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Physiotherapy, Physio, Pain, Chronic Pain

The Facts Behind Chronic Pain – Physiotherapy

THE FACTS BEHIND CHRONIC PAIN

As previously mentioned in my last blog, when the brain perceives you are in danger it calls upon many systems in its response to this discerned threat including:

  • The muscular system- run away, fight
  • The sympathetic system-increase heart rate, sweat
  • The immune system –promote healing, sensitise neurons
  • The endocrine system-reduce gut and reproductive activity

Together all these systems work together to get you out of trouble creating a pain experience, or motor experience or a stress experience.

When we initially injure our tissues we go through an immediate inflammatory response.  This initial inflammation is to be appreciated as the body’s immune and rebuilding cells are directed to the injured area. Give thanks, muchas gracias! Often pain is experienced here as the chemicals involved in inflammation can sensitise the nerve endings in the area. This causes a barrage of messages to be delivered to the brain. However, as the healing process continues the pain levels should drop as the inflammation subsides and the tissues heal.

Personal Health, Rathgar, Physio

 

Tissues!

Pain nearly always involves something going on in the tissues! Therefore, managing the tissues involved will help you manage your pain.  Understanding the processes behind the pain experience in both the brain and the tissues will provide you will enormous control in your pain experience. When pain persists past the natural healing time of the tissues we can say with certainty that the brain has concluded that a threat continues and that you still need protection and consequently pain. The central nervous system is highly adaptive and will respond to the demands it is placed under. If continued messages from a damaged, inflamed, scarred or weak tissue continue arriving, the brain gets more tuned to that zone and better at listening. It’s the continuous influx of messages that can lead to the brain ‘over-listening’ to that area and in turn over responding.

personal health, Dee Ryan, Physio,

 

When this happens you can become aware of more pain in areas that just hurt a little before, or areas that didn’t previously hurt at all now have started to hurt. Rather than calmly supervising the operations on the ground floor, the brain has now become a hyper-vigilant boss micromanaging every movement in that sector. The pain persists, spreads, perhaps worsens and now even small movements can become painful. This is an indication that the alarm system can become faulty.

                                                   Screen Shot 2016-07-06 at 15.26.46

This enhanced sensitivity of the alarm system is nearly always a feature of ongoing pain. Due to this increase in sensitivity in the tissues, the brain is now acting on faulty information. It is no longer receiving accurate information about what is going on in the tissues. Consequently, the brain perceives that there is more danger in the tissues than is actually the case.  As a results the brains responses such as thoughts, beliefs, immune, muscular, endocrine are amplified and exaggerated. Oh my! At this stage brain in attempt to look out for you makes those body parts harder to use….does this sound familiar to you?

Contact us for more info….

For fear of over-informing I will leave you to digest the above information. In my next blog, I will explore further changes that can occur in the brain during chronic pain. As before, be a friend and tag a friend who you feel will benefit from further understanding the processes involved in the pain experience! For further information or to book an appointment with Dee, contact us at Personal Health on 416 4002.

Exercise, Gym, Physio, Tendons

Should I Exercise when injured? Ask the Physiotherapist

Should I Exercise when injured? Ask the Physiotherapist

Should I stay away from the Gym while I get better? Absolutely not!

A lot of our physiotherapy and exercise patients are concerned about abandoning their regular fitness regime, particularly when injured and experiencing pain. Let’s get one thing straight – the days of a physiotherapist suggesting you should avoid activity are long gone. You should most certainly continue turning up at the gym, in fact we’re probably going to push you there! We will simply look at tweaking some of the programme you are working through. While rest is always a good thing for the human body, strength and exercise are a vital component of rehabilitation.

Tendons respond to loading … But not too much!!

Tendon damage is a very frequent issue presenting in clinic at www.personalhealth.ie.

A tendon is where the muscle attaches to bone. If you imagine a juicy steak – the grizzly bits in by the bone are tendons. A juicy muscle belly is rich in blood vessels, which promote healing once our circulation is good. However the tendons (the grizzly bit) have less blood supply and therefore take longer to heal. Tendons do get better, no need for alarm. They are just a bit more complex. They respond to various forms of therapy and rehabilitation – one such approach is increased loading to help the healing process. Just not too much… and correct technique is vital.

