Post-Op Rehab

NEXT STEPS..

So you have finished your in-home rehabilitation, what’s next?

Well one thing is for sure, your rehabilitation does not stop there! The fun and exciting part of your rehabilitation starts now, as you can push beyond the boundaries of your home.

Everyone’s next step can vary based on personal preference, recommendation of your physiotherapist and approval from your surgeon. The transition can likely begin back in the clinic where you are able to have continued guidance and reassurance from a physiotherapist. Here we work with you to reevaluate your current goals and set some more functional and longer term goals based on your aims. Our Mile End and Salisbury clinic are a great foundation and further provide other great avenues for you to continue your rehabilitation with the same team.

Getting back into the gym is one great option and we recommend a supervised gym session with one of our physiotherapists, so you feel comfortable and reassured. Our physiotherapists can work with you to develop an individualised gym program based on your functional status and goals. Supervised gym sessions can somewhat mimic your guided in-home sessions, except you have awesome new and exciting equipment to work with and progress you further.

Group classes are a great compliment treatment and are a fun and social alternative to continue your care.  We offer a wide range of classes, all of which are run and supervised by a physiotherapist, so you can feel guided throughout the process. Check out Sophie’s earlier blog on classes, to help you understand more about what we offer and the overall benefits.

Hydrotherapy can initially be disregarded by some, but once a patient hits that warm water and feels the freedom of movement they are more than likely hooked. Hydrotherapy is a great option as it provides a great alternative to gym based exercises, particularly for those who may still be limited by pain and stiffness post operation. In the pool you can be guided by a physiotherapist to continue working on mobility, range of motion, strength and even balance.  

The options are endless for those continuing their care after rehabilitation in the home. Feedback from previous patients suggest that the continued care with a physiotherapist is both comforting and reassuring, especially during a process of unfamiliarity.  It is important to understand that all journeys differ and what works for some may not work for others. Therefore, your transition for continued care after in-home rehabilitation will be individualised to suit you.

Conclusion:

At PhysioWest we want your journey to run as smoothly as possible. We love to work with you in and out of the home, to help you work towards those more functional and longer term goals. If you would like some more information and discuss our options further come into the clinics to see our team at PhysioWest.  

Plantar Fasciitis

Plantar Fasciitis explained

With gyms only starting to re-open again, many of you have been shifting your focus towards beating your best running records. We’re now starting to see a lot more foot and ankle injuries in the clinic as a result, with the most common injury being plantar fasciitis.

 

What is plantar fasciitis?

Plantar fasciitis is the irritation of the plantar fascia, which attaches to your heel and the bottom of your toes. The role of the plantar fascia is to support the arch of your foot, and to absorb and distribute load throughout your foot while you are walking and running. If the plantar fascia can’t handle the load that is being placed through it, such as a sudden spike in running, then it can become irritated and possibly weakened which leads to pain.

 

What causes plantar fasciitis?

As well as an increased exercise or running load, there are a few other factors that may predispose someone to experiencing plantar fasciitis which include;

• High BMI
• Reduced ankle mobility
• Foot posture abnormalities
• Poor footwear
• Other health conditions

 

How do we treat plantar fasciitis?

There are a number of different treatment methods that help alleviate pain from plantar fasciitis such as;

• Rest
• Ice
• Non-steroidal anti-inflammatory drugs
• Massage
• Stretching
• Shoe inserts or orthotics
• Foot taping
• Shockwave therapy

These treatment methods are great at relieving the short-term and often high level of pain from plantar fasciitis, but it is important to include a structured exercise program if you want to continue performing exercises such as running.

Strengthening exercises involving heavy resistance have been shown to be effective in reducing and preventing pain from plantar fasciitis. The reason that heavy strength exercises help is because they increase the load tolerance of the plantar fascia, which means that you can put more stress through the plantar fascia without causing injury or irritation.

 

If you have been experiencing heel or foot pain as a result of running, make sure to use the links below to book in with our physios to get you started on an in-depth rehab program to get you back on track.

 

Injury Prevention

Does stretching help to prevent injury risk?

