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Category: Physio

New GLA:D® Program for hip and/or knee osteoarthritis coming soon!

Juhi, Matt and Sandra recently undertook the GLA:D® – “Good Life with osteoArthritis: Denmark” course and are now certified GLA:D® physiotherapists. We will soon be launching our in-house GLA:D® Program – a 6 week program of education and exercise designed to help reduce the symptoms of hip and/or knee osteoarthritis. Over the 6 weeks patients will attend 2 education sessions and 12 supervised exercise sessions, each of about 60 minutes.

GLA:D® is an evidence-based approach shown to help people of all ages with mild, moderate and severe osteoarthritis by reducing pain, increasing mobility and enhancing quality of life. Often surgery such as joint replacement can be avoided and, if having a total knee joint or hip replacement, completing the GLA:D® program prior can lead to a quicker recovery.

The GLA:D® exercises can be personalised to each individual participant, continued at home and repeated as and when you feel you may benefit from them.

 

Click here to read more about our upcoming GLA:D® Program.

 

Click here to express your interest in our GLA:D® Program and we will contact you once it has launched. You can also call us on 3857 5815.

 

 

7 EXERCISES TO HELP A STIFF BACK

Does your back feel stiff? Read on to find out how you can improve your thoracic mobility…

Our daily habits make us very prone to stiffness in the thoracic spine, which often makes it hard to stretch, bend or flex your spine, and can lead to back pain and tension. We spend a great deal of time through the day in thoracic flexion (forward bending) e.g. when showering, sitting at a desk, looking at our phone, preparing food, eating, doing housework, etc. 

Unfortunately, our usual daily routines rarely require us to extend our thoracic spine so, unless we go out of our way to do otherwise, we are often stuck in a forward position. Over time this leads to a fixed flexion posture and can be hard to reverse. It becomes especially hard to reverse as we age and, if not addressed, often leads to a great deal of debilitation in later life. 

Poor thoracic mobility can also have flow-on affects into the neck, shoulders and lower back. With our thoracic spine in a flexed position, we are more likely to overload the neck muscles, impinge the shoulder joints and place more pressure on our lower back, especially when sitting through the day. Natural movement, combined with joint mobilising exercises for the thoracic spine can help offset poor habits and help us to improve overall posture and prevent movement restriction later in life.

The following exercises can almost all be done with no equipment, with a couple of exercises only requiring a foam roller and a broomstick.

1. Cobra pose

Start lying face down with toes pointed and hands on the floor underneath your shoulders. Push up through your arms and extend spine as far as you can, ensuring you also lift your head and look straight ahead. You can lock out your elbows if able, otherwise if this feels too extreme you can rest on your forearms. Hold this position for 10 seconds before returning to the starting position. The aim here is to get as much extension through the spine as possible. Repeat 5 times and remember to keep breathing as you stretch.

 

2. Archer stretch 

Lie on your side with your hips and knees bent to 90 degrees, keep your knees together as you arc your top arm up towards the ceiling and continue all the way around onto the floor. Hold for 10 seconds and repeat 5 times. The aim here is to get as much rotation through the spine as possible. Do the same lying on the other side. 

 

3. Child’s pose 

Get on your hands and knees, drop your bottom back onto your heels while keeping your palms firmly planted on the floor. Let your head drop between your arms and push your chest to the floor. Hold for 30 seconds and repeat 3 times. You can get a wider stretch by pushing your knees out to the sides so your legs form a V.

 

 

4. Cat cow stretch

Get on all-fours with your hands directly below your shoulders and knees directly below your hips. Alternate between arching and curling the spine. The aim here is to move your spine through its full range of motion in each direction. Repeat 10 times in each direction.

 

 

 

 

 

 

5. Roller Thoracic extension 

Lying down on a foam roller, with the roller sideways underneath your body, extend back over the roller as far as your feel comfortable. Roll up and down trying to extend the spinal segment above the roller as much as possible. If this feels too intense or uncomfortable you may want to work on the cobra stretch more until you gain more mobility. 

 

6. Thoracic rotation with stick 

Rest broomstick on shoulders and place hands on top of stick at each end. Rotate the spine to the side as far as possible, trying to point the stick to 12 o’clock if able, hold for 5 seconds. Repeat 10 times in each direction.

 

 

7. Thoracic side bends with stick 

Rest broomstick on shoulders and place hands on top of stick at each end. Bent to the side through the spine, trying to point the stick down towards the floor as far as possible, hold for 5 seconds. Repeat 10 times in each direction.

