Blog Contents:
Click on the links below or scroll down to see a blog post:
Lumbosacral dysfunction:
What is it & what can you do about it?
15.03.2021
Lumbosacral dysfunction:
What is it & what can you do about it?
15.03.2021
Lumbosacral dysfunction refers to any condition where the lower spine and pelvis are causing pain, stiffness or loss of ability to do simple activities such as turning over in bed, getting out of a car, standing, sitting or standing. It can also involve irritation or pinching of a nerve, or issues with muscles. discs & spinal joints. Pain can be felt in the back, groin, hip, buttock and/ or legs or feet. There may be pins and needless or numbness. or muscle weakness.
Sounds complicated? In truth all areas of the body require a physio to consider many things when diagnosing a problem., but the pelvis is, for me, the most interesting joint due to its complicated mechanics and fantastic treatment methods.
Having had a Sacro iliac joint issue myself. I have made it my mission to train in as many treatment methods to diagnose and treat this area. It often co exits with muscles being underactive & overactive . There may be issues also with the legs and feet and so a whole body approach is employed.
Whether you are young or bold, stiff or hypermobile, pregnant, sedentary or a sports person you may need this area thoroughly assessed by someone competent in this part of the body. Contact me & I will be happy to take on the challenge & help to resolve your pain and issues!
How are your older relatives and friends faring in this second lockdown?
12.01.2021
How are your older relatives and friends faring in this second lockdown?
12.01.2021
Winter is difficult as you get older. The possibility of falling on slippery uneven pavements, and feeling any arthritis more with the wet cold weather can make you want to stay indoors on these gloomy days. Add to that a lockdown and concerns over catching Covid and it is likely that people , especially those who are older, are doing less at the moment.
Unfortunately this drop in exercise and activity can lead to reduced fitness, loss of strength, flexibility and balance. So why does this matter? Sadly it can make you weaker to fight off any illness and begin a downward spiral of strength and balance. This then accentuates the fear of going out and the risk of falling.
WHAT CAN YOU DO?
There are a great many exercise classes, videos etc. online. For the younger generation this is easy to do, but what if you or someone you love cannot use a computer. Or they have medical or physical conditions or problems and concerned whether they are safe to do these general exercises routines.
TELEPHONE AND POSTAL PHYSIOTHERAPY SERVICE
As a Physiotherapist I am familiar with the issues of older folk and those with medical conditions. I would like offer a selection of options that may help you or your relative or friend through this difficult time. If a remote consultation is not possible, I can speak to a client on the telephone and get a picture of what the issues are. Together we can problem solve, talk through advice, exercises, suggest who to contact for support, home adaptations or treatment. I can send a pack of advice & exercises to act as a visual reminder and prompt.
I am at the end of the phone during the day for any questions that are not an emergency situation. My prices are deliberately lower due to the pressure the pandemic has placed on people in order to make my services more accessible to more people.
Choosing a Therapist Or Instructor
10.06.2020
There are SO many Pilates Instructors and Physiotherapists online! It's daunting to choose who to approach. So, I have noted down a couple of helpful hints here to help you feel confident that you've the right person for your needs.
1. CHOOSING A PILATES INSTRUCTOR
As Pilates has not been patented there are a huge variety of types and instructors. The first decision is whether to choose a fitness instructor or physiotherapist. Factors to consider first are:
(i) Price
(ii) Whether you need your instructor to have medical training.
Generally price will increase as the instructor has a higher level of qualifications. Pilates Instructors should hold a minimum of Level 3 on the Register of Exercise Professionals (R.E.P). At level 4 they have some training in understanding some medical conditions.
However The R.E.P. is a fitness industry register, not an allied health register. In other words the instructors are trained for the fitness industry and have not had medical training of a level that would be expected in a hospital environment, not even level 4. Consequently, a combination of qualifications such as those gained from the Australian Physiotherapy and Pilates Institute (APPI), coupled with a 3 year Physiotherapy degree, is higher than that of any REPS level. Of course that does not mean fitness instructors are bad.
(iii) How do I know if my instructor is good?
This is difficult to assess, but you can look at the following and consider how important to you these factors are:
- What are their qualification, background and experience?
- Recommendations and reviews
- How many people are in the class?
- How much attention do they give each client during each exercise?
