Our greatest asset – movement!

Happy New Year readers! We have our fingers and toes crossed for an enjoyable and positive 2021. We all know that the turn of the year is an opportunity for many to wipe the slate clean and start over. It doesn’t matter if you are a resolution-setting type person or not, have you thought about what you could do to improve your health this year? If you need some help to decide this, we are here for you. If you’re going to jump on the movement train and try to increase your exercise this year, that’s a great aim, and we applaud you for it. Movement is key to everything we do, and as humans we need to move often in order to stay healthy. Moving often is very important, but we must also move WELL in order to get the most out of our bodies and be truly healthy.

Why is movement so important?

Our bodies are designed to move. Not only do we need to be able to physically move from place to place to carry out our daily tasks, but the insides of our bodies also rely on our movement to function properly. We’ll explain more, but first have a think about what it would be like to be unable to move. Without movement, we cannot reach for the box of tissues, kick a ball, blink or swallow. It’s easy to take it for granted, until you no longer have it. For some people in this world, having a lack of, or inability to move is a reality. There are conditions which change the way we move, or stop it altogether. Neurological conditions such as motor neurone disease, Parkinson’s disease and progressive supranuclear palsy are examples of progressive conditions that alter a person’s ability to move. As conditions progress, a person eventually requires help with daily activities, including toileting, dressing and eating, to name but a few. Hopefully this puts into perspective how important movement is, and how those of us fortunate enough to be able to move should make it our duty to move often, move well and make the most of life.

Benefits of moving

The benefits of regular movement include:

  • Improved muscle and joint function: Movement is pivotal for our muscles and joints (and other body tissues) to remain fully functioning. If we want our muscles to get stronger, we have to contract and relax them over and over. Movement also helps to keep a steady production of fluid that nourishes the insides of our joints.
  • Reduced pain: This is where moving well plays a big role. Our body systems have to work in unison in order for our movements to stay efficient. As soon as something in the chain begins to fail (e.g. muscle injury, joint restriction), our movement becomes inefficient and this paves the way for pain to develop. Following injury, we need to retrain our movements to a more efficient level in order for pain to disappear for good.
  • Improved mental health: Movement in the form of exercise is a great way to keep your mental health in check. When we move, our body releases hormones that make us feel good. Endorphins (known as the happy hormones) are hormones that are released when we exercise. Regular movement equals regular release of hormones, and if you feel good, your mind remains clear, your motivation levels increase and your concentration levels improve. You become a more productive person, and you feel great for it. The world becomes your oyster!
  • Improved circulation of fluids around the body: Our body relies on movement to help with the flow of different fluids around the body. Our lymphatic system (our bodies defence and waste disposal system) relies almost completely on our movements and muscular contraction in order to pump lymphatic fluid around the body. We also need to move to help pump blood from our limbs back up to the heart.
  • Improved digestion and regulation of bowel movements: Moving helps our digestive system function more efficiently, by aiding with passage of food along the digestive tract and out again when we need to open our bowels. Movement is one form of treatment for constipation!
  • Improved sleep: Regularly pushing our bodies during exercise can help increase the amount of deep sleep we get each night. Our bodies need this to repair and rejuvenate for the next day.
  • It helps us to remain independent beings: As we have already mentioned, when we lose the ability to move, we become dependent on others around us to help us get through each day. Working on your body every day, ensuring you are moving well and often, will help you to maintain independence into your latter years. 

What happens when we don’t move?

It seems pretty straight forward that if we don’t move regularly, we are leaving ourselves open to a poorer functioning body. Essentially, the reversal of all the good things mentioned above:

  • A weak body: If you don’t use it, you lose it! Lack of movement leads to weakened muscles and bones, stiff joints, and an increased risk of injury.
  • Increased pain and swelling: Poor movement patterns lead to injury and pain. Lack of movement can also cause fluids in the body to pool in the extremities, leading to swollen limbs.
  • Increased rates of depression and low mood: No movement means we don’t get that regular boost of the happy stuff. Over time this can lead to low mood and an increased risk of developing depression.
  • Increased weight gain: Lack of exercise is a big risk factor for becoming overweight and developing many other related conditions including diabetes, high blood pressure and heart disease. People who move less and are overweight also at higher risk of becoming constipated.

Need help?

