald

  • abdominal pain
  • bloating
  • constipation
  • diarrhoea
  • flatulence
  • poor appetite
  • indigestion

It is important to note that many conditions have symptoms that can mimic IBS. Inflammatory bowel disease, coeliac disease and microscopic colitis are a few. It is important that the diagnosis of IBS has been carried out, coeliac disease has been ruled-out and alarm features are absent.

Many people have had symptoms of IBS all their lives and done nothing about it. It is so often put down to having “a sensitive tummy”. As a Dietitian, I would estimate 60 – 70% of my patients suffer with IBS. It is very common for people to come to a dietitian for a different reason and drop it into conversation when discussing their diet. People wonder how it has become so much more common these days. However, when asked about their family history many report one or both of their parents have avoided a food for years as it “doesn’t agree with them”. 

Irritable Bowel, Dietitian, Rathmines

The truth is, more people feel comfortable discussing their digestive health and doing something about it. People live busy lives that can often be stressful and many are now more conscious of their diet and looking after their health. I have seen patients with such severe symptoms it has a huge impact on their quality of life. They are unable to attend work, they fear getting public transport, avoid social activities or not sleeping at night as a result. Why live with something like this when symptoms can be managed effectively?

Multifactorial

The exact cause of IBS is not known and it is thought to be multifactorial. Suggested causes may be; a previous gastrointestinal infection, prolonged antibiotic use, stress, medication, alcohol, poor diet and lifestyle factors. Two thirds of IBS patients perceive their symptoms are related to food. Symptoms can come and go and may be exacerbated in stressful situations which can make it difficult to identify the exact triggers.

So how do people go about managing their symptoms of IBS?

Dietitian, Dublin 6, Caoimhe McDonald

  • Medical management using anti-diarrhoeals, anti-spasmodics, laxatives or low dose antidepressants
  • Self-help – 7% treat themselves with no medical supervision
  • Herbal remedies
  • Psychological guidance
  • Probiotics
  • Lifestyle changes
  • Dietary guidance

Diet assessment and adjustment by a qualified dietitian is so important in the management of IBS. Many patients prefer dietary management rather than a reliance on medication. As a dietitian specialising in digestive health, it is very rewarding to see a patients’ symptoms improve. With guidance on diet, meal pattern, lifestyle factors and stress management, people will notice improvements. Some may immediately feel better after increasing fibre in the diet, increasing fluid and introducing exercise. Others may find eliminating certain foods beneficial or the use of a probiotic.

FODMAP Diet

There is a growing interest in restriction of short chain fermentable carbohydrates called FODMAPs (fermentable, oligosaccharides, disaccharides, mono-saccharides and polyols….a mouthful I know!) for IBS management. The low FODMAP diet is an exclusion diet specifically for patients with IBS which has been supported by 30 clinical studies. Research has shown that limiting these foods (high in FODMAPS) can alleviate the symptoms associated with IBS.  The low FODMAP diet should be done under the supervision of a dietitian as exclusion diets are at risk of nutritional inadequacy.

If you feel you could benefit from seeing a dietitian in relation to digestive health or any other dietary issue contact Caoimhe McDonald at Personal Health. Caoimhe has worked with patients with IBS for years and can help you identify the triggers for your IBS. Caoimhe will provide meal suggestions, recipes and shopping lists to make sure your diet is still balanced and you are getting all the nutrients you need.

In Conclusion, diet is not always the cause. It can be just one contributing factor to IBS. For many, stress management may be the best solution. Contact the Personal Health team to make an appointment with Consultant Dietitian Caoimhe McDonald or Psychotherapist Susan Duffy on 01 4964002.

Personal Health, Rather Road, Chronic Health intervention

Surprise Your Bones….

Exercise for Osteoporosis

Medically Led Fitness

Responsible Exercise for Osteoperosis

When I was training as a student in Cork University Hospital our lead Clinical Educator, Fiona, had a stock phrase for helping patients with Osteoporosis.

‘Surprise your Bones’ said Fiona regularly, in a gentle Scottish lilt. Whether it was her accent or it’s ‘catchiness’, the phrase seemed to stick!

Fiona was a Clinical Specialist in the area and really believed in the positive benefits of exercise for Osteoporosis. The tricky part is knowing what are the correct exercises, what are the safe ones and what needs to be avoided. The even trickier part is making a class relevant/enjoyable to a 60 year old lady. We know you would rather be on the golf course or anywhere else!

Medically Led Fitness Osteoperosis Classes

Exercise can be responsible and good fun

Personal Health Exercise Classes

At Personal Health, our Chartered Physiotherapists manage a nice happy medium in this class. We aim for the whole thing to be enjoyable, sociable and challenging enough to ‘surprise the bones’ into shape.