- Are the classes mixed ability? If so, how does this affect the individuality of the exercises taught? How does the instructor divide their time between clients of a different level? Are they all exercising at a level appropriate to themselves, or made to plateau at a certain level, or even trying to do exercises beyond their capabilities?
- How much information do they ask for regarding your medical history, injuries and symptoms?
- How you feel after a lesson e.g. does it aggravate or ease your symptoms for a long time?
- If problems or symptoms have arisen in a class, do you understand why and what to do to prevent that?
- What advice do they give you? Does it answer your questions/concerns and help you?
- Do you understand how the exercises relate to any problems, diagnoses or symptoms that you have?
- Does their style of teaching suit you personally, do you have confidence in them?
- Do they adapt the exercises to suit you & offer different solutions to your problems/symptoms until an effective solution is found, if possible?
- Do they speak in jargon or do you understand what they say?
- Do you feel you are starting to learn how to manage and reduce or solve problems/symptoms?
2) CHOOSING A PHYSICAL THERAPIST
First it is useful to understand what the difference is between a Chiropracteur, Osteopath, Sports Phsyiotherapist & Chartered Physiotherapist. You can find my blog post explaining the difference HERE.
i) How do I know if my therapist is good?
Physiotherapists gauge whether their hands on treatment is effective by doing a variety of tests before and after treatment is given. This is compared to how the patient is feeling before & after the class. Between treatments the patient should note how they feel. A little short term soreness after treatment is considered normal & even unavoidable in some cases, but should not be severe nor extend for days. If this is concerning you, it would be strongly advisable to discuss it specifically with the therapist to avoid misunderstandings either way.
In the majority of cases recovery is a gradual thing. It's reasonable to expect around a 30% or more improvement per treatment. The rate and amount of change will vary according to the type of treatment given. Initially, the change may not last, but this should improve over subsequent treatments, if all advice is followed.
There are many many postgraduate courses where a qualified Physiotherapist can expand on their knowledge and skills. These are expensive and so we can't possibly attend them all! At times if a therapist has come to the end of their skill set, they may refer you to a colleague or recommend another physio with more experience about the problems you are facing.
Unfortunately, there will be poor clinicians in any field of work. There are regulatory bodies that work to try and ensure good practice is maintained. They must be registered with the Health and Care Professions Council an d Chartered Society of Physiotherapists .
ii) The importance of a good Therapist:Patient team:
It is fair and reasonable to say that the success of any treatment given by a therapist is to a certain extent at the mercy of what the patient does between one treatment and another.
To give you an example, I could treat a builder for a low back pain. Directly after this, the patient could feel better & tests show improvement. Unfortunately he could then do something at work, not follow advice nor do the exercises set and so undo any beneficial treatment given. In the beginning, improvements gained from treatment could be particularly 'fragile' and can easily be 'undone'.
I explain this to clients using the analogy of knitting! In my physiotherapy treatments I teach you to knit. I give you the tools needed ( exercises and advice), and start the process off ( treatment). I make sure that you have all that you need to continue. At first progress is slow, you may make mistakes ( hurt yourself). I help you see where you went wrong & how we correct this ( changes of habits/posture/ergonomics etc). I can then teach you different type of stitch. ( another treatment, progress exercises) and soon after a few sessions you need my help much less and may just need an occasional appointment to complete the knitted jumper ( recover!). If a client doesn't heed my advice, do exercises or complete the program of lessons they are in effect unraveling all the work done with no benefit to be had ( or no jumper in this analogy)!
iii) Should I change therapists if I feel like I am not making progress?
If a patient is going to see a therapist for an injury and has being given a treatment plan, and then later the patient reads or hears about an alternative therapist or treatment which seems to offer a quicker and better resolution, the patient may be tempted to drop what you told them to do, and switch to the new solution. Similarly this could be the case if progress slows down or stops.
In such instances I would advise a client to tell me honestly that this lack of progress etc is concerning them. Then I would be likely to offer up any alternative treatments, explaining what they could add to the treatment to speed things up. If however it is clear that all treatment options known have been explored, the client is acting on all advice and doing exercises as prescribed, a good therapist will then admit they have come to the end of the line as regards to their skill set. If other therapies are a possibility then these should be suggested, or the therapist should mention other alternatives, for example a review or referral by their GP. Sometimes a clinician may suggest that the client seeks a referral to a Pain Clinic, if their symptoms have enveloped into a chronic and unresponsive pain.