If you’re struggling with back pain, stiffness or just want to help your body grow stronger and healthier, call or book online to have an appointment with a member of our team today.

 

This post was written by Greg Holmes, Physiotherapist at Stafford Physiotherapy and Pilates. 

Conditions we love (Ally): Headaches

We should start with a disclaimer… We don’t love these conditions themselves; we love treating them!

Headaches a

nd migraines can be a very debilitating condition suffered by a large percentage of the population (1 in 20 people!). They can range from mild pain, lasting just a few hours, to severe throbbing pain causing the sufferer to be unable to leave their house for days.

I have been fortunate enough to learn how to diagnose and treat headaches from Dean Watson, the founder of the Watson Headache Approach. I have found it to be a very rewarding method of treatment with the main aim of treatment being to identify the cervical (neck) joint that reproduces your area of headache pain.

Typically, people come into the clinic with a headache and through the assessment of the upper cervical spine segments we usually find the joint that intensifies the exact head pain they get. They are then so relieved when maintaining pressure on that joint referring to their headache pain that their head pain resolves. It is this ‘reproduction and resolution’ of head pain that is so powerful in desensitising the brainstem, which is the underlying disorder of headache and migraine sufferers. 

I love that it is a drug free intervention that is successful in reducing headaches in 80% of headache or migraine sufferers. I especially love it when I can relieve the headache of someone who has been suffering for years and thought that they just have to put up with it forever. I find it to be a very systematic and reproducible method of treatment that does actually work, with results starting from the very first session. 

EXERCISE

Here is my favorite headache exercise. It is best done when you are just feeling the onset of head pain or any associated symptoms that precede your headache.

Hold this for 20seconds or until the headache subsides.

Repeat up to 5 times in a row.

If you’d like a to see Ally or one of our other physios regarding your headaches (or any other issues!), please call or book online.


This post was written by Allyson Flanagan, Physiotherapist and Clinical Pilates Instructor at Stafford Physiotherapy and Pilates. 

SANDRA’S 8 FAVOURITE KNEE EXERCISES

To help knee osteoarthritis + other knee conditions

Did you catch our recent blog post on knee osteoarthritis? It can be a real pain in the backside, preventing you from moving as much as you’d like or doing the things you love. Surgery is very much avoidable if we commit to strengthening exercises. So, to get you started, Sandra has shared her favourite knee exercises.

The important muscles to strengthen for a healthy knee are:

  • Quadriceps at the front of the thigh
  • Gluteus medius in the buttock that help control hip rotation and knee alignment.
  • Hamstrings (back of the thigh),
  • Gluteus maximus (buttocks)
  • Calf muscles
  • Foot muscles in the arch

SANDRA’S 8 FAVOURITE KNEE EXERCISES

  1. Wall squat (for quadriceps) OR
  2. Mini squat with band OR
  3. Knee extensions over a towel
  4. Wall stand (standing clam) for gluteus medius
  5. Sit to stand with slow lowering back to sit
  6. Step up and step down
  7. Single leg calf raises
  8. Foot doming

 

< Wall squat

Can be done against the wall or with a ball behind your back. Feet should be about 30cm out from the wall and about 10 cm apart. Slide down to 60 degrees with your knees going over the second toe (you don’t have to go down to 90 degrees). Hold for 6-10 seconds and slide back up. If there is pain in the knee joint, you are too low. If you can’t do this one, try the knee extensions over a towel.

Mini squat with band >

Put an exercise band around your instep on both feet and take your feet slightly wide so that there is tension. Perform a small mini squat short of pain, keeping the knees in good alignment over the second toe.

< Knee extensions over a towel

Place a towel or foam roller under the knee. Keep the knee on the towel and raise your foot until your knee is straight. Hold for 6-10 seconds and slowly lower.

Wall stand >

Face side on to the wall and push your knee to the wall, while taking your weight on the other leg. Hold 6 seconds. To progress, push into the wall with your knee, then lift your foot. You can place a small, soft ball between your knee and the wall. For an advanced exercise, add a bend in the supporting knee. Keep your shoulders and hips facing forward and don’t lean on the wall.

Sit to stand

Choose a higher chair for beginners. Sit and then slowly stand, making sure your knee goes over the second toe and doesn’t sway inward. Lower slowly and you can pause just before your bottom goes onto the seat. To progress, try doing it one legged, but your knee must remain in good alignment over the second toe. You can also try it on a lower chair for an additional challenge.