Typically Osteoporosis affects females far more than males, usually over the age of 55. It is diagnosed by DEXA scan which is able to measure bone density. This is usually through imaging of the hip bone.

For those managing Osteoporosis it tends to be a quiet process. There’s typically no pain, and one might only be alerted to it’s complexities when in the A&E room after something has caused a fracture.

Areas such as the base of the thumb/ wrist and hip are more vulnerable for fracture. This is based on the age and activity profile of those diagnosed with the disease. Similarly a focussed approach to improving balance and/or falls prevention can be a smart way to approach the condition.

Frequently an osteoporotic patient will be undergoing ‘medical’ management of the condition by taking prescribed tablets –  ’Calcichew’- or something similar. It has various classifications in terms of severity. Often patients opt for a sustained (but finite) period of injection therapy as treatment. These injections aim to increase the strength of cortical bone structure in addition to the focussed dietary and exercise interventions.

Personal Health Dublin 6

Chronic disease is just a definition not a life sentence

Medically Led Fitness

In Personal Health our Medically Led Fitness programmes are geared towards optimising chronic health issues. By definition, ‘chronic’ relates to time and duration – not severity.

So with a chronic diagnosis like Osteoporosis, you have the power to successfully thrive. At Personal Health, we provide a helping hand, some time and a refreshing enjoyable approach to managing your chronic health issue.

USAIN BOLT – THE RACE FOR OLYMPIC FITNESS!! by Ronan Fallon

USAIN BOLT – THE RACE FOR OLYMPIC FITNESS!!!

Last week in Jamaica, Usain Bolt pulled out of the national finals following a second night of discomfort in his hamstring muscle. The diagnosis is a Grade 1 muscle tear. This is potentially a big problem as he needs to qualify for the Olympic Games on the 22nd of July in London. 

Usain Bolt Running out of Time, Ronan Fallon, Physiotherapy, Personal Health, D6

Will he run out of time??

Firstly, what is a Grade 1 muscle tear? Put simply, muscle injuries are clinically graded on a scale of 1-3 with 1 being the least serious and 3 being a severe rupture.

If you are dealing with an Olympic athlete, he will probably undergo an MRI to confirm what the medical team already know from their clinical examination of the presenting problem. 

Secondly, what happens next? There is a battery of treatments that an Olympic athlete will receive. Usain Bolt has flown to Germany to see a specialist for further treatment. Ultimately, these treatments are designed to speed up the healing process. These can vary depending on all sorts of issues, mainly money! However, Mother Nature’s physiological healing timeframes need to be acknowledged and respected.

Medical team, Usain Bolt, Personal Health,Ronan Fallon, Physiotherapy, Personal Health, D6

 

Muscle is like a Rope!

A reasonable analogy is that the fibres in Muscle tissue are similar to the strands of a rope. Once an injury has occurred, then the amazing human healing cycle begins. This can take weeks to fully return to somewhere close to the pre-injury condition.

Here’s the problem, the Hamstring muscle has to be fully healed and strong before you even attempt to put it through the most severe test which is flat out sprinting. 

Usain Bolt of Jamaica starts in the men's 200 metres heats during the world athletics championships at the Olympic stadium in Berlin, August 18, 2009. REUTERS/Dominic Ebenbichler (GERMANY)Ronan Fallon, Physiotherapy, Personal Health, D6

I am sure that Usain is being managed extremely carefully as the medical and physiotherapy team attempt to combine the tricky task of accelerating healing and loading appropriately in an effort to prepare for the ultimate test on the 22nd of July.

Elite athletes such as Usain Bolt are obviously supreme physical specimens. This generally helps shave a few days of the well-known recovery timeframes. Also, access to medical and physiotherapy services which will be babysitting him 24 hours a day is also a bonus. 

Usain Bolt, Bubble wrap, Personal Health,Ronan Fallon, Physiotherapy, Personal Health, D6

Bearing all this in mind, and considering that he is the fastest man on the planet. I am confident that he will get through the qualification stages even if he is not 100% fit. 

If you are an Olympic athlete, recreational runner or 5-a-side player, all muscle injuries are very well understood. Chartered Physiotherapy will help with grading and managing recovery.

Football, Physio, sport, Physiotherapy, Fitness

Will Jonathan Walters be fit for Saturday ? by Ronan Fallon

Well is he going to be fit to continue?

Last night’s match in Paris saw the boys in green put in a great performance on the European stage. It’s fair to say that we could have easily taken all three points. Unfortunately, this result did have an impact on Jonathan Walters.