So, in short, give your therapist the opportunity to alter your treatment plan or explain what the issue is, before you try someone or something new!
I hope this helps. Please do not hesitate to contact me via message LINK or email LINk with any questions - however small!
Stay safe & well!
What is the difference between Osteopaths, Chiropractors and Physiotherapists?
08.06.2020
Hands up if you know the difference between Chiropractors, Osteopathy and Physiotherapy! Read on to explore their similarities and differences, and find out how each discipline can help you.
To the average person they may seem like more or less the same job. All deal with musculoskeletal pain, require a university degree, and certification from an accredited course. But while they may seem similar at a glance, the three professions take different approaches to health, so it is important to understand what sets each one apart from the others before deciding which of these professionals is best for you.
If people who primarily focus on muscles sit at one end of a spectrum (i.e. massage therapists to relax or personal trainers to strengthen) and people who primarily focus on joints sit at the other (i.e. chiropractors), physiotherapists and osteopaths sit together in the middle.
Osteopathy
Osteopathy & Physiotherapy have developed from their origins to become more similar to each other. Physiotherapy originated from nursing into massage and exercise therapy when it was prescribed by doctors. Since then, physiotherapists have developed into autonomous therapists who diagnose and treat patients according to their own specialist knowledge and training. The profession has become less focused on local treatment of a specific joint and instead the body as a whole unit is assessed, based on the understanding of how each part interacts and impacts structures around it. The well-being of an individual depends on the skeleton, fascia, muscles, ligaments and nerves functioning smoothly together.
Osteopaths have strong historical ethos of being holistic practitioners who look at the body as a whole. This is why at times an osteopath may be treating your diaphragm when you have low back pain or your ankle when you have hip pain. These origins of osteopathy were based on outdated principles and had struggled to progress into a more modern evidence-based approach, especially such an approach to pain and dysfunction. In the past few years, this has started to change and the profession has evolved. Nevertheless it is still lacking the science that underpins its profession & they are less exposed to medical conditions and a narrower breadth of injuries and complaints.
Some osteopaths choose to specialise in craniosacral or visceral based assessment and treatment. These specialisms may render one osteopath more appropriate for your care over another. Using visceral techniques e.g. if you have irritable bowel syndrome (IBS) and lower back pain combined, an osteopath may treat your bowel specifically with ‘hands on’ techniques. Physiotherapists may not have taken post graduate courses teaching such techniques, although they may be aware of possible links.
Osteopaths are quite similar to chiropractors in that they also place a lot of importance on manual manipulation, although they tend to be a lot more gentle. Osteopaths also use ‘hands on’ treatments but may not compliment this with exercises for you to carry out between your treatment sessions, making you more reliant on receiving their 'hands on’ treatment. This does vary from one clinician to another however.
One of the key differences between the two degrees is the breadth of the medical conditions the clinician would be exposed to and expected to treat. Physiotherapists work in a wide variety of health settings to treat respiratory, neurological and musculoskeletal conditions. This provides physiotherapists with an excellent foundation and range to their knowledge and skills.
Osteopaths may work alongside other health professionals, such as GPs, nurses and midwives as well as alternative medical practitioners. It is not as widely available on the NHS and the majority of osteopaths and chiropractors work in private practice.
Physiotherapy
Physiotherapy is a science-based, dynamic profession that is based on the best available evidence for treating and managing pain and movement. Physiotherapy is much more aligned with Western medicine or the ‘Medical model’ than osteopathy.
All physiotherapists have a thorough training in musculoskeletal treatment. Most physiotherapists will use a combination of ‘hands on’ treatment and exercise-based treatment (rehabilitation). ‘Hands on’ or manual therapy may involve techniques applied to your muscles, fascia, nerves and joints to improve their mobility, reduce pain and stiffness and improve your ability to function well.
It is very uncommon that you will see a physiotherapist that does not give you a home exercise-based programme. These exercises are aimed at reinforcing the benefits you have received in your treatment session and are an essential part of most treatment plans. A significant body of research has now been established to show exercise therapy is a very important part of a treatment program for any many conditions.
