Stress and the body

Part 1: Physical stress on the body – without stress there can’t be change

Most people think of stress as being a bad thing for your body but in a lot of ways it can be very beneficial and in fact is crucial to our survival.


The human body responds to stress by improving its capacity to withstand that stress and thereby becoming more resilient. This can be witnessed when the body acclimatises to extreme temperatures or changes in altitude, or when building muscle strength in the gym. In fact, you can apply the same rules to all of the body’s systems.


Humans have harnessed this throughout history to improve our health whether it be football players exposing themselves to a variety of stresses in the pre-season to become stronger and more robust or using a small dose of a disease in a vaccine to immunize the body to that disease. A recent dieting trend is to intermittently fast from food which is just taking advantage of stress applied to the body’s digestive system.

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In physiotherapy we use stress to our advantage daily. Let’s say hypothetically that a patient present to us after a recurrent episode of lower back pain and has decided to completely rest and stop all exercise to allow the pain to subside. The problem is that the pain didn’t resolve and now when the patient returns to exercise the symptoms return worse than ever! Often these injuries can arise from a lack of resilience in the area of injury and so by resting the tissues you might find that the loading capacity of the tissue actually can decrease. So by keeping moving and safely loading all of the muscles, bones, joints and discs the capacity will continue to increase, allowing the patient to return to normal function (MAGIC!)

Pain Management Resources

The following resources are ones we, as physiotherapists, commonly recommend to clients to help them manage their pain. These relate primarily to chronic pain, which is ongoing or longstanding or recurrent. They are useful whether or not you have been diagnosed with a “condition” (eg. disc bulge, osteoarthritis, spinal stenosis). They are particularly useful when other forms of management, especially hands-on or “passive” treatment, have not been successful in resolving your pain.

The “best evidence” in the research into chronic pain tells us that “active” forms of treatment work best. This means a suitable form of exercise, which could include Clinical Pilates, gym programmes, therapeutic yoga and/or aerobic exercise such as walking, swimming and cycling. It also means being proactive with self-management strategies, which involves identifying and addressing factors, unique to you, that may contribute to your pain.

These groups are two of the most up-to-date and internationally renowned in pain and pain management research.  Both groups are Australian, the first being West Australian.

painHEALTH: www.painhealth.csse.uwa.edu.au
(sections “Management” and “Stories” are particularly helpful)

NOI Group: www.noigroup.com/en/resources

The NOI group also has several associated books (and even an app!) for the self-management of pain. 

The websites themselves are very informative, using multimedia including videos and imagery to “explain pain”. 

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I've torn my ACL....what now?

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Whether you get surgery or not, an important thing to understand is that there is no quick fix after an ACL injury. If you plan to return to your previous level of activity the rehabilitation process can be long and difficult but is imperative to minimise chance of re-injury. 
Step 1: Get a plan. Navigating the lengthy rehabilitation process can be quite a daunting prospect so getting a solid plan written up is the first thing you need to do. Your physio will happily explain this process to you in detail.
Step 2: Optimise pain and swelling early. This might involve talking to your GP about appropriate painkillers or anti-inflammatory’s to take, or using non-pharmacological pain and swelling management such as ice, compression, elevation or combine all 3 using a device such as the GameReady. Horizon has use of 2 GameReady devices for this purpose. 
Step 3: STICK TO YOUR PROGRAM. This might sound obvious but ACL rehabilitation involves a lot of hard work and consistency is key. At Horizon we will treat you like an elite athlete and use everything at our disposal to optimise your recovery but ultimately it comes down to you being able to follow your program effectively. 
If you want more details about this process drop into Horizon and grab an ACL booklet that highlights what to expect throughout the rehabilitation or book in to see one of our friendly and talented physiotherapists. 

Do Schoolbags Cause Back Pain?

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As children get older the prevalence of lower back pain increases with a whopping 47% of 15 year olds reporting to have lower back pain. So what is causing this? Could it be the schoolbag full of books that they carry every day?
The short answer is: maybe… A recent systematic review looked at this and found no convincing evidence that schoolbag use increased the risk of lower back pain in adolescents although there is evidence for increased risk if the child reports the bag to be heavy.
This likely means that a heavy schoolbag may be one of many contributing factors to an individual having lower back pain and is unlikely to be the sole cause.
If you are having lower back pain or have a child with lower back pain and would like more information book in to see one of our friendly and experienced physiotherapists.

Should I Exercise During Pregnancy?

