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Physiotherapy

How should I set up my desk?

sitting

With so many of us working from home at the moment you may be thinking “how am I meant to set up my desk?”  Here is a short guide with some tips to help you work from home comfortably.

The first thing to remember is there is not just one right way to sit at a desk and it may look slightly different depending on your work demands and your body.  It is important to remember that even the best posture is not going to be completely comfortable eight hours a day.  Our bodies are just not designed to sit for that long!  Your posture should be comfortable and natural for you.

sitting

 

Seat

First of all, sit with your feet flat on the floor and your chair height so that your hips are just above your knees. A good seat that is adjustable and has some lumbar support will serve you well. If your seat does not have any low back support an easy solution is to fold up a towel and place it behind your low back. You should be sitting with a slight tilt backwards at around 100-120 degrees, rather than directly upright.

 

Desk

The desk should be at a level where your elbows are by your side and forearms can rest on the desk around 90 degrees.  Make sure that the things you use regularly, like the keyboard and mouse, are within reach while sitting and you are not stretching to reach them repeatedly throughout the day.

 

Screen

Screen height is one of the key things that can make a big difference to the neck and upper back strain.  If you imagine your screen is divided into thirds: top, middle, and bottom.  When sitting comfortably, your eyes should fall at the line dividing the top and middle thirds of the screen. This is usually where laptops fail.  If you are trying to work with a laptop, consider purchasing a separate keyboard so that you are able to raise the screen.

 

It is important to stand and move often.  As a general rule getting up every hour to stretch, move and reset will help keep your body feeling good.

 

If you would any further advice on setting up your desk at home, our team are here to guide you.  This information is quite general and a more detailed assessment by an Osteopath or Physiotherapist can help individualise the set-up. We are available for 1-on-1 appointments or take advantage of our Telehealth option, which should allow us to view your set-up and help tailor it to your needs.

 

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Written by Osteopath Natalie Anderson

3 tips for relieving tension in your lower back

Many of us are familiar with low back pain. In fact, most people will experience low back pain at some point in their adult life, with many of those people experiencing recurrent episodes or episodes acute enough that the pain and its effects limit their activities of daily living. The cost of health care, loss of work and income can be significant, not to mention the burden of experiencing and managing this pain and how this affects our participation and enjoyment of life.

Our brain and bodies are very clever – when the brain receives messages that there is a perceived problem or pain in an area such as the back, it responds by recruiting muscles around the area to tighten and stiffen in order to ‘guard’ the body segment and those around it and to limit movement. This is a “first aid” response to create stability by locking everything down, also known as ‘spasm’ or ‘back spasm’. This can happen to varying degrees – sometimes you’re unable to move, other times there will just be increased stiffness and tightness. When this occurs, it is common to also experience secondary discomfort from the contraction and lack of circulation in the muscles, and stiffness in the joints.

The great news is that you can proactively manage low back pain. Depending on where you are in your back pain journey, we recommend a combination of hands-on treatment with your osteopath, physiotherapist, myotherapist or remedial massage therapist, along with exercise rehabilitation with your physiotherapist, exercise physiologist or diploma-trained Pilates instructor. In between sessions you can use these three simple tips anytime you’re feeling sore or stiff to keep you moving and pain-free.

 

Release the hips

Here are some gentle stretches for your hips and some release work you can do with a ball to help reduce spasm and tightness.

  • Hip flexor stretch

3 tips Low back pain tension

  • Glute stretch

3 tips Low back pain tension

  • Hamstring stretch

3 tips Low back pain tension

 

Move the spine

The aim here is to get the spinal segments around the affected area moving well, then gently start moving the affected segment in safe, non-painful ways. Moving your joints will help decrease tension and improve circulation in the area.

  • Thoracic Mobility: book openings

3 tips Low back pain tension

  • Lumbar rotation: side-to-side (feet elevated on a lounge or legs on a fit ball).

3 tips Low back pain tension

 

Activate the stabilisers & reiterate to the body that it is safe to move.