As a footballer having played for 20+ years, I have seen some pretty drastic changes in the way “warm-ups” are conducted. Do yourself a favour and watch Diego Maradonna warming up in his prime on YouTube – you will be treated to some stretching, dancing, smiling and him juggling a ball. I also remember getting to soccer as a young kid; the coach would always start warming up with static stretching. Following this, we might start practicing shooting to prepare us for the game. Coaches and players would never start this type of activity without an adequate warm-up these days. 

Although warm-ups have changed over time, one thing seems to be relatively constant in warm-ups at a lot of levels of sport; and that is STRETCHING. I still hear coaches at all levels of sport promoting stretching as something that will prevent injuries. This is pretty far from the truth and is inconsistent with what the current research tells us. Although stretching often feels great and shouldn’t necessarily be discouraged, research has identified that it DOES NOT reduce your risk of injury. 

When preparing for a game or training, your time would be much better spent on an active warm-up which prepares your body for movements that are specific to your sport. There are a number of complex mechanisms that are at play here, but put simply, this type of active warm-up supplies more blood to your muscles so that they are ready to function and it also activates the communication pathways between your brain and muscles. 

To have maximum injury risk reduction, adequate warm-ups, a routine structured strength/exercise program and careful management of exercise load is the best approach to reduce injury rates in Football (and all other sports for that matter). Stretching will not reduce your injury risk and for more advice to avoid injuries, use the links below to book in and come have a chat with us. 

~ Nathan Andijanto, Physiotherapist

 

REFERENCES:

Nuzzo JL 2020, ‘The Case for Retiring Flexibility as a Major Component of Physical Fitness’, Sports Medicine, vol 50, no. 5, pp. 853–870.

 

Shoulder Pain

My own experiences with shoulder rehab

Matt Stamatas – Physiotherapist

My passion for treating and helping people with shoulder pain comes from significant personal experience with shoulder pain and dysfunction.

In 2010 I experienced a significant loss in shoulder function, being unable to raise my right arm above my head at all. After a brief period of severe pain, I lost all strength in that shoulder and it stopped me participating in sport and going to the gym. After speaking to several other physios and a neurologist, I was at a loss as to what to do. Eventually, I decided to work on the movements I couldn’t do and trained them up in the gym. I started with no weight at all and very few movements, and eventually added weight and increased my repetitions. Over a period of 3 years I eventually regained all function in my right shoulder. I then went on to have a relatively successful rowing career so it worked a treat.

However, after I stopped rowing I experienced a similar problem in my left shoulder. Again, I had a period of severe pain and then loss of strength in the shoulder. I was extremely frustrated, but I knew what I had to do this time. I repeated the process again and trained it up with weights and by challenging myself to move in the ways I found most difficult. Eventually, two years later I can now lift more weights that I ever could prior to my injuries. Despite two set-backs, I continued to get stronger through the use of exercise and by challenging my body to move differently.

The point of this all is to highlight how exercise was the determining factor for my recovery. There was no hands-on magic that could be done to help what happened to my shoulders and there was no one else who could do the work for me.

The answer lay simply in commitment, movement and time.

Sometimes that can be hard to hear when you are hurting or can’t do the things you love, but the reality is that hard work will pay off if you commit yourself to it. My personal experience has made me want to help people experiencing any form of shoulder pain or dysfunction because I know the challenges it can present. I understand the frustration, I understand the pain, but if I can do it with my shoulders so can you.

If you want some assistance in creating a shoulder rehab program right for you, click the link below to book in with one of our Physiotherapists and let’s help regain your function and power!

Hip Strength

The Important Role of our Hips – ‘These Hips Don’t Lie‘

The Hip Joint is one of the most important joints in the body because of the vital role it plays in movement. Whether you’re an athlete wanting to improve technique & performance or a part of the general population who just want to move well, good hip strength & muscle patterning is integral.

There are 3 layers of muscles around the hip; the deep, intermediate, and superficial layers. 

The deep to intermediate muscles prevent excessive impact loading, i.e. from weight bearing activities such as running, and excessive shearing/translation/impingement of the hip, i.e. from the larger superficial muscles being used such as the gluteals, quadriceps & hamstrings.  Weakness and dysfunction can lead to joint damage & patterns of wear.

For athletes, dysfunction could mean that the order of activation from deep to superficial is not occurring. Or, muscles are not activating at all and the body has compensated by over activating muscles in other areas to achieve a certain action. 