Inflammation vs tissue damage

Tendons can be overworked or overloaded and as a result they become inflamed. There may not be actual tissue damage such as a partial tear/rupture. However, the inflammation caused by excessive loading can be a real irritation.

Running on a dodgy ankle

Think about some long distance running on a dodgy ankle. This might cause the achilles tendon to become inflamed – referred to as a tendinopathy. Sometimes the inflammation in the tendon is mechanical in nature. This means the problem is caused by incorrect mechanics when we run. The solution, while a very keen runner may not like to hear it, might be to reduce time on the road and go to the gym.

Strengthening and Lengthening

Strengthening and lengthening the damaged tissue is a key factor in rehabilitation. No better place than the gym for this. If you are worried about technique, frequency, sets, reps, loading, tempo, duration, rest or any of the above – we can help.

  • Firstly, we will walk you through the process in clinic.
  • Secondly, we will send on all the exercises from our video library
  • Thirdly, we can monitor your progress from afar, but with room for a helping hand
  • Finally, we will discharge you back to healthy happy living as soon as we possibly can

So in order to get yourself back out on the roads, or back in the gym, come to Personal Health….

Book Online here: https://personalhealth.janeapp.com/

 

Spine, Spinal Surgery, Rehab, Surgery, Physio, Rehabilitation, Fusion, Dublin

Recovery from Spinal Surgery – How can Physiotherapy help?

Recovery from Spinal Surgery – How can Physiotherapy help?

We often look after patients who are recovering from spinal surgery. There are many types of surgery and interventions that a spinal specialist will use to optimise the recovery of the patient – ranging from discectomy to rhizotomy, and decompression to fusion – the terminology can be confusing. What all orthopaedic and spinal specialists recommend however is a targeted and specific rehabilitation plan with a physiotherapist.

In patient recovery

Most surgical interventions see the patient getting out of bed independently less than 24 hours post surgery. On the hospital ward the Physiotherapists and the Nursing team work together to encourage as much movement as is recommended. This can be surprising for patients who have been dealing with acute and/or chronic back pain for a long period prior to surgery. The surgical approach of our spinal specialists these days has become so refined and skilful that the in-patient recovery time has significantly shortened in recent years. This is a big benefit for all concerned.

Outpatient recovery

After the patient is discharged from hospital, they will be armed with a small advice leaflet to maintain an adequate baseline of activity  – and this suffices for the initial 7-10 days post discharge.

After this the outpatient recovery ought to take on a more dynamic aspect as the rehabilitation progresses. The passage of time and long rest periods will indeed help in terms of tissue healing times. However an overly passive approach to back rehabilitation is not advised.

Spinal surgery patients at Personal Health

We have had a large amount of patients manage their journey to recovery in Personal Health. Some choose the clinic simply because of location, others because they feel reassured that we have experience. Word of mouth seems to be a deciding factor for many, as they have heard good reports. However for those undecided we can provide some further information.

The journey to an active lifestyle once again

The most obvious reason for spinal surgery is excessive pain levels. Often the pain has become so debilitating for people that their day to day function is simply no longer possible. The journey to living an active lifestyle once again is a rewarding one, but it takes some determination and patience. If one has chosen to go down the path of surgical intervention, why not optimise the outcomes?

From Purgatory to Heaven

We have a varied and fun (believe it or not) approach to rehabilitation. It ought not to feel like penance, rather an opportunity to move from Purgatory to Heaven. We use strengthening exercises for the lower limb – thighs and gluteal muscles in particular. Similarly, we look to improve range of motion either above or below the surgical site. This can involve the whole spinal column, divided into its component parts of lumbar, thoracic and cervical. Also the small matter of re-training countless postural muscles can be less like homework than it sounds.

The body is designed to move

While inhibited movement is a natural part of recovery, it is important to reduce our inhibitions around natural movement. Even post surgically, the spine remains a column of strong bone, connective tissue and muscle. The body is designed to move and rediscovering the joys of this is a great feeling for people in their rehabilitation.