^ Step up and step down

Choose a small step to begin and slowly step up and lower (knee over second toe)

Calf raises >

Beginners start with 2 legs – go up for 3 seconds, hold, then lower for 3 seconds. Progress to single leg and increase the number gradually. You should aim for 25-30 single leg calf raises. Avoid very hard surfaces like the tiles in the bathroom. Don’t rock forward as you raise up.

< Foot doming

This can be done standing or sitting. Put your foot flat on the ground and then lift your arch, keeping your toes down straight.

 

Things to note:

All exercises should be done in a slow, controlled manner; don’t build up momentum, rock forward, turn your body.

Keep the knee in good alignment – if the knee swings inwards, the exercise needs to be modified.

Keep the head and neck in good alignment too!

During the wall stand and wall squat, make sure the arch of your foot does not collapse inwards – lift your arch.

 

If you’d like one of our physiotherapists to help you with some personalised knee exercises, please call or book online.

 

All about knee osteoarthritis + how we can help (part one)

Knee osteoarthritis (OA) is a common chronic joint disease that causes pain, stops you doing certain activities and can cause you a lot of stress and distress. The symptoms can be pain, stiffness (especially after rest), swelling and tenderness. Often people find it harder to squat, kneel, walk up stairs, get up from a low chair and some have pain that stops them from sleeping.

Research shows that strengthening exercises improve pain and function. Surgery is not inevitable if we look after our knees by supervised exercise that progresses within limits.

Physiotherapists are the best heath and exercise professional to advise you about your knee exercises, where to start, how to adjust the exercises if your pain flares and how to progress your exercises safely to prevent further damage. We have studied the anatomy, the pathology (disease), the latest effective evidence based exercise regimes and we know how to treat the symptoms.

 

Physiotherapy can help in a number of ways:
  • We can conduct a thorough assessment of your knees and provide you with an accurate diagnosis as well as education to help explain why you are experiencing your pain and stiffness
  • We can mobilise (move) the joints of the knee. This can be for pain relief, to increase circulation to the area or to stretch tight structures.
  • We can teach specific strengthening exercises for the hips, knees, ankles and feet; especially the quadriceps and gluteals. This can improve joint alignment and correct muscle imbalances
  • We can strap the knee to improve movement, reduce pain and decrease swelling
  • We can use dry needling and western acupuncture to help release tight muscles around the area and relieve pain
  • We can use cupping to help release the ITB (iliotibial band) and other tight muscles
  • We can advise you on what activities that you can do that you enjoy (even if it is modified)
  • We can give you strategies to cope with the pain (like relaxation and distraction, local heat or ice).
STAY TUNED FOR PART 2: SANDRA’S FAVOURITE KNEE EXERCISES, TO HELP KNEE OSTEOARTHRITIS + OTHER KNEE CONDITIONS
Definitions:

Osteo = Bone Arthro = joint Itis = inflammation
Chronic = pain that persists for over 12 weeks
Femur = thigh bone
Hamstrings = Thigh muscle at the back that bends the knee
ITB (iliotibial band) = fascia at the side of the thigh that goes from the top of the thigh to below the knee.
Muscle imbalance = Often the inner (medial) thigh quadriceps weakens and the outer (lateral) quad pulls the knee cap towards it. This can happen for people who don’t exercise and for people who do a lot of fast exercises and no slow weight bearing exercise
Patella = knee cap
Quads (quadriceps muscle) = front thigh muscle that straightens the knee
Tibia = shin bone
Total Knee Replacement = a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve pain and disability Parts the tibia and femur are replaced to create an artificial joint.
Knee Reconstruction = surgical procedure to replace the torn ACL (anterior cruciate ligament). This is not done for Knee OA.
VMO (vastus medialis obliquus) = the inner part of the quadriceps (front thigh muscle) that helps stabilise the knee cap

Returning to running after pregnancy

When is it safe to return to running after pregnancy? You ran before you got pregnant. You might have continued running during pregnancy. And now you’ve had the baby and you’re keen to get your joggers back on and hit the pavement once again. So when is it safe to do so?

There is a general lack of evidence-based research around returning to running in the postnatal period. Running is a high impact activity which places a significant load on the entire body, especially the pelvic floor muscles. The most recent guidelines* are from 2019 and suggest waiting a minimum 12 weeks after birth. The guidelines also suggest that women meet a series of criteria for adequate strength of the pelvic floor and lower body muscles before hitting the pavement again.