Once you’ve reduced some of the tightness and stiffness, you can do some gentle activation and stabilisation work to help support the joints and tissues, in addition to sending reassuring messages to your brain that it is safe to move. Focus on moving with your breath here.

  • Supine core/hip disassociation: bent knee opening

3 tips Low back pain tension

  • Glute med: Sidekick/clam

3 tips Low back pain tension

  • Glute max: Bridge

3 tips Low back pain tension

  • Quadruped: spinal stabilisers

3 tips Low back pain tension

 

These are just a few general tips. We recommend having an assessment and receiving specific advice and guidance on which exercises and stretches will provide the greatest benefit to you, your particular symptoms, and the underlying cause of your back pain. Contact The Body Refinery for further in-person support from our wonderful health care team, who are armed with the knowledge and experience to guide you through healing, rehabilitation and prehabilitation to avoid recurrence, keep you moving well, and enjoying life.

written by Myotherapist and Pilates Instructor Sarah Holloway

5 Things to Remember when Returning to Running

Running – when you’re fit enough to run, to really run, it feels amazing and simple – just you, your running shoes and the ability to go wherever your legs can take you.

Running is different things to different people: a moment of mindfulness and awareness of yourself; a sacred, quiet time at the start or end of the day; a time to think; to compete; or to socialise.

Running can be a truly life-affirming exercise. However, it’s rare for people to uphold a consistent running routine throughout life, and our time on the pavements, trails, roads can wax and wane, ebb and flow. So if you’ve been more ebb than flow with running, here are 5 things to remember when returning to running, to ensure you don’t end up with a running-related injury just when it’s getting good again.

 

  • Our bodies like building up to load gradually. Too much too soon increases the risk of injury.

Incidence and prevalence of running injury in long-distance runners are high, ranging from 20 – 80% of runners. The predominant site of these injuries is the knee (7-50%), with other lower and upper leg injuries being next most prevalent.

Evidence indicates that long weekly training distances and a history of previous injury are risk factors for injury. Our bones and tissues will adapt to the loads under which they are placed, however, they need time to make these adaptations. Getting the right balance of training load while building tissue load capacity is key in mitigating running injuries, thus gradually increasing your running distance will help to minimise the risk of injury to your body, particularly your knees.

 

  • Be fit to run

The fitter we are, the better we can run. The overall load experienced by your body can be significantly reduced through: good running form; a relatively quick cadence; and less ground contact time. This can be achieved by having: cardiovascular fitness to maintain good form; leg speed; and enough strength and recoil in our tissues to minimise ground contact time. Building up to this slowly will make all the difference.

 

running

 

  • Cross-training – cardiovascular fitness, hip, core, and leg strength and stability is where it’s at.

Including other cardiovascular fitness routines in your training will help you get fitter quicker without overloading your body with running. Consider incorporating swimming, cycling, spin, and/or Tabata/HIIT classes between runs to help increase cardiovascular fitness.

Strengthening is preventative because it helps your tissues adapt to load. Running-focused strength routines are usually based on exercises around the lower leg, thigh and hip, pelvis and core to support the hip, knee and lower limbs. Exercise physiology sessions, Studio Pilates and group classes such as Barre, Reformer, Mat and TRX can be fantastic additions to your cross-training.

(Read our Hip, Core and Lower Leg Strength for Endurance Runners blog for more tips!)

 

  • Our bodies need rest

When you’re starting out or getting back into running, allow a rest day between each active day.

Without rest, you cannot recover, and without recovery, improvement may slow and you may become susceptible to injury. It’s okay to incorporate stretching, mobilising and light yoga on your recovery days – just make sure you’re taking it easy.

As your body adapts and strengthens you can start to change up your training and rest schedule to incorporate more running and exercise. Your exercise physiologist or physiotherapist can provide invaluable advice in planning your training and rest schedule.

Other great additions to your training regime are regular myotherapy or remedial massage sessions, which help maintain good tissue quality and joint range of motion. Once every 2-4 weeks is recommended, depending on your running load.