It is well known that he has been struggling with an Achilles tendon problem for the last few weeks. The Achilles tendon is the common tendon from the calf muscles into the heel bone.
It is a notoriously tricky problem for anyone from an international footballer to a mid-week 5-a-side social footballer or tag rugby player. As such, it was not a good sign that Jonathan Walters reported last night that he was struggling with this issue from the very first minute!

Achilles tendon
As you can see from the image, pretty much all activity on the football pitch requires load to go from the calf muscle and through your Achilles tendon. This allows the athlete to propel forward to run & jump.

 

MANAGEMENT

Chartered Physiotherapy Dublin 6

Decisions Decisions…..

There is no doubt that the Irish medical team are using all of the resources at their disposal in an effort to get Jonathan fit for Saturday. This is a very quick turnaround for an injured achilles such as this one.
I suspect that they will be using a battery of treatments including anti-inflammatories, Icing, Soft tissue for the calf muscles and most importantly rest.
The crucial component in this management strategy is controlling loading. Thai is the weight that he takes through that inflamed tendon. He should be on crutches for 48 hours. This would allow the Achilles to recover without the stress of his bodyweight on every step.

Medical Team

This is a tricky conundrum for the medical team today. How long can they afford to rest Jonathan from team training in preparation for the Belgium match? Martin O’Neill and his team will have  already discussed this and may have even made a decision on ruling him out.
It’s very difficult to see how Jonathan Walters will be fit for Saturday. An MRI scan will show the true extent of the damage. As a result all we can work off are the soundbites from Management and player alike.

In conclusion, we’re all hoping for a speedy recovery and that his removal from the game early might just give him a chance for the big game on Saturday.

COYBIG !

Ronan

pain, chronic pain, exercise, physio, physiotherapy

Do you really understand your pain? by Dee Ryan, Chartered Physiotherapist

Pain is often misunderstood, and as a result can cause fear. This fear and confusion can drive our pain experience. This blog explores the true meaning of pain with you. It might facilitate a different approach to your pain management, and hopefully can improve your coping strategies.

Pain is the body’s alarm system. It is designed to be a helpful response to protect you. This alarm system is assisted by your vision, hearing, smell and taste. For example, at halloween you see a bonfire, hear the wood crackling, smell/taste the smoke and feel the warmth. These sensory cues are helping your brain decide how best to respond to a given situation.

FireBeachPain
A key point to understand about pain is that once the brain decides you’re in danger, you will feel pain with or without the presence of tissue damage.

YOUR BRAIN DRIVES YOUR PAIN

Pain can be straight forward. But like most things in life, it can also be a complex process requiring some patience. Pain from direct tissue damage is clearly understood – an ankle sprain for example, see our Rory McIlroy blog:

Here, for example, the ligaments are sprained and in an attempt to protect you (how loving!) your brain decides the ligaments are at risk and need healing. Subsequently pain is felt in order to allow ligament repair and remodelling.
Pain can also be reflective of behaviour, emotions, memories, belief systems and what the pain means to you. A nice analogy for this is to imagine the ingredients of emotion, stress, memory, belief and behaviour are mixed together and make up the batter to a special kind of cake called pain. This cake is cooked in a particular oven called the brain. How the cake of pain turns out is very much so dependent on the oven – what temperature it is cooked at, how long it is cooked for etc. So it is clear the brain directly influences the end product- the pain cake.

 

pain management Personal Health Dublin 6

Is your pain getting out of hand?

Regardless of analogies, there is a proven science to this…..

Our body house these incredible sensors which continuously send messages to the brain via electrical impulses (neural pathways). Some sensors report on temperature, some respond to mechanical change, others to chemical change. There is a certain type of wire called a nociceptor which delivers messages of danger to your brain. They respond to any form of stimulus which is considered a threat. Remember nociception is just the delivery postman of the message, not the message itself.
Not every message being delivered from the sensors reach the brain. At the level of the spinal cord there is a sorting process, and the number of messages being passed is under control. Similar to a bouncer manning a nightclub. The danger messages can sometimes be granted access and are delivered to the brain. Here the brain has to make a decision how best to react to all this information it has been given.

Dee Ryan Chartered Physiotherapist in Dublin 6 discusses the complexity of pain

Those shoes are quite nice mate…..

Next week

Next week I will discuss the various systems which the brain calls upon in its response to these issues. Similarly I will expand on the effects of pain over a prolonged period of time- known as ‘chronic pain’.
Be a friend and tag a friend who you feel will benefit from further understanding the processes involved in the pain experience!