A physiotherapist will attempt to identify why the problem manifested in the first place, and prevent it from recurring in the future. This means looking at the physical side of things, such as posture and movement patterns, as well as psychological aspects such as stress or anxiety, and social factors such as work habits and hobbies, environmental/ergonomic and lifestyle issues, family history and past traumas and illnesses.
At the core is the patient’s involvement in their own care, through education, awareness, empowerment and participation in their treatment, enabling people to stay in work while helping them to remain independent for as long as possible.
Chiropractors
In general Chiropractors tend to concentrate on the spine for diagnosis and treatment whereas Osteopaths focus more on restoration of blood flow as their goal. The differences between Chiropractic and Osteopathy originate from a subtle difference in philosophy.
A Chiropractor’s main focus on the spine is the specific alignment of the vertebrae. The main treatment they offer is manipulation, which is when the joints are pushed to their furthest possible range of motion & misaligned vertebrae are “back in the right place”. Physiotherapists have the viewpoint that often joints are only moving through part of their range in this situation, or they may be 'stuck' in one part of their range. This can lead to pain eg if one bends forward and a vertebrae is stuck in the position for bending backwards. Manipulation may free it temporarily but unless the muscles etc, which have adapted to the vertebrae's limited stiff position, are stretched and strengthened the bone will go back to where it was due to their pull. This necessitates regular repeated treatments. Manipulation can be useful though for very stiff joints.
Chiropractors may offer exercises and lifestyle advice, but this is not a big part of their intervention.
In summary…
Despite their differences in philosophy and treatment, the aim of each discipline is to relieve pain and help your body work well.
It’s important to remember, too, that no two practitioners will provide the exact same treatment. It’s worth researching and trying different people so that you find a practitioner who best suits you and your needs.
Both osteopaths and physiotherapists will specialise in certain areas as they develop their experience and progress their interests and career. Due to the variety of specialisms within the professions, I would advise that you inquire about the skills and experience of the individual clinician you plan to see. It may be that you could see both different therapists at different times as that is what would be the best combination to get you back to doing what you love as quickly and safely as possible
For more helpful hints, please read my blog titled 'Choosing a therapist'.
11.05.2020
Top Tip For Seeing Your Physiotherapist:
Keep A Symptom Diary!
I have found that the best method, when trying to describe the symptoms you are feeling to a medical practitioner, is to have prepared a symptom diary ahead of time. How many times have you remembered, just as you leave the GP surgery, that you've left something important unsaid?
Yes! We've all done it!
A symptom diary is particularly important to you during this period of lockdown. This is because with social isolation physios are not able to carry out all the tests to muscles/nerves and joints that we would normally do. Thankfully, by using Zoom consultations I can still look at the affected area and watch how you move. This provides me with important clues for your diagnosis.
In your diary, I suggest that you write down when symptoms happen, how you are feeling & what you were doing at the time. You could do this on paper, on a Word Document, in a list or using a table. Whatever suits you best! A word document would help you share your diary with me, if you can do this. The diary would help me when I am trying to diagnose or understand what sort of issue/injury or condition you have, and how I can help you with it.
Ideally, each day the entries would follow this format:
Date: Wed 12th Oct
Time: 00:00 am/pm
Task:E.G.walking, gardening. sitting, standing....
Issues/symptoms: Stiffness, discomfort, pain etc
Pain Rating: x/10 -> 0 = no pain, 10 = max pain
Activity that causes the symptom: Give specific details eg walking uphill, bent and pulling weeds....
How long before it Immediately aggravates the symptom: x mins, x hours
How is the symptom is eased:E.G. stretches, ibuprofen, ice pack, massage, exercises, lying down...
How long it takes to ease Approx mins/hours
If you would like to make a Zoom appointment with me for Physiotherapy or Pilates, I offer a brief telephone or, if you prefer, an email conversation during which I can talk you through how to use Zoom. It's easier than you might think!
Click the image above to go to
Zoom's website.
08.05.2020
Can I get any help & can I do anything myself to deal with symptoms such a s aches, pain and stiffness
during lockdown?
The answer is most definitely YOU CAN!