 

  • Good shoes are important

It is worth investing in a pair of shoes that effectively support your feet and lower limbs. If you’re a runner from way back, you’ve probably already found a brand or style that you know and love. If you’re not sure, seek advice from your physio or a specialist running shoe retailer. Ensure you replace your shoes when they are worn – a general rule of thumb is at around 500 + kilometres or approximately every 6 months if you’re running frequently.

If you would like assistance to improve your running form or training schedule, have any running-related discomfort that requires attention, or would like to be guided through exercises in a personalised class, call the friendly admin team at The Body Refinery.

Our Refined Runner program may be just the thing for you.  Our team includes diploma-qualified Pilates Instructors, Physiotherapists, and Exercise Physiologist, and an Osteopath who enjoy helping runners achieve their goals, pain-free and in good form. Additionally, our hands-on Myotherapist and Remedial Massage Therapists are here to help keep you in top form.

 

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The Importance of Advice and Education

The Importance of Advice and Education

As physiotherapists in the musculoskeletal field (i.e. muscles, bones, ligaments and nerves), our treatments are often viewed in terms of the hands-on work we do. While this can be a critical aspect of our overall management of patients, an equally important part of our treatment is the advice and education we provide.

Imagine there were certain things you were doing or positions you were putting yourself in that were making your pain or injury worse, but you weren’t aware. I’m sure you’d like to know so you could change or avoid these actions or postures in your daily life. There may also be certain things you could be doing to help relieve your pain and assist in your recovery. Knowing how and when to add such steps to your daily routine could be life-changing.

As patients, you know your body best and have most likely worked out what makes your pain worse, what makes it feel better, and have already made certain changes in your life to help manage your pain.

However, there are likely multiple other small things you haven’t recognised, which could be hindering your recovery.

Things like being up-to-date with the latest research – for example, applying ice to acute injuries is no longer recommended, but applying heat is.

Pilates low back pain

What about increasing awareness that the way you are moving your body could be creating unhelpful movement patterns that will take time to unlearn before new optimal movement patterns can be created?

These are just some examples of patient advice and education which can be crucial to recovery. There are even some chronic pain conditions where hands-on treatment can actually make the pain worse, and for patients affected by such conditions, physiotherapists rely on providing professional advice and education as the primary form of treatment.

Physiotherapy advice also extends to the exercises we prescribe, whether this be your home exercise program or clinical rehab or clinical strength sessions undertaken with a physiotherapist or exercise physiologist in the studio.

Finally, when it comes to treatment planning, communicating your diagnosis, providing recommendations for all management options, outlining a course of action (including the number of sessions required for the most effective recovery) and overall prognosis, this all constitutes advice and education. This is a huge part of our role as physiotherapists, and something we aim to implement at The Body Refinery, along with hands-on treatment, in our “Pain to Performance” model.

Our physio team aims to do everything we can to help you, which includes passing our knowledge onto you to enable you to help yourself.  So next time you are in the studio attending a class or an appointment, get the most out of your session by putting your physio’s advice into action between your sessions and even after you are pain-free, for preventative purposes.

Sever’s Disease

Is your active child complaining of heel pain? Have they started walking more on their toes? They may be suffering from a common paediatric condition called Sever’s disease.

Sever’s is an overuse condition many 8-14 year old children suffer from, being most common at 8-10 years old for girls and 10-12 years old for boys. It occurs when the Achilles tendon pulls on the growth plate at the base of the heel and becomes inflamed. The calcaneus bone is not fully developed until around 14 years of age. Until then the pressure put on the growth plate, particularly with high levels of running and jumping can cause it to become inflamed and painful.

Sever's Disease

 

Luckily there are some easy things that can be done to help manage this condition. 

  • load management and rest, your osteopath or physiotherapist can help to guide you with what is appropriate. 
  • cold therapy 20 minutes on 10min off 20 minutes on, particularly after activity. 
  • foam rolling the calf muscles
  • spending less time barefoot or using heel cups and cushioning shoes.

If this sounds like your child could suffer from Sever’s Disease, our team is here to help! Book in with our Osteopath or one of our Physiotherapist’s for treatment now.