To Book an appointment at pH ; Visit us online at www.personalhealth.ie or call 01 4964002

Shoulder, Injury, Fitness, Rotator Cuff

Have I Got a frozen Shoulder? Or is it a Rotator Cuff?

Have I Got a frozen Shoulder? Or is it a Rotator Cuff? – Physiotherapy

Frozen shoulders can be a complicated and very frustrating issue. Typically they can last for up to 18 months. The shoulder becomes very inactive and day to day function is compromised. It is not a common presentation in the clinic here. Often people are concerned they have developed a frozen shoulder. However it is more frequently an issue to do with rotator cuff damage, or a type of shoulder impingement, or both of these together.

What is Frozen shoulder?

Frozen shoulder is medically termed as ‘adhesive capsulitis’. Fibrous adhesions start to develop within the shoulder joint and ultimately surround the shoulder capsule. The capsule itself becomes very inflamed – hence the ‘itis’ on the end of the word capsule. The result is significantly reduced shoulder function. Certain movements can cause sharp pain and as result the patient begins to move the joint less and less. It is best treated with injection therapy, some physiotherapy (aiming to preserve some range of motion), and in more acute cases there is surgical intervention. In the case of surgery the shoulder joint is manipulated under anaesthetic to restore greater movement. Although surgical intervention naturally cannot have a guaranteed success rate, it can provide a degree of improvement in the extremely frozen shoulder.

What is the Rotator Cuff?

The rotator cuff is a grouping of soft tissue structures that protect and strengthen the shoulder joint. It is comprised of muscles and tendons including the Supraspinatus, Subscapularis, infraspinatus and Teres Minor. These surround and attach into various parts of the shoulder joint and the shoulder blade. The cuff gives stability in particular, however it is vulnerable to damage as we get older.

How the shoulder joint moves

The shoulder is a relatively vulnerable joint compared to some other major joints within the body. It moves in multiple directions – as opposed to the hip or knee. There is a higher incidence of shoulder dislocation for example, because of this greater level of movement. Essentially the joint moves in multiple directions; forwards,backwards, sideways and in a rotational fashion.

Some typical Examples

The majority of shoulder issues presenting in clinic here in Rathmines relate to the rotator cuff as opposed to a frozen shoulder. Very often our clients are unaware how the issue might have developed, as it can be a very innocuous incident which causes the initial damage. Some typical examples such as starting a lawn mower, pulling a heavy suitcase or simply out walking the dog on a lead can cause an initial tear to a tendon and the issue slowly escalates from there.

What we do to treat the issue

We do an initial assessment of the joint to find out what the specific issue is. We use a number of orthopaedic examination tests to get an accurate diagnosis, without need for MRI referral. Once we have a solid diagnosis, we then work on restoring range of motion to the damaged joint. We simultaneously work on improving stability and strength. Don’t worry, there’s not too much hardship and homework – we send on video exercises to our clients so they can work away on their own schedule as suitable.

 

To schedule an appointment with one of our Physiotherapists, jump straight to our booking system here or call 01 4964002.

 

Cancer, Exercise, Health, Fitness, Physio

Exercise for Cancer Patients – Physiotherapy

Exercise for Cancer Patients – Physiotherapy

The Guardian newspaper recently (7-5-18) discussed powerful evidence in relation to the benefits of exercise for cancer patients. The published research is from The Clinical Oncology Society of Australia. This research has helped to launch its position statement on the role of exercise alongside surgery, chemotherapy or radiation in cancer care.

Research gets widespread endorsement

The research is endorsed by a group of 25 influential health and cancer organisations, including Cancer Council Australia. It is the first researcher-led push, anywhere in the world, for exercise to be an essential component of treatment for cancer. Indeed the statement goes further, suggesting exercise should be prescribed to ALL cancer patients. Furthermore it states ‘not to do so would be harmful’. A definitive and powerful stance indeed.

Why Personal Health provides Exercise for Cancer patients

At Personal Health, we welcome the position taken by the Clinical Oncology Society of Australia wholeheartedly. A number of our cancer patients have had great results with regular intensive exercise. Their positive experiences have included increased energy levels (or reduced fatigue), maintenance of weight and lean muscle mass, and improved mood. Overall there is an improvement in Quality of Life – and this is objectively measured as opposed to mere speculation.