OK, there is of course no substitute for an experienced therapist assessing you in person. However, whilst this lockdown is keeping us safe, we can ease if not cure many problems. The issue is that in the beginning many problems are relatively easy to treat. They can become more complex over time when you, trying to cope & carry on, start compensating, moving differently, or sometimes avoid moving at all due to pain.
It may be that you do need some help from a medical professional, but if you would like to discuss your problems earlier with a remote consultation, then I would be happy to help. This can be recorded for you to look back at later.
Don't worry if you struggle with technology!
For those not familiar with Zoom, it is like Facetime or Skype. All you need is internet and a big enough screen to see clearly. It won't cost you to join Zoom either, I pay all those costs. All you only have to pay for is the consultation itself with me.
Once connected, we can see & talk to each other. I can ask questions, look at how you move, and you can show me where it hurts etc. Then I tell you what I believe is causing your symptoms or problems. W e go through what this means, what I can do & what you can do for yourself. I will email you a copy of any exercises & advice given, so that you can read through it as often as you like. If I feel it is necessary, I will suggest who you should go to if you need further advice or treatment elsewhere.
How are your older relatives and friends farin g in this second lockdown?
How are your older relatives and friends farin g in this second lockdown?
Winter is difficult as you get older. The possibility of falling on slippery uneven pavements, and feeling any arthritis more with the wet cold weather can make you want to stay indoors on these gloomy days. Add to that a lockdown and concerns over catching Covid and it is likely that people , especially those who are older, are doing less at the moment.
Unfortunately this drop in exercise and activity can lead to reduced fitness, loss of strength, flexibility and balance. So why does this matter? Sadly it can make you weaker to fight off any illness and begin a downward spiral of strength and balance. This then accentuates the fear of going out and the risk of falling.
WHAT CAN YOU DO?
There are a great many exercise classes, videos etc online. For the younger generation this is easy to do, but what if you or someone you love cannot use a computer. Or they have medical or physical conditions or problems and concerned whether they are safe to do these general exercises routines.
TELEPHONE AND POSTAL PHYSIOTHERAPY SERVICE
A s a Physiotherapist I am familiar with the issues of older folk and those with medical conditions. I would like offer a selection of options that may help you or your relative or friend through this difficult time. If a remote consultation is not possible, I can speak to a client on the telephone and get a picture of what the issues are. Together we can problem solve, talk through advice, exercises, suggest who to contact for support, home adaptations or treatment. I can send a pack of advice & exercises to act as a visual reminder and prompt.
I am at the end of the phone during the day for any questions that are not an emergency situation. My prices are deliberately lower due to the pressure the pandemic has placed on people in order to make my services more accessible to more people.
Hands up if you know the difference between Chiropractors, Osteopathy and Physiotherapy! Read on to explore their similarities and differences, and find out how each discipline can help you.
To the average person they may seem like more or less the same job. All deal with musculoskeletal pain, require a university degree, and certification from an accredited course. But while they may seem similar at a glance, the three professions take different approaches to health, so it is important to understand what sets each one apart from the others before deciding which of these professionals is best for you.
If people who primarily focus on muscles sit at one end of a spectrum (i.e. massage therapists to relax or personal trainers to strengthen) and people who primarily focus on joints sit at the other (i.e. chiropractors), physiotherapists and osteopaths sit together in the middle.
Osteopathy
Osteopathy & Physiotherapy have developed from their origins to become more similar to each other. Physiotherapy originated from nursing into massage and exercise therapy when it was prescribed by doctors. Since then, physiotherapists have developed into autonomous therapists who diagnose and treat patients according to their own specialist knowledge and training. The profession has become less focused on local treatment of a specific joint and instead the body as a whole unit is assessed, based on the understanding of how each part interacts and impacts structures around it. The well-being of an individual depends on the skeleton, fascia, muscles, ligaments and nerves functioning smoothly together.
Osteopaths have strong historical ethos of being holistic practitioners who look at the body as a whole. This is why at times an osteopath may be treating your diaphragm when you have low back pain or your ankle when you have hip pain. These origins of osteopathy were based on outdated principles and had struggled to progress into a more modern evidence-based approach, especially such an approach to pain and dysfunction. In the past few years, this has started to change and the profession has evolved. Nevertheless it is still lacking the science that underpins its profession & they are less exposed to medical conditions and a narrower breadth of injuries and complaints.