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Come and see what an osteopathic approach can do for you or your child. Natalie is available for appointments Monday, Tuesday and Thursday at The Body Refinery.

Book today to experience the benefits of Osteopathy through our App or on 07 3358 3915.

Pilates For Bone Health – Osteoporosis

bone health

While bones feel solid, the inside of the bone is actually filled with holes like honeycomb. Our bones are constantly being remodelled – old bone is removed and new bone is formed. As we age, we begin to lose more bone than we build. This can result in a condition called osteoporosis. The tiny holes within the bones get bigger, and the solid outer layer becomes thinner. In other words, our bones get less dense. This makes them more prone to fracture, even from a minor bump or fall. The most common fracture sites are the spine, wrist and hips. Fractures in the spine reduce the height of the vertebrae and can lead to a stooped or hunched posture called kyphosis, reduced mobility, pain, balance problems and increased risk of falls.

What are the symptoms?

Osteoporosis is often described as a ‘silent disease’ because there are no symptoms. Often people aren’t diagnosed or treated for osteoporosis until they sustain a fracture.

Who is at risk?

There are certain risk factors for developing osteoporosis. These include:

  • Female sex
  • Certain medical conditions and medications (e.g. thyroid problems, rheumatoid arthritis)
  • Family history of osteoporosis
  • Calcium and/or vitamin D deficiency
  • Sedentary lifestyle
  • Smoking
  • Excessive alcohol consumption

If you are over 50 and have any of these risk factors, speak to your doctor about having a bone density scan.

bone health

How is it treated?

Medication and lifestyle changes are the main forms of treatment for osteoporosis. Exercise is also very important. Current guidelines recommend a combination of weight-bearing exercise, resistance training and balance training. Exercise programs should be performed regularly (at least three times per week), challenging, progressive, varied and individualised to the person.

 

Pilates for osteoporosis.

People often overlook Pilates as an exercise option for the management of osteoporosis, probably because they are only thinking of traditional mat exercises. However, Pilates can also be performed on specialised equipment such as the Trapeze Table and Reformer. This type of equipment-based Pilates incorporates weight-bearing and impact activities which can improve bone mineral density. A recent study in postmenopausal women with osteoporosis found a significant increase in bone mineral density in the lumbar region following a clinical Pilates program.

Equipment Pilates can also help to build muscle strength by adding resistance in the form of springs. Other benefits of Pilates include correction of postural changes, reduced pain and improved mobility, balance and coordination.

If you have been diagnosed with osteoporosis or low bone density, make an initial physiotherapy appointment at the Body Refinery today. Our physiotherapists will perform an assessment and design a safe, effective and individualised clinical rehab program incorporating both Pilates informed exercises and traditional rehabilitation exercises to improve bone density, strength, posture, balance, coordination and reduce the risk of falls.

 

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Book today to experience the benefits of Pilates through our App or on 07 3358 3915.

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Pelvic girdle pain

Pelvic Girdle Pain (PGP) is a specific form of lower back pain that arises during pregnancy, usually between 14 and 30 weeks. The pain is located around the SIJ/buttock area and may radiate to the back of the thigh. PGP is very common during pregnancy, affecting approximately 56% to 70% of women. 

It is thought to be caused by hormonal changes during pregnancy which increases the laxity of pelvic ligaments in preparation for birth. This increased mobility of the pelvis can increase strain on the muscles and cause irritation or inflammation of the joints. In some cases, the pelvis may even be slightly ‘out of alignment,’ especially after a fall. 

Pregnant women with Pelvic girdle pain will experience pain with sitting, standing or walking for long periods and have difficulty with asymmetrical movements such as stairs and turning in bed. 

pregnancy massage The Body Refinery New Farm Brisbane

Some tips for helping to manage Pelvic Girdle Pain include:

  • Avoid prolonged sitting – get up at least every 30 minutes
  • Stand with weight through both legs evenly 
  • Avoid walks for hours at a time
  • Avoid stairs – take the lift or escalator where possible
  • Roll in bed with knees together
  • Shorten stride length
  • Avoid walking on soft surfaces like sand 

It is important to remember that your pelvis is supposed to be more mobile during pregnancy to make birth easier. It does not mean your pelvis is ‘unstable’, it just means you have to learn to control that increased mobility. 