Re-training patterns, strengthening or providing specific feedback to the right areas can be key in reaching sporting goals. This can be done through strengthening in sports specific exercises often combining sporting movements with gym-based exercises.

For the general population, a mixture of habits, creating any type of exercise routine and increasing movement in everyday life can improve strength and movement patterns.

Prolonged sitting is a big contributor to weakness and dysfunction in the hip. The muscles around the hip are either constantly in a lengthened position (gluteals) or contracted position (hip flexors) when seated for long periods of time.

Think about how long you sit throughout a day – at breakfast, to/from work, at work, dinner, watching television at night?

Think about how long you actually move or exercise in a day – 30-40 minutes out of a ~12hr day?

What can I do?

Firstly, try to reduce your sitting time – set reminders to get up every half an hour. What else can I do? Try performing some exercises at work! Try some squats/sit to stands at your desk to get those hip muscles activating, (if there’s room) get some glute bridges or ‘fire hydrants’ (work your way up to the advanced version) into your day or even incorporate a lunchtime walk, even for 10-15 minutes. Not only will this help to maintain balanced and functional muscles, research has shown this is great for the brain therefore work efficiency!

Secondly, Physiotherapy has a lot to offer in guiding and developing hip strength and stability. Physiotherapists can assess and treat dysfunctional muscles so they can start to build up in strength. As well as give guidance on the right hip exercises and progressions to reach your goals (and prevent dysfunction returning), whether with a sport or general hip strength and stability focus.

Book in with one of our therapists for a hip assessment, where they can collaborate with you to create a relevant treatment plan, and help you achieve all your functional goals!

Low Back Pain

My experience with Low Back Pain…

Firstly – Yes, physios get back pain too (unfortunately). And yes, it sucks just as much for us when it happens. So, I thought it would be good to share my own journey and some of the things I learned along the way when I was dealing with my Right Sided Low Back Pain.

Low Back Pain (LBP), for whatever reason, can be really scary when it happens. Even for me, someone who knows alot about it, it’s still a worrisome time. I remember beating myself up for being overly worried, particularly in the face of everything that I have learned and know about LBP. But I eventually came to the realisation that the worry, the fear, the concern; it’s all a part of the natural process of a pain experience. Why should it be any different for me?

I decided to dig a bit deeper (like I do with all my patients, again why should I be any different?) and found that my concern and anxiety around what I was feeling stemmed from my inability, at the time, to participate in the things I enjoyed. I had just started running (as many of us did when covid hit), and loved going to the gym 3-4x per week before covid. My back, and ofcourse covid, was limiting my ability to partake in the things I loved. And it was clearly affecting my pain, and particularly my outlook. So what did I do? I stepped back and looked at everything as a whole and tried to formulate a good plan. 

First, I wanted to understand my pain. I thought I might’ve irritated some of the tissues in my lower back, but this is almost impossible to discern accurately, and something I could manage with some good advice to keep moving within my limits, and modify any aggravating activities to give it a chance to settle. I had to trust my body would take care of me (this is easier said that done when you’re in pain).

Next, I acknowledged and addressed how ‘what I was feeling’, irrespective of just my pain, was affecting my overall pain experience. I was frustrated and upset that I couldn’t do what I enjoyed, and this was causing stress and doubt which was contributing to my negative outlook. We know that the psychological and emotional components of a pain directly influence the overall experience, just as much as my possible ‘angry back tissues’. So I addressed them – instead of running I walked, instead of ‘gyming’ I ‘home gymmed’ and worked around and slowly back into my more uncomfortable lifts. I made sure I stuck to my stress management strategies which for me is guided meditation and structured exercise. I feel these strategies had the biggest impact in reducing my overall pain experience in the early days and were imperative to building my confidence back up post-injury.

With time, things began to settle and I was able to get back to what I loved (when the gyms finally reopened!). 

So what did I learn?- back pain sucks!…. But! It’s usually pretty short lived, and if you take the time to address all the factors of your pain experience, we can have a much less ‘sucky’ time while experiencing it. It’s not the be all and end all, and we all experience it in our own way, so we shouldn’t beat ourselves up over the concern and worry that comes with it, it’s normal. But, you want to make sure you are confident to deal with these things by yourself, and if not, that’s where we can help out. It’s our job to coach you through your own experience, and help you get back to doing what you love!