Evidence is indisputable

The lead author of the research, Prof Prue Cormie from the Australian Catholic University, said the statement was based on “indisputable” evidence. “Really we are at the stage where the science is telling us that withholding exercise from cancer patients can be harmful,” Cormie said. Our philosophy in Personal Health has always promoted exercise as a form of medicine and rehabilitation for people living with prolonged health conditions. Our team of Chartered Physiotherapists & Occupational Therapy are passionate about providing insight and support for Cancer patients.

Exercise is Medicine

Professor Cormie is a huge advocate of exercise in general, and elaborated further in relation to cancer therapy. “Exercise is the best medicine someone with cancer can take in addition to their standard cancer treatments. That’s because we know now that people who exercise regularly experience fewer and less severe treatment-related side-effects; cancer-related fatigue and mental distress. They also have a lower risk of their cancer coming back or dying from the disease’,

Lifestyle Change

At Personal Health, we apply the best evidence to help lifestyle change. A simple way to boost cancer survival rates is to improve diet and include regular exercise. It is simple in concept but difficult to implement regularly. We provide a helping hand, a support network at home or in clinic, and a familiarity with the challenges you face. Some patients have had to maintain lean muscle mass in order to optimise chemotherapy/radiotherapy, others have had to improve range of movement post surgery. There are lots of differing angles and solutions.

Professor Cormie agrees …

It seems Prof Cormie agrees with our approach and vice versa. ’If the effects of exercise could be encapsulated in a pill, it would be prescribed to every cancer patient worldwide and viewed as a major breakthrough in cancer treatment,”  

She further elaborated “If we had a pill called exercise it would be demanded by cancer patients, prescribed by every cancer specialist, and subsidised by government.”

Types of Cancer patients in Personal Health

To date we have worked with patients who have had Breast Cancer, Oesophageal and gastric cancer, Prostate and Bowel cancer. Based on the latest evidence above we see no reason to be exclusive just for these types of cancer. Our service provides benefit for all those dealing with the various difficulties on the journey to recovery.

We offer 10 physio-led exercise appointments for 500 Euro in a non-intimidating gym environment. This is covered under Chartered Physiotherapy in your Insurance Policy.

Call us now to find out more.

01 496 4002

www.personalhealth.ie

Exercise, fitness, ageing, arthritis, Lifestyle, Dublin 6

Physiotherapy – Motion is Lotion – the benefits of exercise for the over 70’s

Physiotherapy – Motion is Lotion – the benefits of exercise for the over 70’s

 

All the big Consultants we know very regularly use the phrase ‘wear and tear’! It’s a gentle way of talking about the decline of our once glorious body. Arthritis is not curable but it is absolutely manageable. The trick is to exercise correctly while simultaneously not antagonising the inflammatory joint. Movement is key and motion is lotion!

The over 70s lifestyle

A great number of our patients are of a certain age …. but who’s counting right?

What we can confirm apart from dubious birth certificates is that they are a smiling, well oiled vintage. Many of them are golfers, almost all of them are regular walkers. Some join exercise groups dotted around the community. These people are living busy lives, booking concert tickets on the Ipad, gardening and loving the sport on TV. The Grandchildren are beautiful but exhausting, and often that mayhem is followed by a well deserved glass of wine. Lets’s not forget the odd holiday or three … Vitamin D is good for the joints, the skin and the soul.

Motion is Lotion

There is one shared quality among this group who cross our threshold in Personal Health.

They are keeping active. A former P.E teacher from my schooldays had a phrase referring to healthy joints; ‘Motion is Lotion’. This was as relevant for teenage kids as it is now for the ageing population.  It makes perfect physiological sense. Regular activity at any age helps circulation within our joints. An oxygenated blood flow swishing it’s way through our spine, shoulders, hips and knees is all good news. But it is particularly relevant when we are getting older.

Move More or Move Less? ….Move Clever….

Movement, Hips, Arthritis, exercise, Fitness, Dublin, ageing

The magic of Jimenez…..aaaaaaannnd Stretch !!