If you think you are experiencing PGP, please book in for an appointment with one of our women’s health physiotherapists.

In the initial consultation, our physiotherapists will take you through a detailed history and physical examination to ensure an accurate diagnosis and develop an individualised treatment plan. This may include:

  • Advice and education 
  • Hands-on treatment such as massage or joint mobilisation to relieve muscle tension and restore alignment 
  • Fitting for a pelvic belt to help reduce movement of the pelvis
  • Stabilising exercises to help manage your pain and improve your day to day function

Depending on your goals, our physiotherapists may also recommend clinical rehab or pregnancy conditioning classes. 

To make an appointment at our New Farm studio, call our reception staff on 07 3358 3915 or click the link below. Please, be sure to request one of our Women’s Health physiotherapists.: Courtney and Charmion

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Calcification in your shoulder – shockwave can help

Calcific tendonitis is a common cause of shoulder pain. It occurs when calcium deposits in or around the rotator cuff tendons, most commonly the supraspinatus. It usually affects people aged 40 to 60 years and is more common in women than in men.

People with calcific tendonitis will generally have shoulder pain, stiffness, difficulty sleeping on the affected side and problems with activities of daily living such as dressing and work. Diagnosis is confirmed with imaging such as ultrasound or Xray. Calcific tendonitis of the shoulder is typically treated with rest, anti-inflammatories, physiotherapy, corticosteroid injections and if all else fails, surgery.

calcific tendonitis shockwave The Body Refinery New Farm

More recently, shockwave therapy has emerged as an alternative treatment option. Shockwave delivers acoustic waves to the affected area with the intent of breaking up the calcification. Studies have shown shockwave can help to reduce pain, increase shoulder function and dissolve calcifications in people with calcific tendinitis of the shoulder. These improvements are also long-lasting with patients showing improvement in symptoms and resorption of calcifications at 6 months follow up.

The Body Refinery’s shockwave machine is made by EMS Swiss DolarClast, the world leader in Shockwave therapy and technology.

If you have been diagnosed with rotator cuff calcifications, please talk to your physiotherapist, myotherapist or massage therapist about Shockwave. The initial appointment is 45 minutes long and will include a full assessment and a minimum of 15 minutes of treatment. Following sessions can go from 15 to 60 minutes depending on the type of injury. Shockwave appointments are only performed once a week to allow the injured area to rest.

Book today to experience the benefits of Shockwave Therapy. Call 07 3358 3915 or follow the link below.

Achilles tendinopathy

achilles tendinopathy shockwave therapy the body refinery new farm

The Achilles tendon is the largest and strongest tendon in the human body. However, it is prone to injury, with Achilles Tendinopathy being one of the most common overuse injuries.

How does it occur?

It was previously thought that Achilles pain was due to inflammation. However, recent studies show that Achilles Tendinopathy involves little or no inflammation. We now understand that Achilles Tendinopathy occurs when the Achilles tendon is overloaded, either in a single episode or gradually over time. It has been described as a continuum with three phases: reactive tendinopathy; tendon disrepair; and degenerative tendinopathy.

Reactive tendinopathy is usually seen in younger people and results from an acute overload such as a burst of unaccustomed physical activity or a direct blow to the tendon. In response, the tendon thickens but if the load is reduced, the tendon will return to normal. If the tendon is not allowed to rest however, it will progress to the next phase – tendon disrepair. In this stage, the collagen fibres that make up the tendon become disorganised but it is still possible to reverse these changes with treatment. Things become more difficult in the final stage – degenerative tendinopathy. This stage generally affects middle-aged, recreational athletes who have a history of Achilles pain. At this stage, there are degenerative changes in the tendon that are difficult to reverse.

 

What are the symptoms?