Looking to make some changes? We’d love to help you get where you want to be. Come and see us today, and we can look at you move, pick out what needs working on, and set you the task of putting it right. Don’t take movement for granted, it is a gift. Let us help you move well each day so you can keep your body functioning, your mind stimulated, and life good!

Taping for treatment

Have you ever been to the physio for a treatment and left all wrapped up like a mummy? Tape. It’s one of the various tools in our arsenal that we sometimes call upon to help a person in their recovery from injury. But we joke of course – no-one ever leaves us with that much sticky stuff on, that they resemble an Egyptian from the afterlife. Although tape can be a life-saver!

Tape has been used as a treatment tool for decades. There are many different types, each designed to aid the body in some way during the recovery period of an injury (anywhere from the onset of injury to return to sport training or match play). It can be used before, during and after activity. It is widely available, relatively cheap and is an excellent tool to use alongside other forms of treatment, including massage, joint mobilisation, needling and exercise therapy. A physiotherapist may even use it on your body even if you are not injured, in order to reduce the risk of one happening.

The reasons a physio may use tape are:

woman with tape on shoulder
  • To reduce pain
  • To stabilise / support a joint
  • To correct posture and increase awareness of a particular body part
  • To aid in achieving efficient movement of a body part
  • To prevent a joint from moving
  • To reduce the risk of injury or re-injury
  • To increase feedback to the brain of a particular body part
  • To increase confidence in a person looking to return to sport / activity
  • To reduce swelling of a particular body part

Types

There are several different types of tape. Some of the more commonly used types here at Physiotherapy for Women include rigid and kinesiology tape (aka K-tape). Read on to find out a bit more on these types.

Rigid tape

Rigid tape (aka sports or athletic tape) is an inelastic type of tape primarily used to provide stability at a joint. Joints that require stability may be those that move excessively, or where the integrity of the joint has been compromise. Like when you seriously sprain your ankle chasing your children playing tag or when enjoying a social netball match with your girlfriends.  In the ankle sprain a ligament can be overstretched or torn, making basic weight bearing activity such as walking very painful.  To assist the ligament to heal correctly, tape can be applied in a special pattern which provides a rigid barrier to specific movement which could further damage the ligament. The taping may be soon after the ankle injury (this depends on severity) or when your return to moving quickly and/or when you return to quick movements in a family situation or when back on the court. Rigid tape can provide support to the joint and give a person confidence to start using the joint as it should be, without fear of re-injury. This is usually a temporary treatment though as the aim of the physio and the injured person should always be to return to a pre-injury state, if it’s possible. In the unfortunate event that a person’s injury means they cannot return to a 100% pre-injured state and perform at a high level, tape is a cost-effective way of providing support needed to play, even if at a reduced intensity or level.

Here at Physiotherapy for Women, we are super conscious of what effect tape can have on a person’s skin. Some people are sensitive to the adhesive or glue that is used on the sticky side. And sometimes tape needs to be in place for many days at a time. For this reason, under-wrap was designed. Under-wrap is applied to the skin first to provide a barrier against the glue of the tape. The rigid tape is then placed over the top where its full effects can still be experienced. Your skin care is a priority of ours, so we always use under-wrap before applying rigid tape to an injured body part. We’ve got your back (or you knee)!

Other examples of injury where rigid tape may be used include knee sprains, pregnancy sacroiliac sprain, shoulder dislocations or ligament sprains, or in the treatment of plantar fasciopathy or a dropped foot arch.

Kinesiology tape (K-tape)

K-tape is an elastic type of tape that has several proposed uses. It molds to the counters of the body well and is designed to promote movement, rather than restrict it. K-tape may be applied to a body part to:

  • Reduce pain and/or delayed onset muscle soreness (DOMS) following exercise
  • Increase blood flow to, and drainage of fluid away from the body part
  • Increase awareness of the body part to the patient
  • To guide effective and efficient movement with minimal to no restriction

The increase of awareness of the affected body part is a particularly useful tool for us as physiotherapists when planning our treatments. After an injury, the intimate connection of the body part and the brain can become foggy. The brain may slightly lose its ability to know exactly where the joint is and what it should be doing. It sounds scarier than it is, but with exercise and rehabilitative treatment, this connection can be regained. K-tape is a great way of assisting with this, as the covering of the skin over the injured area provides extra input to the brain about what is going on at the joint(s). It’s complicated, but pretty cool huh?!