The first 12 weeks after birth is commonly referred to as the 4th trimester. There is still a large amount of relaxin in your body, which means the connective tissue, such as ligaments, is still more stretchy than normal. Your body is still recovering from birth during this period, especially if you had perineal tears, episiotomies, a caesarian section or any other complications. The pelvic floor muscles are weak after pregnancy and birth and you may have symptoms that indicate these muscles need strengthening.

Symptoms of pelvic floor weakness can include:

  • Incontinence – leaking, inability to control bladder and/or bowel
  • Heaviness in the vagina
  • Dragging sensation in the vagina and perineal region
  • Pelvic pain

There is strong evidence to support an individualised assessment and structured exercise program for pelvic floor rehabilitation in the management of these conditions. Sandra is qualified to undertake pelvic floor assessments and can refer you to a specialised pelvic floor physiotherapist if needed.

It is also important to be assessed by a physiotherapist if you had a rectus diastasis (abdominal muscle separation). Our physiotherapists can screen for this.

Low impact exercise such as walking is encouraged in the first 3 months (12 weeks) of the postnatal period. Following this a graded return to a running program should be implemented to build lower limb strength and gradually introduce loading again to the pelvic floor muscles.

Call us today to get started!

* Reference: Returning to Running Postnatal – guidelines for medial, health and fitness professionals managing this population. Tom Goom, Grainne Donnelly and Emma Brockwell. March 2019

 

If you’d like one of our physiotherapists to help you get running again post-pregnancy, please call or book online.

 

This post was written by Lucy Beumer, Sports and Exercise Physiotherapist and Clinical Pilates Instructor at Stafford Physiotherapy and Pilates. 

Lucy’s back!

We’re very excited to share that Lucy will be back working at the practice shortly! She is looking forward to returning and to working with both current and new patients.

Physiotherapist applying rocktape | Stafford Physiotherapy CentreLucy has an impressive skillset with a Bachelor of Physiotherapy, a Masters of Sports Physiotherapy and further study in dry needling, muscle energy techniques, running biomechanics, kinesiology, taping, diagnostic ultrasound, strength and conditioning coaching, and sports rehabilitation. Read more about Lucy here.

Lucy will be working Wednesdays and Saturdays from July. Her hours are limited so bookings are essential!

 

To book in with Lucy please call or book online.

How to safely return to the gym post COVID

Now restrictions are easing and the gyms are back open, it’s really important that we transition our home workouts back into our gym routines safely, without overloading and injuring ourselves. It’s important that we restrain our excitement, for the moment, take an honest account of our loading in the past few months and plan before we return to lifting with heavier and regular weight again. Our strength will be reduced, so reduce your weight!

Warm up and cool down

Make sure you reintroduce a good 5-10 minute warm up before you commence your sessions. Try to target the area you will be training, if you are training an upper body resistance session for example, you should include some light weight or body weighted exercises targeting that area before loading up! It’s a good idea to have a dynamic stretch or use a foam roller if you have been static and sitting at work all day!

Cool downs are often neglected, however also very important now you are training again. Be sure to stretch after your sessions and grab the foam roller for a few minutes for your legs or upper back to reduce the extra tone that will build up in your muscles, just remember to wipe down after! #COVIDsafe.

Loading

If you haven’t been lifting during the past two months, your body loses strength far faster than you want to believe! Start conservative, reduce your weight to start and aim for higher reps.

Prioritise good movement patterns again first. It’s important to allow some time over the first few weeks for your stabilising muscles to remember how to lift again. If you load up too quickly these muscles can become tight leading to breakdown in movement patterns which can result in injury.

Contain your excitement; you can’t get back two months of minimal training in two weeks, so be patient! Aim for around 10-15% increase in load each week.

If you are unsure of your technique, book in a few sessions with one of our physiotherapists, or an exercise physiologist at the gym, for guidance around movement patterns. This can be much more cost effective than future dealings with an orthopaedic surgeon.

Rest

Rest is very important for any training, particularly if you are changing the loading (weight, frequency or type of training). Your body needs time to adapt and change. You most likely will experience some serious DOMS (delayed onset muscle soreness) during the first few weeks returning to gym. Listen to your body, it’s ok to experience these DOMS however, if you are feeling pain greater than 2 days post exercise, you should reign it in!

Space out your sessions, make sure you give the worked muscle group a solid 1-2 days recovery before loading up again. If you are training whole body workouts, have rest days between sessions, take time on these days to focus on cardio, stretching, trigger pointing and foam rolling.