With regular movement our joints begin to move more freely – regardless of previous injury or medical diagnosis. Let’s take the hip as an example. It is a joint that regularly succumbs to arthritic change as we get older. The natural tendency is to move less with arthritis present in the joint. This is often due to pain while weight bearing. It is a perfectly natural reaction to move less. Unfortunately this is the completely wrong thing to do and means the joint will only deteriorate quicker. We need to start moving clever without impacting the damaged part of the joint.

Non Impact Movement

One of the best remedies for joint pain is to move the joint in a non weight bearing way. Cycling (indoor exercise bikes or outdoors in the park) allows the hip joint to move without compressing the ‘wear and tear’ we referred to previously. Most importantly, it strengthens and lengthens the muscles that surround the joint. It is a positive cycle whereby the blood flow helps lubricate the joint. This in turn eases inflammation. As soon as we have facilitated greater movement, the joint has greater range. This means the muscles protecting the joint automatically get stronger while stretching and contracting with greater activity.

The Solution

Get active!! If you would like to choose Personal Health as your option, we will be waiting with open arms. There are comfy seats and tea on tap (post exercise) to recover and recuperate. We always have time for a few chats too. Hopefully see you soon!

Diabetes, Fitness, Exercise, Physio, Dietary, Dublin 6, Rathmines

The Personal Health Diabetes Programme

Everybody is scared at the start when it comes to embarking on a new journey! The Personal Health Diabetes programme is no different. We thought we were gentle, approachable, understanding and compassionate people!! But what we didn’t consider was that people with Type 2 Diabetes are petrified about making small changes in their lifestyle. Most participants have waited for years before contemplating and finally making some small changes. But they are all delighted once they start and most comment that they wish it happened sooner.

Guilt and Stigma

When we have got to know our participants after a few weeks, often people have mentioned carrying a guilt and stigma with them for developing a condition like Type 2 Diabetes. The condition is lifestyle related, so they feel they have let themselves down in some way. The reality here is that feelings of guilt and stigma are futile. What is important is to take action now and make small but attainable changes to your lifestyle. Former Chair of International Diabetes Federation, Dr Tony O’Sullivan has visited us here to assess the Personal Health Diabetes programme and was impressed, commenting  ‘This programme is suitable for anyone living with diabetes and will really contribute to better control of the condition’.

Sociable and Friendly

Our participants are a lovely sociable gang. 

Diabetes, Health, Fitness, Exercise, Dublin 6, Rathmines

They meet regularly on Tuesday afternoons in clinic and despite the chats and giggles, they get their work done. The fitness levels, size and shape differs from person to person but all are accommodated. The one non negotiable is that they do some good honest work, ending up a little sweaty and breathless (don’t worry nobody crawls out the door!).

What does Type 2 Diabetes programme involve?

Mark Hynes (Chartered Physiotherapist) is running the Type 2 Diabetes programme along with our Dietitian Caoimhe O’Leary. They are doing a brilliant job! 

Dietary, Dietitian, Diabetes          Diabetes, Fitness, Exercise, Physio, Dietary, Dublin 6, Rathmines

The programme involves turning up on Tuesday afternoons at 5pm. Once an initial screening is complete the client is cleared for progress and the fun begins. The exercise classes (4 per month) last approximately 40 minutes in total. Caoimhe also runs a monthly workshop discussing practical and non sacrificial changes to enable healthy eating.

What are the benefits?

Some people choose to test their progress every few months and this has given participants great feedback.  Some see changes in blood sugar levels. Others experience weight loss. Most improve on strength scores and stability. Others feel steadier on their feet and more confident. Most describe greater energy levels. Crucially, as healthcare professionals we see a group reducing the risks associated with the condition. It is a hugely rewarding experience for all concerned.

What do I wear, what do I do, what happens in general??

People tend to arrive a few minutes beforehand in comfortable, exercise clothing. For those arriving from work , there are clean and spacious changing rooms with showers and storage. During each class there is a warm up , some strength training, balance and co-ordination tasks, some short sharp bursts of activity (High Intensity Intervals), some stretching and functional movements, and plenty of advice about pacing yourself. Turn up people! You’ll be glad you did!