Another fantastic quality of K-tape following injury is its ability to assist the body in ridding fluid or swelling around an injury joint or muscle. The tape is applied in a special way which lifts the top layers of skin away from the underlying muscle to allow for greater flow of fluid… It can speed up the whole process considerably!

Ready for your dressing now?!

It depends completely on the type of injury and where you are in the recovery process as to which type of tape we choose to use on you. We will always discuss with you the benefits of tape so you can make an informed decision with us for your treatment and plan going forward. And don’t worry, we will avoid turning you into a mummy (often less is more with taping).  If you are worried about skin reactions we can trial small patches of several different tapes on your skin before doing a big taping of a body area.

If you’re keen to learn more, or find out if tape can benefit your recovery, just ask next time you are in for a treatment with us.

Women living with diabetes

Diabetes mellitus (DM) is a chronic condition that affects the body’s ability to breakdown (or metabolise) the food we eat into energy, for use by the trillions of cells that make up the human form. Diabetes is a global problem, and while it affects both men and women, there is one type that affects women only – gestational diabetes. Last year, over 460 million people were living with a DM diagnosis worldwide. In the next decade, this figure is expected to rise to approximately 580 million people. The disease comes at a great cost to healthcare services, and to life. In 2019 alone, global healthcare costs for DM reached $760 billion, and a total of 4.2 million people died from complications of this disease. The key to living with this disease, as with all diseases, is to understand the disease and how it affects the body.

Diabetes in-depth

The main characteristic of DM is high blood sugar (aka hyperglycaemia). Sugar in the form of glucose is the body’s primary source of energy. The body gets glucose by breaking down carbohydrates from foods we eat (i.e. breads, grains, fruits and vegetables). Glucose is then distributed to all of the cells around the body via the blood. In order for our cells to reap the benefit of glucose, they require the help of a hormone called insulin to grab the glucose and take it into the cell. We get insulin from the pancreas, an organ found tucked away behind our stomach. In DM, there is a problem with the production of insulin in the pancreas. It either is not produced at all, or not enough good quality, usable insulin is produced. Without insulin, glucose in the bloodstream builds up and up, the body is not able to get the energy it needs, and this is a huge problem.

Types of DM

There are three main types of DM:

  • DM type 1: This form of the disease is caused by an autoimmune response of the body. In simple terms, the body’s defence system sends in the cavalry and destroys the insulin producing cells in the pancreas. People with DM1 are required to inject a synthetic form of insulin regularly throughout the day using either a needle or pump mechanism. 
  • DM type 2: By far the most common form of DM. One of three mechanisms exist… 1) The pancreas doesn’t produce enough insulin. 2) The insulin produced is ineffective. 3) The cells of the body do not respond to insulin in the correct way. In many cases, DM2 can be managed effectively by making lifestyle changes and without the need to have to inject synthetic insulin. However, some people require medication and may eventually need the help of insulin injections to effectively manage the condition.
  • Gestational DM: Ladies… this one is just for us! Gestational DM may develop during pregnancy. The good news is that most cases will automatically resolve once your little bub is born. In this form, the blame doesn’t lie with the pancreas not producing insulin. Instead, hormones produced by the placenta during pregnancy block the effect of insulin, and the cells are not able to take up glucose. The pancreas will try to produce more insulin to fight the effect of these hormones, but as pregnancy progresses, hormone production ramps up and your poor little pancreas is sometimes unable to keep up. The result is gestational DM.

Signs and symptoms

Uncontrolled blood sugar levels can lead to the development of immediate symptoms including:

  • Excessive thirst and hunger
  • Increased urination
  • Tiredness and fatigue
  • Headaches

Over a prolonged period, if blood sugar levels are poorly managed, it can result in damage to blood vessels throughout the body. Common long-term effects of uncontrolled diabetes include:

  • Damage to nerves that affect the limbs, including the hands and feet
  • Kidney disease and failure
  • Blindness
  • Heart attack
  • Stroke
  • Ulceration of the skin that take a long time (or are unable) to heal
  • Skin infections
  • Weight and mood changes

During pregnancy, the mothers blood sugar levels are closely monitored, especially if the mother is at high risk of developing gestational DM. Those at greater risk include overweight, older women, and those with a family history of DM. Uncontrolled gestational diabetes can lead to a baby with a high birth weight, and needing help to stabilise their own blood sugar levels immediately following birth.