~ Luke Lopian, Physiotherapist

Weight Training

Does Weight Training Stunt Growth?

It is a widely held belief that weight training can stunt growth when performed by children and adolescents. In fact, no study has ever shown that lifting weights inhibits growth and numerous studies have concluded that resistance training is relatively safe for growing bodies.

 

This common misconception is often surfaced by the belief that lifting weights damages the growth plates in young people. However, what many don’t realise is that sport itself subjects children to far greater forces than you’ll find in a weights room. Think about the impacts that running, jumping and tackling have on the bones and joints of our body.. then ask yourself why we won’t let little Johnny pick up a light dumbbell?

 

Research suggests that resistance training, when performed appropriately and with good technique, provides a number of benefits for children. These include improved strength, power and builds more resilient bodies with even stronger bones and joints. Strength training also helps reduce the risk of fractures and prevents sport-related injuries.

 

It is recommended by the Australian Strength and Conditioning Association that children are at least 6 years old before undertaking resistance training, provided that they have the maturity to follow instructions and understand the dangers at hand. It’s important to begin weight training under the guidance of a professional to learn correct lifting techniques and program appropriately to your ability.

 

If you’re interested in developing a structured weights program for your child, come in and speak with the team at PhysioWest!

Reflections – Pain

Rehab and flare ups,

2 steps forward, no steps back?

It is a common occurrence that throughout a process to recover from an injury, you can get a flare up of pain. You can be doing so well, right on track to achieving your goals, and then something triggers your pain once more, and it can feel like you’re back to where you started from.

All of that exercise for nothing, right? Well, not quite!

Rarely is the path to recovery a straight line, there will usually be a bump in the road to complicate things. It might be that you did one too many dead lifts that day, run that extra kilometre instead of taking it easy, or maybe it’s something not so obvious such as poor sleep from the previous night or an overly stressful week at work. Due to the nature of pain, there may be many different contributing factors that can result in a flare up. When they occur, it can be a good time to reflect on what might be impacting it, what you might be able to modify to help get yourself through the flare up, and how you might avoid another one in the future!

Don’t lose hope! Just because the plan you set didn’t play out exactly as you would have hoped, you shouldn’t throw in the towel just yet. Flare ups are temporary, and will settle quickly. Then you can get right back on the horse where you left off.

When you have a solid plan to achieve your rehab goals, you can only succeed, or learn. Flare ups are never a failure.

Do you want help managing your flare ups?  We would love to help. Click below to make a time and let’s work together to get you back on track with your rehab goals.

Reflections

Recent running reflections with Matt.  

 

The whirlwind of 2020 has been an opportunity for me to reflect on exercise and why we do it. Through distancing and isolation to keep the community safe, gyms, pools and team sports were all put on hold for the greater good. This was difficult for many of us, me included, who love to exercise with friends and enjoy the competitive team sport environment.

 

Surprisingly, it also gave me a new outlook on exercise from an angle I hadn’t thought of much before. With soccer off the cards for a while, I decided to increase my running load to stay fit for when the season would take off again.

 

At first it was “run this distance”, or “beat this time”, which inevitably pushed the bar higher and higher and left the outcome always just short of satisfying.

 

Thankfully, my watch and phone went flat one morning on a run (should’ve flicked the power-point to ON). I ran without a goal in mind, enjoying the breeze, sunshine and focusing on my breathing. It was a real wake up call for me. I realised that I exercise to feel good, to be healthy, to look after my body, and to enjoy movement.

 

The health benefits of running are well documented in terms of reducing mortality risks, as well as improving mental health. There doesn’t have to be a gold, silver or bronze, just the feeling that you’ve looked after yourself well.

 

So, coming full circle – if you’re keen to run but don’t know where to start, take the pressure off yourself and focus on enjoyment. Pick your favourite song on your playlist, head down the beach with a friend, or treat yourself to a run up to the local coffee shop. The main thing is to have a go.

 

If you would like some more guidance on how to make this happen, our running assessments at the clinic will take a big picture look at the way you move, and set you up on the road to success so you can enjoy running in an ongoing way.

THE BENEFITS OF GROUP EXERCISE AND OUR PHYSIOWEST CLASSES

Having trouble holding yourself accountable to regular exercise?