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The British Journal of Sports Medicine have recently published a much needed update on exercise recommendations during pregnancy. Appropriate exercise during pregnancy has be shown to be associated with less complications as well as enhancing maternal physical and mental health.
The amount of exercise that is appropriate for you may depend on your previous level of fitness as well as any current or previous health issues. If you are having certain issues during pregnancy such as pre-eclampsia, then exercise may be limited. It is recommended that all pregnant women who aren’t currently meeting the new guidelines and don’t have any contraindications to exercise start to progressively move towards them. The updated exercise recommendations will be released next year.
If you would like to know what exercise you should be doing during pregnancy and what you should avoid, or if you want to start doing Clinical Pilates during your pregnancy come in and see one of our friendly and experienced physiotherapists. Genevieve has a special interest in Women’s and Men’s Health and can also assist with other pregnancy related issues.

What to do with a Sprained Ankle

As all of the Winter sports seasons have come to a close we are hearing the question “can I play on this sprained ankle?” The ankle sprain is the most common sporting injury accounting for up to 45% of all injuries. It also has recurrence rates of 73% and has a 59% possibility of long term disability. And yet it is an injury that is commonly brushed off and played through.

The first thing that you should do after even a minor ankle sprain is have it assessed by a physiotherapist or other relevant health professional. When rehabilitating your ankle it is important to optimise the strength, flexibility, balance and motor controlback to at least pre-injury levels. It is also usually a good idea to brace or strap your ankle when returning back to sport.

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The Miraculous Healing Disc

If you’ve ever had lower back pain and been diagnosed by a health care professional as having a disc related injury such as a disc bulge or protrusion, you’ve probably felt that sinking feeling in your gut and immediately started asking yourself questions like “will I have this for the rest of my life?” or “will I need to have surgery for this?”. We have long known that much like an ankle sprain or any other injury discs will heal themselves spontaneously. A recent meta-analysis showed that in the United Kingdom 82.94% of patients who had disc herniation spontaneously reabsorbed without surgery.

It's time that we stop being so fearful of lower back injuries and started realising how strong and stable our spines are.

If you’re having lower back pain and want to know the best course of action, book in to see one of our experienced and friendly physiotherapists.

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How do I treat persistent neck pain?

Neck pain is one of the most common symptoms leading sufferers to seek help from health practitioners, but what can be done for long term chronic neck pain?

Chronic or persistent neck pain is multi factorial so the short answer is that it depends on your particular presentation. Treatment for neck pain, like many other injuries, shouldn’t be a “one size fits all” approach. Once you have had a thorough assessment of all of the potential contributing factors to your neck pain treatment might consist of education, manual therapy, stretching and exercise. Research has shown that specific neck and shoulder exercises can improve neck pain, disability and strength after 1 year and 3 year follow-ups. So like many other injuries, having appropriate strength and control is important in the resolution of your symptoms. 

For more information about neck pain book in to talk with one of our friendly and experienced physiotherapists.

Neck Twists

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  • Slowly rotate neck all the way to one side

  • Hold for 3 seconds then slowly rotate all the way to the other side

  • Repeat 10 times to each side

Neck Rolls

  • Side flex your neck by bringing your right ear down towards your right shoulder•Slowly roll your neck around until your chin is towards your chest

  • Continue rolling until your left ear is towards your left shoulder

  • Roll back in the same fashion

  • Repeat 10 times to each side

Beating Tendon Pain

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Have you ever had tendon pain? These disorders can occur in many tendons around our body including the Achilles, knee, hip, shoulder and elbow (golfers or tennis elbow). They can be very painful and disabling, but how do we treat them?


WHAT DOESN’T WORK?
Anti-inflammatories may be beneficial in the early stages to settle pain and bursitis but long term use of anti-inflammatories including cortisone injection has very limited evidence. Because tendon pain, also known as tendinopathy is not an inflammatory process it is hard to justify use of anti-inflammatories and in fact repeated cortisone injections may weaken the integrity of the tendon.
Stretching used to be a common treatment for tendon pain but in actual fact may be counterproductive in the natural healing process of the tendon and may cause more pain.


WHAT DOES WORK?
Exercise!! As usual exercise comes to the rescue. The most important thing you can do for your painful tendon is to use appropriate exercise. This might mean temporarily pausing irritable exercise and instead doing specific rehabilitation to improve the integrity and natural healing of the tendon. It may also be necessary to address biomechanical factors that are putting additional load or compressive load through the tendon.
For more information about tendons book in to talk with one of our friendly and experienced physiotherapists. 

Surgery or Exercise?

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About a million orthopaedic surgeries are performed each year in Australia and these numbers are continuing to rise. A recent study marked a significant increase in shoulder surgery in Western Australia including a 473% rise in public funded rotator cuff surgeries. These numbers are reflected similarly for other joint surgeries such as knee and hip replacements.
A recent news story on SBS Insight shined a light on this data and asked the question; how many of these surgeries are necessary? The evidence for surgery in many of these cases has little scientific evidence when compared with conservative treatments such as exercise. So when considering a surgical management do your research and talk to as many experts as possible before deciding if you can get just as good or better outcomes from options such as physiotherapy, exercise rehabilitation or Pilates.