Our role

Although much of the diagnosis and medical management of DM will be handled by your doctor, we as physiotherapists have a very important role to play. Exercise is a key player in the management of type 2 diabetics especially. Exercise helps to improve how efficient your insulin works, which helps you to control your blood sugar levels. Exercise will also help with weight management, reducing the risk of cardiovascular problems such as heart attack and stroke. If implemented in a controlled way, there is good evidence suggesting exercise, as well as a super clean and controlled diet, can reduce the impact, delay and even prevent the onset of DM type 2. As well as helping you implement a healthier lifestyle overall, we can also help in the following ways:

  • Screening your body for signs of nerve and blood vessel related problems
  • Educating you on what to look out for regarding skin issues
  • Screening you for associated conditions, including frozen shoulder, carpal tunnel syndrome and other musculoskeletal problems
  • Reminding you to get your eyes tested
  • Screening and monitoring for signs of depression (which is strongly associated with DM)

Our main goal, whether you are pregnant or otherwise, is to encourage you to be active on a daily basis and provide education on what is important to you from an individual perspective. If you need some help to get your head around diabetes, and especially the role of exercise for its management, then please get in touch today.

woman with diabetes injecting insulin

An urgent (bladder) matter

Do you have a problem with your bladder and feel you need to speak to someone about it? To talk about bladder issues is a big deal for many people because it feels very private. But, did you know that 1 in 3 women in Australia have a bladder control problem? Yes, it really is THAT common. This month’s blog aims to release the fear of speaking out about a condition known as bladder urgency, and to show you that help is at hand.

woman with bladder urgency

What is bladder urgency?

Bladder urgency is a sudden, desperate and uncomfortable need to empty your bladder. Imagine walking down the street doing your weekly window shopping and instantly feeling like you have to wee. At this point it’s a frantic scramble to try and find the nearest toilet to avoid having an accident there and then. The feeling can be described as a “busting need to go to the toilet”. This can occur several times a day, and if it does, this need to urinate over and over is known as frequency.

Types of bladder urgency

There are two types of bladder urgency:

  • Dry urgency: You have the sudden urge to urinate and are able to reach the toilet without leaking any urine
  • Wet urgency: You have the sudden urge to urinate and leak urine on the way to, or as you reach the toilet

Dry urgency will commonly go undiagnosed because women who experience it think it is their normal bladder habit, and do not seek the help of a professional. It is those women who have accidents before reaching the toilet (a distressing and often embarrassing experience) who tend to speak up and ask for help.

Causes of bladder urgency

There are many causes of bladder urgency, including:

  • An overactive bladder that contracts when it should not
  • Overactive, weak, or damaged pelvic floor muscles
  • An overly sensitive nervous system (triggered by stress, anxiety, poor sleep and even winter chills)
  • Constipation
  • Low oestrogen levels (commonly associated with breast feeding and menopause)
  • Poor toileting habits
  • Trained family habits extending through generations

A common picture we see in clinic is that of someone experiencing urgency due to an over-sensitive nervous system. A normal bladder can store anywhere between 500-700mls of urine before the brain tells you to go for a wee. In a normal setting, this occurs without the sudden, urgent feeling. With an over-sensitive nervous system, only small amounts of urine collected stimulate nerve endings in the bladder wall, sending messages to the brain to tell the woman to find a toilet… and quick. The bladder (said to be overactive) is unable to fill to its normal levels, and many people will start to develop a pattern of lots of toilet visits, combined with only eliminating small amounts of wee each time. Unfortunately for many women, this can run through the day and night, leading to disturbed sleep patterns, which increases stress and anxiety levels.

Now throw COVID-19 into the equation. The current pandemic is creating a lot of added stress and anxiety for many of us. Here at Physiotherapy for Women, our therapists have noticed a marked increase in cases of bladder urgency presenting to the clinic over the last four months. The pandemic has forced many of us to work from home, providing the convenience of a comfortable toilet nearby whenever needed, leading to poor bladder habits. As you can see, there are many factors at play here with lots to consider for the therapist and patient when implementing treatment.

Treatment

Assessment and treatment of every woman’s bladder issue requires a Physiotherapist who has completed the required post-graduate training in women’s health. The aim is to help each woman develop her own skills in reducing the bladder urge, frequency of urination, and any leakage she may experience. Everyone’s circumstances are different and requires a unique approach for the individual. We have treated many women with bladder control conditions, meaning we know how to work with you to find out what works for you.