 

You are not alone and I’ve definitely been a culprit of this myself! Sometimes finding the motivation to drag yourself to the gym or go for a run over watching another Netflix episode can be challenging.

You’ve probably heard the adage that ‘exercise is 90% mental and 10% physical’. Overcoming these mental barriers can be extremely testing and it’s easy to find an excuse; “I’m too tired”, “it’s too cold”, “I’ll go tomorrow instead”. You’re in a constant battle with yourself!

It’s well known that exercise has multiple benefits for both physical and mental health. Whilst it reduces your risk of detrimental health conditions, it is also an extremely effective natural anti-anxiety/stress treatment. The release of endorphins during exercise stimulates a range of beneficial responses within our body. However, that doesn’t make it any easier to find motivation and stick to a regular exercise regime!

BUT, have you tried group exercise or working out with a buddy?

Exercising with others is a powerful motivator and helps keep you accountable to regular exercise, as you’re less likely to excuse yourself from these scheduled encounters.

Research has shown that working out in a group can actually lower stress by 26% and improve quality of life (Yorks, Frothingham & Schuenke 2017).

The study investigated the effects of group exercise compared with individual exercise. Those who exercised in a group setting showed:

• 6% improvement in mental health
• 8% improvement in physical health
• 26% improvement in emotional health
• 2% reduction in stress levels

And, those who exercised individually worked out for twice as long than those in a group but reported no significant changes in anything except mental health – with an 11% increase.

Not only do you reap the benefits listed above, but peer exercise has also been shown to improve performance! With another study finding that those who exercised with a more-capable partner increased their plank time by 24% (Feltz, Kerr & Irwin 2011).

There you have it… results are in and if you ask me, it seems like group exercise is the way to go!

Eager to give group exercise a go? COME JOIN OUR GROUP EXERCISE CLASSES! We love new members!

We have a variety of different classes available to cater for all ages and skill levels, so rest assured there’s something for everyone whether your goal is to build strength, control or to de-stress after a long days work.

The ‘WHAT, WHY and HOW?’

What are all the different classes on offer?

• Balance: With a focus on increasing strength and balance to maintain independence.
• Body Flow: Stretching and yoga-based class, ideal for relieving muscle tension and stress.
• Body Reform: Equipment based exercises using pilates reformers and trapeze tables to build strength and improve control.
• Body Strong: Gym based class using weights and machines with a focus on building strength.
• Core: Mat based exercises to challenge and build core strength/control.
• Hydrotherapy: Water based exercises to help improve movement and build strength.
• Mums and Bubs: Light strengthening and stability exercises for new mums and bubs.

 

Why join a group exercise class?

• Improved strength and flexibility
• Injury prevention and/or management
• Improve posture
• Improve control, stability and quality of movement
• Weight management for overall health and well-being
• Improved mental well-being and social interaction

 

But, why PhysioWest group classes?

• 45-minute classes
• Small class numbers 4-5 ppl max
• Physiotherapist supervision to optimise technique and movement
• Personalised Programs – work towards your specific goals at your own pace
• Progress and be challenged as you improve
• Fun and upbeat classes in a social group setting
• $25 classes, claimable on private health
• Every 5th class is free
• Pay for 10 classes upfront (incl. x2 free classes) and receive 50% off a remedial massage in-clinic at the end of each 10-week block

 

How?

Think you might be interested, but not sure what class would suit you?

Book in with one of our physiotherapists for a Pre-class Assessment where they will identify your goals, create a personalised exercise program and suggest a suitable class to help you meet these goals! You can even trial a few different classes and see what one tickles your fancy!

 

We can’t wait to see you in class soon!

 

Sophie Alderslade, Physiotherapist, PhysioWest

 

 

References:

Feltz, D, Kerr, N & Irwin, B 2011, ‘Buddy Up: The Kohler Effect Applied to Health Games’, Journal of sport & exercise psychology, vol. 33, no. 4, pp. 506-26, DOI: 10.1123/jsep.33.4.506.

Yorks, D.M, Frothingham, C.A & Schuenke, M.D 2017, ‘Effects of Group Fitness Classes on Stress and Quality of Life of Medical Students’, The Journal of the American Osteopathic Association, vol. 117, no. 11, pp. e17-e25, DOI: https://doi.org/10.7556/jaoa.2017.140.