And now my parting gift to you until next week….a superb video which explains pain in less than 5 minutes:
https://www.youtube.com/watch?v=RWMKucuejIs

 

Mobility, Flexibility, fitness, movement, health

The Pursuit of Flexibility

As the years go by, the pursuit of flexibility can be a wistful bygone goal. In reality we stiffen up a fair bit as time flies. So, what seemed to be regular flexible movement at one stage, now seems difficult to attain. Why do I groan all of a sudden when I’m standing up from a chair ???

Let’s be kind to ourselves here – mobility and flexibility are often impossible due to our lifestyle demands. Similarly, if we do find some free time, is stretching a priority? It seems so boring… Perhaps not?

Well, there is a lot more to flexibility than static muscle stretching…. A lot more!

And best of all, it can genuinely provide relief, positively affecting your mood.

 

Be kind to each other

Many components affect our flexibility including:

Joint Capsule
Muscle
Ligaments
Tendons
Nerves

I am going to focus on joint stiffness in the thoracic (mid) spine as this is a common presentation across office workers. It is also equally common in multiple sports including cycling, rowing, boxing, wrestling and hockey.  Here is why…

The thoracic spine is the area of our spine located between your neck and low back. Thoracic mobility is important for optimal movement. The mobility of spinal joints and their surrounding capsules adapt depending on the activities performed. Multiple sports require the athlete to move with their arms positioned in front of their body, this positional demands often result in the shoulders sitting forward and a round upper back consequently increasing the risk of developing stiffness in this area.

As the mobility of the thoracic spine affects the function of the shoulders, neck and low back, it is strongly recommended to spend time ensuring your thoracic mobility is being maintained. It is all about balance.

IMG_2129
The more time you spend sitting at your desk, or training, then the more time you need to invest in maintaining your mobility and flexibility. To prevent long-term changes the idea is to position your body in the opposite positions from what you train or work in. For most people this will involve mobilising your upper back in extension and in combined extension and rotation. In other words, straightening your spine.

Over the past years I have found the following thoracic mobility exercises to be highly effective in maintaining and restoring thoracic movement:

1.Thoracic extension on foam roller:

Stretches the pectoral muscles and forces extension in the upper back. Ensure your low back is flattened on the roller for most efficiency. Hold for 30 seconds. Repeat 2-3 times. You can alter the position of your arms between 90 degrees and 120 degrees to bias different areas of your upper back. See image below.

IMG_3255 (1)

 

2. Segmental flexion and extension over the foam roller:

Place fingers on temples to promote thoracic extension. Position the foam roller horizontally and roll along your upper back. Stop at the segments which feel more uncomfortable and stiff. To bias the mobility at these segments, slowly extend over the roller towards the ground. Support your lower back whilst doing this by tucking your bum in. See pictures below as the athlete moves from thoracic flexion into segmental extension.

IMG_3256 IMG_3257

 

 

 

 

3. Bows and Arrows:

Position yourself in side-lying so that shoulders and hips are in line. Bend your knees so that your hips and knees are in line (this offloads your low back ensuring the movement is coming form your upper back). Outstretch both arms. Reach the top hand past the bottom hand and then pull backwards as though drawing the arrow on a bow. In this drawing back motion, aim to have the top shoulder facing up towards the ceiling. This is a slow and controlled movement and aim for 10 repetitions 2-3 times on each side. See the images below.

IMG_3258

IMG_3259

4. Shaking it all out:

Finally, if all else fails….Try loosely and gently relaxing your stomach, if you have ‘a belly’ (everybody does by the way) let it real and hang over your belt. Then gently allow some light  shaking through all the main joints, neck, shoulder, spine, hips, knees, ankles and feet. Just like the way Diego Maradona used to warm up for football games…..

 

 

Tag a friend if you feel this article is relevant to them, or that co-worker who constantly complain of upper back stiffness! If you have any further questions or queries regarding thoracic mobility or wish to purchase a foam roller contact us at Personal Health on 01 4964002 or email info@personalhealth.ie.

Physio, Golf, Tennis, Physiotherapy, Fitness, Exercise

Tennis Elbow, Golfers Elbow or both – the dreaded Country club!!

Tennis Elbow, Golfers Elbow or both – the dreaded Country club!! 

country club

 

I’m regularly asked about both Golfers & Tennis elbow in the clinic. Generally they are a large portion of the non-contact elbow injuries that patients develop. Commonly, it’s a term that people have heard of but are not quite sure what it actually is! Golf or tennis may not be on your list of hobbies to be struck down!