Running, Prehab, Physiotherapy, Hip, Knee

Top 10 tips for Runners

Get Started Today to Enjoy a Summer on the Move

Have a Plan:

Whether your aim is to run your local park run every Saturday or to make the Olympics in two year’s time you need to have a plan. There are two options: You can go online to get a generic plan based on achieving a set distance in a target time. Many runners have used them to good effect. The only problem is they might be too advanced or too easy for your running ability. The second option is to get a qualified coach who will tailor a programme to your needs and ability. It is important to have goals with these plans and they range from weekly goals (running 3 times a week) to yearly goals (running  5K in under 20 minutes).

Running gear:

Fail to prepare, prepare to fail. This is where so many new runners fall down. The most important piece of equipment is the shoes and it should be first on your list to buy. Nowadays if you go into any sports shop in the country they will do a gait analysis on you to see which shoes would suit you. They video you while running on a treadmill for a few minutes and then the footage is played back in a Freeze by Freeze frame if necessary to assess your foot plant, stride and running pattern. This information can then be used to find the best shoe for you. Also to consider when buying shoes is the terrain you will be running on (Grass, Road, Trails or track).

While hitting the road you will need heavier shoes with more support. While on the track you would be looking for light shoes with little support. The socks are just as crucial as the shoes as you need running specific socks due to the extra padding across the ball of the foot, the toes and heel area. There’s also usually padding or a tighter area through the arch to allow the shoe to fit more closely and add better arch support. Now on to the shorts and T-shirts which is the uniform of all runners around the world. These need to be lightweight, breathable and sweat-wicking. As we live in Ireland it rains or is extremely windy most of the time. So running jackets, base layers and running tights can be your friends in the constant battle against the weather.

Start where your fitness level is:

If you haven’t ran in years or done any cardiovascular exercises you cannot expect to go out and run 30 minutes straight without needing a rest. To get around this start off by alternating running with walking throughout the run (a minute of walking followed by a minute of running). Another way is to just take short breaks when you need it on the run. So if you are starting off, start with the run/walk method – go slowly and don’t run more than 3 times a week. This way you’ll gradually build your pace and distance and prevent injury.

Always warm up, cool down and stretch:

Before every run you should do some dynamic stretches such as rolling your shoulders back, hip circles, lunges and squats. The dynamic stretch should be followed by five minutes of a slow jog. The warm up and dynamic stretches are done to get every muscle in the body ready for the run and to prevent injury. After you run jog slowly for 5 minutes and finish with some static stretching which you hold for 30 seconds (Quad, Hamstring and Calf stretch).

Running, Stretching, Physio, Physiotherapy

10 percent rule:

As you start progressing on with your running and feeling good, it is important not to over do it. That is why there is a 10 percent rule where you are not meant to increase your weekly training mileage by more than 10 percent per week. People who increase their weekly mileage too quickly get injured. The only exception to the 10 percent rule is if you are starting at a single-digit weekly mileage after a layoff, you can add more than 10 percent per week until you’re close to your normal training load.

The Conversation Rule:

Running is not all about going as fast as you can all the time. Especially on easy runs you should be able to have a full conversation with the person you are running with. People whose heart rate and breathing rates were within their target aerobic zones were found to be able to hold full conversations. Those who couldn’t were running faster than their target aerobic zone. The exceptions to the conversation rule are during hard runs, speedwork or races.

The Hard / Easy day rule:

It states to take one easy day after every hard day of training. An easy day is defined as a short run, slow run, a cross training day or no exercise at all. A hard day is defined as a long run, tempo run or speed workout. Apply The hard/easy day rule to your monthly and yearly training plans by treating yourself to one easy week each month and one easy month each year. The exception to this rule is after the most tiring long runs or speed workouts especially if you are older. You should wait for two or three days before your next hard workout.

Don’t delay refuelling after runs:

Making sure you refuel properly after a run is probably more important than the run itself.  Especially if you have done a fast run. Your post run meal is very important because it will aid recovery.  It is recommended that the post run meal contains carbohydrates for energy replacement and a good source of protein for muscle repair as soon as possible. After a run it is important to have that post run meal within the hour of running. For quick energy before having the post run meal have a banana while cooling down and doing your stretches. As it is quick and easy to eat.