Treatment techniques may include:

  • Release of overactive pelvic floor muscles
  • Strengthening and re-training of weak or damaged pelvic floor muscles
  • Stress management
  • Advice on training your bladder habits

Do not let your bladder be the boss of your life. We encourage you to speak up now and side-step the negativity surrounding bladder problems. Call us on 08 8443 3355 to get help from our experienced, highly trained Physiotherapists.

Core topic: The thorax

Hello ladies and welcome to another installment of our health blog. This month we are focusing on the trunk, specifically the mid-back region of the trunk known as the ‘thorax’. This is one of the most commonly treated areas of the body in our clinic. It is central to many disorders we see on a daily basis, including neck, shoulder and low back complaints.

Anatomy

The trunk or ‘torso’ is the central core of the human body, out of which comes our arms, legs and neck. The torso can be broken down into three parts: the thorax, the abdomen and the pelvic bowl. The thorax, being the top part of the torso, is separated from the abdomen (the lower part) by a big muscle known as the diaphragm. Above the diaphragm sits the lungs and heart which are surrounded by our protective rib cage. The rib cage is made up of 12 pairs of ribs that (for the most part) attach at the back to the ‘thoracic’  vertebrae in the spine, and at the front to our chest bone (aka the ‘sternum’). It is an intricate part of the body which is made up of lots of joints, ligaments and muscles that all function together to allow us to move and breathe efficiently.

An analogy

woman being massaged helping her thorax and mid-back pain

The thorax, being a large part of our core, plays a pivotal role in the transfer of loads or forces that act on the body when we move. Our body is a unit, so it makes sense that a problem in one area can affect another area distant from that part. The mid-back has close connections to the neck, shoulder, low back and pelvis. If we have pain or are not moving well in the mid-back, then this can lead to problems in all the other areas (and vice versa). We liken the thorax to a train station. The trains coming into the thorax are the various loads or forces that are transferring from other parts of the body. Choo-choo!

A good example here would be if the muscles that span and stabilise the thorax are too tight, too weak, or simply activate at the wrong time in an attempt to handle one of the trains (forces) transferring through the region, the station becomes loud (ouch!) and over-excited. What results is pain and poor movement patterns.

A stiff rib or spinal joint may be able to cope with the loads temporarily, but eventually derailment occurs, and chaos ensues. The same can be said for joints at the other end of the spectrum. An overly flexible joint will struggle to deal with load just as much as an overly stiff joint does. Again, poor movement and pain occur.

The emotion of it all

Treating a person in pain is a complex thing. Yes we have to take into account how someone is moving and what they do daily to increase load on their body, but there is commonly an underlying emotional aspect to a person’s pain that we also need to break into with our treatment. Many women we treat do not realise the effect that stress has on their bodies. Pent up energy from everyday life stresses and difficult work and social aspects, gets stored and held in the thorax region of the body. Common areas we treat here include the tops of the shoulders, ribs and diaphragm. Muscles become tight, joints become stiff, and unless we can help to restore balance to this busy area of the body, the cycle continues with poor movement and painful episodes. When the trains aren’t running on time, it can get a bit much!

Problems in this region can also lead to poor breathing mechanics which can lead to a variety of issues including lack of energy, fatigue, and poor muscle function. A release of the diaphragm muscle under the rib cage can be helpful in releasing the tension and emotion held within us.

Treatment

Every woman we see in clinic requires a specific treatment plan, based on their presentation and needs. Pregnant, young, old, active or sedentary… We listen carefully to every woman who comes through our door before carrying out a thorough examination. Our findings will then help formulate a unique treatment plan which we discuss with each patient in depth before commencing treatment.

For complaints in the thorax, whether it be an angry over-worked muscle, a stiff spinal joint, or a sprained rib joint, we use a combination of:

  • Hands-on techniques to relieve tight muscles and stiff joints
  • Exercise prescription to increase strength and flexibility, and improve movement patterns
  • Postural advice / exercises
  • Stress management techniques to increase a patient’s awareness of their emotional state

Next steps

If you are struggling with mid-back, rib or pain elsewhere in the thorax, please call us today on 08 8443 3355. We’ll focus the spotlight on your busy train station and get things running smoothly and on time in no time at all.