Some osteopaths choose to specialise in craniosacral or visceral based assessment and treatment. These specialisms may render one osteopath more appropriate for your care over another. Using visceral techniques e.g. if you have irritable bowel syndrome (IBS) and lower back pain combined, an osteopath may treat your bowel specifically with ‘hands on’ techniques. Physiotherapists may not have taken post graduate courses teaching such techniques, although they may be aware of possible links.
Osteopaths are quite similar to chiropractors in that they also place a lot of importance on manual manipulation, although they tend to be a lot more gentle. Osteopaths also use ‘hands on’ treatments but may not compliment this with exercises for you to carry out between your treatment sessions, making you more reliant on receiving their 'hands on’ treatment. This does vary from one clinician to another however.
One of the key differences between the two degrees is the breadth of the medical conditions the clinician would be exposed to and expected to treat. Physiotherapists work in a wide variety of health settings to treat respiratory, neurological and musculoskeletal conditions. This provides physiotherapists with an excellent foundation and range to their knowledge and skills.
Osteopaths may work alongside other health professionals, such as GPs, nurses and midwives as well as alternative medical practitioners. It is not as widely available on the NHS and the majority of osteopaths and chiropractors work in private practice.
Physiotherapy
Physiotherapy is a science-based, dynamic profession that is based on the best available evidence for treating and managing pain and movement. Physiotherapy is much more aligned with Western medicine or the ‘Medical model’ than osteopathy.
All physiotherapists have a thorough training in musculoskeletal treatment. Most physiotherapists will use a combination of ‘hands on’ treatment and exercise-based treatment (rehabilitation). ‘Hands on’ or manual therapy may involve techniques applied to your muscles, fascia, nerves and joints to improve their mobility, reduce pain and stiffness and improve your ability to function well.
It is very uncommon that you will see a physiotherapist that does not give you a home exercise-based programme. These exercises are aimed at reinforcing the benefits you have received in your treatment session and are an essential part of most treatment plans. A significant body of research has now been established to show exercise therapy is a very important part of a treatment program for any many conditions.
A physiotherapist will attempt to identify why the problem manifested in the first place, and prevent it from recurring in the future. This means looking at the physical side of things, such as posture and movement patterns, as well as psychological aspects such as stress or anxiety, and social factors such as work habits and hobbies, environmental/ergonomic and lifestyle issues, family history and past traumas and illnesses.
At the core is the patient’s involvement in their own care, through education, awareness, empowerment and participation in their treatment, enabling people to stay in work while helping them to remain independent for as long as possible.
Chiropractors
In general Chiropractors tend to concentrate on the spine for diagnosis and treatment whereas Osteopaths focus more on restoration of blood flow as their goal. The differences between Chiropractic and Osteopathy originate from a subtle difference in philosophy.
A Chiropractor’s main focus on the spine is the specific alignment of the vertebrae. The main treatment they offer is manipulation, which is when the joints are pushed to their furthest possible range of motion & misaligned vertebrae are “back in the right place”. Physiotherapists have the viewpoint that often joints are only moving through part of their range in this situation, or they may be 'stuck' in one part of their range. This can lead to pain eg if one bends forward and a vertebrae is stuck in the position for bending backwards. Manipulation may free it temporarily but unless the muscles etc, which have adapted to the vertebrae's limited stiff position, are stretched and strengthened the bone will go back to where it was due to their pull. This necessitates regular repeated treatments. Manipulation can be useful though for very stiff joints.
Chiropractors may offer exercises and lifestyle advice, but this is not a big part of their intervention.
In summary…
Despite their differences in philosophy and treatment, the aim of each discipline is to relieve pain and help your body work well.
It’s important to remember, too, that no two practitioners will provide the exact same treatment. It’s worth researching and trying different people so that you find a practitioner who best suits you and your needs.
Both osteopaths and physiotherapists will specialise in certain areas as they develop their experience and progress their interests and career. Due to the variety of specialisms within the professions, I would advise that you inquire about the skills and experience of the individual clinician you plan to see. It may be that you could see both different therapists at different times as that is what would be the best combination to get you back to doing what you love as quickly and safely as possible
For more helpful hints, please read my blog titled 'Choosing a therapist'.