Listen to your body:

If something hurts for two days in a row take days off. Two days of pain may be signalling the beginning of an injury. If the pain continues for over a week even with rest days it is probably time to go see your doctor. It’s the same if your body is feeling tired, there is nothing wrong with taking a day or two off to let the body recover from the exertions of exercise. Even if you have to take a week off from running it is not going to have a big impact on your fitness level.

Track every run so you can see your progress and make notes about your workouts:

Apps like Strava and MapMyRun use GPS to automatically store your route, distance, calories burned and your pace so you’ll watch yourself run further and faster over time. These apps also allow you to enter notes about each run so you can see patterns like that the first mile I always feel terrible (going too fast at the start) or you run faster when go first thing in the morning or that you get a pain in your right leg after 3 miles. The apps are also good because you can set up groups with your friends and challenge each other to see who has the most miles in a week .So this adds some healthy competition.

Running, Prehab, Physiotherapy, Hip, Knee

Preparing for Joint Replacement Surgery – PREHAB??

 

Are you on a waiting list for joint replacement?

If so, it is an ideal time to manage your recovery – by starting NOW!

We mean start your rehabilitation before surgery – commonly known as Prehabilitation or Prehab!

The stronger and fitter you are before a major surgery the better your response to general anaesthetic or epidurals. This is a medical/lifestyle issue more than anything to do with your arthritic joint.

In the case of joint replacements, typically the decision for surgery has been made carefully and responsibly between yourself and your orthopaedic consultant based on various issues;

  • excessive pain levels
  • day to day basic activities have been compromised
  • difficulty walking even short distances

As your arthritic joint has deteriorated significantly, so too has it’s range of motion. This means all the surrounding muscles for this joint have become shortened and weaker.

Post surgical rehabilitation of these muscles is a long and sometimes arduous journey.

However, addressing soft tissue (muscle/tendon) weakness now can have really positive effects.

With increased muscular strength around the replaced joint your capacity to bear weight will be optimal in the days immediately post surgery.

Also, you will get a quicker restoration of range within the joint. In the case of knee replacements, you will need to bend the knee beyond 90 degrees in the days immediately post surgery – so your preparation now can only aid this process.

Hip Replacement

In the case of hips, you will need strength in the muscles around the replaced hip joint to ensure there is stability in the joint. This prevents any complications such as dislocating the replaced joint. This type of dislocation can happen when the surrounding soft tissue structures are not strong enough to hold the replaced joint in its new position.

A well prepared patient whose has gone through Prehab, usually means slightly quicker discharge times for those who dislike the hospital setting. Some people go to specialised rehabilitation facilities, while others safely return home and choose to work on their recovery with the support of physiotherapists, family and friends.

Start the Journey Today

Ultimately joint replacement is all about the capacity to regain functional activity. It’s about improving quality of life – whether this is simply to enjoy walking again, or golf, tennis (usually doubles tennis!) and even more personal issues such as improved sex life due to reduced joint pain.

Everybody has a reason, or multiple reasons, to embark on this journey. With the support of your consultant, the hospital staff throughout the procedure, and those who deal with you in the months following surgery, everybody is trying to make this a new lease of life for the patient.

So why not give it your best shot in the lead up??

For more information on Preparation for Surgery contact us now:

01 4964002

info@personalhealth.ie

www.personalhealth.ie

Getting Back to Exercise After Having a Baby – Women’s Health Physiotherapy

 Tips for getting back to exercise After Having a Baby – Women’s Health Physiotherapy

  • After pregnancy and labour women can neglect themselves as they can become consumed by the amazing yet chaotic word of a newborn baby. 
  • Juggling it all can be tough, most of the time something has to give and this tends to be time for yourself that is sacrificed.
  • Firstly don’t be too tough on your self, give your body time to heal. A woman’s body is amazing and you should be proud if it.  Growing and nurturing a baby is no easy feat!
  • My advice would be getting strong and mobile the right way, from inside out!
  • Remember that
    many of the physiological and morphological changes of pregnancy persist for four to six weeks after having your baby.
  • Thus, exercise routines should be resumed only gradually after pregnancy and should be individualized.  Physical activity can thus be resumed as soon as physically and medically safe.
  • This will certainly vary from one woman to another, with some being capable of engaging in an exercise routine earlier than others.