A tennis elbow is an irritation of the tendon on the outside or lateral part of the elbow whilst a golfer’s elbow is an irritation of the tendon on the inside or medial part of the elbow.

If you are unlucky enough to develop both, you become a member of the “Country Club!”

 

Golfers-vs-Tennis-Elbow

 

Basically, the majority of the muscles in our forearms anchor to either the inside or outside of the elbow via a shared tendon. When we overload these tendons from things such as hitting 200 golf balls off a rubber mat or deciding to tackle painting the house in one swoop, we can cause a painful episode in these tendons.

It’s a very common problem. I always like to take people through the anatomy of the issue. Understanding is the key to settling this problem down. We are fortunate to have some state  of the art anatomy tools to facilitate this in the Personal Health clinic.

 

image_Blue_elbow-pain

 

Acute or Long-Standing Issue

The next question is whether it is an acute flare up or a long standing grumbling issue? This largely dictates the management and treatment. Conservative management with appropriate exercise, soft tissue work and de-loading of the tendon resolve this issue in the majority of cases. Surgery and injections are thankfully relatively rare.

 

 

 

Call us to find out more.

Phone: 01 496 4002

Email: info@personalhealth.ie

Website: www.persoanlhealth.ie

Diet, Nutrition, weight, dietitian, dublin 6

Diet, Nutrition…. what is all the fuss about?

Diet, Nutrition…. what is all the fuss about?

what is nutrition

 

When giving presentations I often ask my audience “why do you think diet is so important?”.

Various responses are given; “to lose weight”, “prevent heart problems”,“ prevent diabetes” which are all true but they are long term effects of good nutrition. It is amazing to see how few people think about the short term effects of eating a healthy balanced diet.

We are living busy lives trying to juggle family life, work, friends, exercise to say nothing of diet. Few people have time to sit down and think about their diet and how it affects them.

balanced diet

 

Eating a balanced diet in addition to having regular meals throughout the day can:

  • Boost your energy levels
  • Prevent sugar cravings
  • Protect your digestive health
  • Stop that sluggish feeling after a heavy meal
  • Prevent low mood
  • Boost your immune system
  • Improve your concentration levels
  • Encourage self esteem

Reduce risk

In addition to the short term effects of good nutrition, in the long run a healthy diet can reduce your risk of developing:

  • Obesity
  • Diabetes
  • High cholesterol
  • High blood pressure
  • Cancer
  • Stroke
  • Osteoporosis
  • Anaemia
  • Diverticulitis
  • Irritable bowel syndrome

In fact, many illnesses can be as a result of our genes which we can do nothing about. However, we are in control of modifiable risk factors such as our diet and physical activity and can reduce the risk of various diseases.

How can Personal Health help you to achieve a healthy diet?

Finally, our Consultant Dietitian can assist you and help you to improve your diet by;

  • identifying your specific nutritional needs
  • providing dietary and lifestyle advice tailored to your needs
  • coupled with developing tailored resources such as recipes, meal plans, shopping lists to help you to achieve your goals too
  • providing encouragement and motivation in a supportive, non-judgemental environment.

Diet teamCall us to find out more.

Phone 01 496 4002                                                                      

Email: info@personalhealth.ie

Website: www.personalhealth.ie

Andrew Dunne Managing Director Personal Health

The Orchestra & The Human Body

Dublin_Philharmonic_Orchestra_performing_Tchaikovsky's_Symphony_No_4_in_Charlotte,_North_Carolina

If you’re over 35…..Listen to your body instead of looking at it so much. All your vital internal instruments will thank you – you might even start to sound like a nice melody!

From the time you are born to around the time you turn 30, your muscles grow larger and stronger. But at some point in your 30s, you begin to lose muscle mass and function, a condition known as age-related sarcopenia. Nothing overly serious, but to summarise, it’s to do with nerve cells, brain signalling and hormonal changes.

We’ve all been down this road at some point….

  • Going for a run (too much too soon until it hurts)
  • Buying a new bike that gathers dust in the shed
  • Trying ‘High Intensity’ exercise
  • Abstaining from any of the good stuff in life

The truth is we have difficulty maintaining an ideally healthy lifestyle because of various factors (as above) and external stressors, such as job demands, cost of living and just being beautifully flawed!

But our health matters…..It’s frustratingly complex.

Personal Health

So what do we suggest at Personal Health?

  • Consult with our Medical team about your lifestyle choices
  • Exercise for 30 minutes with our Physiotherapists
  • Make small practical changes to your diet, with the help of our dieticians
  • Learn how to make behavioural changes to your sleep
  • Outsource your health concerns to an expert medical team