It’s important to allow this rest for your muscles to recover and continue to build strength without being overloaded. It might be worthwhile booking in a few regular remedial massages in the next few months.

The biggest risk to injury is this period of load change and building up again. Listen to your body and make sure you follow up with your physio early if you are experiencing altered movement patterns and developing niggles greater than just DOMS. If you can extinguish these niggles early, it’s likely you can continue training and avoid any further time out of the gym.

 

If you’d like one of our physiotherapists to help your injury-free return to the gym, please call or book online.

 

This post was written by Mitch Esdale, Physiotherapist at Stafford Physiotherapy and Pilates. 

CORONAVIRUS CLINIC UPDATE

We posted back in March about the measures we were taking to prevent the spread of coronavirus and keep our patients and team healthy (click here for details). Since then, a number of things have changed and we thought it would be timely to provide another update.

Although some of the restrictions have started to be relaxed in Queensland, we have not relaxed our strict hygiene measures. This includes frequent hand washing, cleaning of equipment between uses, prompt replacement of linens (Sandra our washing lady has been kept very busy!) and use of single use paper dressing towels as needed. We continue to clean high touch areas between appointments and classes.

 

ADDITIONAL DETAILS

PHYSIOTHERAPY APPOINTMENTS

As always, we are treating all musculoskeletal conditions, such as back and neck pain, knee and shoulder injuries and tendinopathy, with hands-on measures and exercise prescription. As physiotherapists, we continue to be the preferred providers of rehabilitation following injury or surgery or a flare up of pain from osteoarthritis or osteoporosis. We are happy to speak to you on the phone if you are not sure whether physiotherapy can help you.

If you need to stay at home, we are able to consult via Telehealth and Ally is doing home visits at standard rates.

 

PHYSIO EXERCISE SESSIONS

We have recently extended the practice and have an additional room. This has allowed us to split the exercise equipment between three separate rooms. We now have a maximum class size of three, with one patient exercising in each room and the physiotherapist moving between rooms.

Additional measures include:

  • Handwashing on arrival (and throughout the class if you wish)
  • Cleaning of equipment after each use
  • Single use of all linens (eg. neck support pillows)
ALL PATIENTS AND CLASS ATTENDEES

If you are showing any signs of illness we ask that you postpone your appointment to ensure the health of our team and other patients. If you have symptoms of cough, sore throat, fatigue or shortness of breath we are happy to waive the applicable late fee. Similarly, our team will not be working if showing any signs of illness and, in this instance, we may need to reschedule your appointment. We appreciate your support. Please do not hesitate to contact us if you have any questions or concerns.

 

We follow the guidelines provided by our Australian Physiotherapy Association and Queensland Health, who provide daily updates as more information on COVID-19 comes to hand.

Home exercise equipment + programs

Do you want to exercise at home and need some equipment? We have full (long) rollers, short rollers, exercise balls, chi balls, sliders, exercise resistance bands (plus handles if needed), hand stress balls and exercise DVDs. We sell these!

We also have home exercise packs available:

  1. Chi ball + exercise band + sliding disc – $30
  2. Short roller + Chi ball + exercise band + sliding disc – $50
  3. Long roller + Chi ball + exercise band + sliding disc – $75

The sliding disc is used to slide your foot along a carpeted or hard surface.

The chi ball adds an extra challenge or assistance to your exercise.

If you would like us to drop them off (and live near our practice at Stafford), we can do that for free.

We already have some information on great exercises on our facebook page (and our VIP facebook page for patients), the blog on our website and our instagram. There will be much more to come soon to help you keep exercising.

If you would like an exercise program to suit your personal requirements (particularly if you have a previous or current injury, chronic pain or a particular need), we will be starting online consultations (Telehealth) in the next few weeks. We can incorporate equipment you may already have at home, or help you choose which equipment to buy.

We are happy to have a short chat to you on the phone if you have any questions. Allyson Flanagan is also doing home visits for those well people who have to stay home.

INTERESTING FACT: In 1918 a terrible epidemic (Spanish Influenza) broke out worldwide, killing millions of people. Joseph Pilates (the founder of Pilates), who was German, was confined to an internment camp in England during the second world war. There were tens of thousands of deaths in England and the camps were particularly hard hit. Joseph Pilates had begun devising strengthening exercises with controlled breathing and mindful movement with equipment using springs to rehabilitate the incarcerated and bedridden with wartime diseases. None of the followers of Joseph Pilates’ exercises got the Spanish Flu!