1. Rest

It is very important to rest to help with your recovery.

Rest on your back or side to

  • Minimize discomfort,
  • Reduce swelling
  • Take extra weight off your pelvic floor and lower abdominal muscles.

2. Pelvic Floor Exercises

  • Pelvic Floor Exercises can be safely started 1-2 days following the delivery of your baby, provided there is no increase in your pain.
  • Deep Abdominal and Pelvic Floor exercises help you return to your pre-pregnancy shape and will help with healing of stitches

Exercises to strengthen your Pelvic Floor

It is important for all women before and after birth whether they have a vaginal or cesarean delivery to strengthen their pelvic floor muscles.

1. Long Hold:

  • Lie on your back with your knees bent and your feet supported but apart.
  • Squeeze and lift around all 3 openings in your pelvic
    floor. These being your back passage vagina and bladder. Like you are
    trying to stop yourself passing wind and urine.
  • Hold for 6-10 seconds, keep your abdominal, buttock and
    thigh muscles relaxed and continue to breathe
    normally.
  • Relax for 3 seconds.
  • Repeat this exercise another 5 times
  • Repeat 3 times a day.
  • As your pelvic floor muscles get stronger, practice in
    sitting and standing.
  • Gradually increase the hold time and number of repetitions until you can do a 10 second hold 10 times.

Remember…Always stop exercising when the muscle fatigues.

2. Quick holds

  • Tighten the pelvic floor muscles as above but only hold for a second before letting go fully.
  • Repeat 5 times in a row.
  • Repeat 3 times a day.
  • Gradually increase your repetitions until you can do 20
    quick squeezes in a row, it may take a few months to be able to do this.

3. Deep Abdominal Muscle Exercise

During pregnancy, as your baby grows, your abdominal muscles stretch and become weakened.

Abdominal muscles are important for back support and in maintaining good posture.

Deep Abdominal Activation

  • Lie on your back with your knees bent and feet supported and hip distance apart.
  • Breathe in, let your tummy rise.  Breathe out; gently tighten your lower abdominal
    muscles (by 20%) by pulling your lower belly in towards your
    spine (as if getting into tight trousers).
  • Keep your upper abdominal muscles relaxed
    throughout the exercise and breathe normally
  • Hold the position for 3 seconds. Repeat 5 times, 3
    times a day.
  • As you get stronger do the exercise in sitting, all fours
    and standing and gradually increase the hold time up to 60 seconds.
  • Women who have undergone a caesarian section should follow all the above advice. However, because you have had an abdominal operation you may be more tired; do not expect too much too soon. You need to wait longer before engaging in more challenging exercises, always seek advice from your medical practitioner. There are several layers of stitches in your lower abdomen that will take time to heal so increase your activities gradually as you feel able.

4. Return to Exercise

At 6 weeks postnatal start gentle exercises:

  • Walking as pain/discomfort allows, gradually increase your distance then your speed.

  

  • Swimming when you have had 7 days in a row free from vaginal bleeding or discharge.
  • Join a Post Natal Pilates or Yoga class and progress the strengthening of your deep muscle system in a supervised, safe and guided environment. 

5. High Impact Exercise (e. g weights, jumping, running)

  • At 3-4 months post natal you should check your pelvic floor strength by; coughing with a full bladder or jumping with a full bladder before attempting high impact exercises.
  • Only begin if there is no urine leakage.
  • If you have leakage, Book an Appointment with a Women’s Health Physiotherapist for an Assessment and individualised Exercise programme.

6. Lastly Exercise should be enjoyed and help relieve stress not add to it! So choose exercise that you like and always listen to your body.

How can PH help?

Book appointment with our women’s health physiotherapist Mary-Kate to get a thorough pelvic floor assessment and specifically tailored exercise programme.

Pre and postnatal Pilates and yoga