People with Achilles tendinopathy will report pain, stiffness and swelling in the Achilles region. There are two types of Achilles tendinopathy depending on the location of pain– mid portion and insertional Achilles tendinopathy. Pain in the middle region of the Achilles tendon is typical of midportion Achilles tendinopathy whereas pain, where the Achilles inserts onto the heel bone, suggests insertional tendinopathy.

 

What are the risk factors?

There are certain factors that can increase the likelihood of developing Achilles tendinopathy. These include: 

  • male sex
  • age >30
  • diabetes
  • high BMI
  • calf weakness and/or tightness
  • foot/ankle stiffness.

 

Other common causes of Achilles tendinopathy include:

  • change of footwear
  • poor, unsupportive footwear
  • change of training surface (e.g. grass to road)
  • increase inactivity

 

How is it managed?

Physiotherapy is highly effective for the management of Achilles tendinopathy. Your physiotherapist will usually provide advice about reducing the load on the tendon and use manual therapy, massage and taping techniques to help relieve your pain. They will also prescribe a specific type of exercise called eccentric exercise. With eccentric exercise, the muscle is lengthening as it contracts. For example, when you do a calf raise over a step. Eccentric training has been shown to not only reduce pain but also improve the structure of the tendon.

Shockwave Therapy The Body Refinery new Farm Brisbane

Shockwave

If you experience ongoing Achilles pain despite these treatments, please talk to your physiotherapist about shockwave therapy.

Shockwave therapy has been investigated as a potential adjunct to physiotherapy treatment. Studies have shown that shockwave can help to improve pain and function in people with Achilles tendinopathy, especially if it is combined with eccentric exercise. Shockwave uses an acoustic wave which increases blood flow to the injured tendon and stimulates healing.

The Body Refinery’s shockwave machine is made by EMS Swiss DolarClast, the world leader in Shockwave therapy and technology.

The initial appointment is 45 minutes long and will include a full assessment and a minimum of 15 minutes of treatment. Following sessions can go from 15 to 60 minutes depending on the type of injury. Shockwave appointments are only performed once a week to allow the injured area to rest.

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Book today to experience the benefits of Shockwave Therapy. Call 07 3358 3915 or follow the link below.

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My Pain in the butt – Coccydynia

Coccydynia, or pain in the coccyx (tailbone), is commonly experienced by women after a traumatic childbirth.  Symptoms generally include (sometimes excruciating) pain around the tailbone and hip when sitting or standing, especially after certain exercises.  It can be very unwelcomed by new mothers, who are often already looking after one or more young children and sometimes returning to work.

Pilates and general physio treatments can help to relieve pain, however, they are not likely to provide a complete and lasting solution.  However, more specific treatments by a Women’s Health Physiotherapist can provide life-changing results and eliminate the symptoms.

Coccydynia

Coccydynia treatment includes manual therapy to release the gluteal muscles and pelvic floor – externally at first and, if indicated, internally.  Treatment may also include mobilization of the sacrum and correction of muscle imbalances through stretching and muscle strengthening. Women’s Health Physiotherapists are trained to treat a range of pregnancy-related matters and to undertake internal examinations, which are sometimes required for the assessment and treatment of certain conditions.

Women suffering from the pain of coccydynia can experience dramatic pain relief after only one or two treatments with an experienced Women’s Health Physiotherapist.  We understand the pain and frustration that conditions such as coccydynia can cause and the relief that is experienced when new mums are correctly diagnosed and successfully treated.  To ensure our clients don’t have to endure a long search for a solution, The Body Refinery team includes Women’s Health Physiotherapists.

Coccydynia treatment women's health physiotherapist brisbane

If you are experiencing pain in your tailbone, hips or buttocks that isn’t improving, especially if you are a new mum, we recommend seeing our Women’s Health Physio.  Internal exams may not be the preferred course of action you are seeking, but many consider this a small inconvenience to have an accurate diagnosis and relief from the pain of coccydynia. Our Women’s Health Physio is considerate and will talk you through any courses of action they consider may be appropriate help you.

Book your appointment today by calling 07 3358 3915. Make sure to request our Women’s Health Physiotherapist, Charmion Bevan.

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