Pain In The Heel: What Is Plantar Fasciopathy?

Plantar Fasciitis

It’s morning, and the alarm clock has just told you it’s time to get out of bed. Another few minutes won’t hurt. You check your emails, social media sites, and you even ring your mum to see how the dog slept last night… basically anything to delay putting your feet on the ground and taking those first steps to get the day started. And it’s because of this pain you’ve been getting on the bottom of your heel every morning for the last few weeks. And it’s getting worse… Time to see your osteopath!

There are a few things that can cause pain on the bottom of the heel, but the most common cause is a condition named plantar fasciopathy (pronounced ‘fash-ee-op-a-thee’. Previously known as plantar fasciitis (pronounced ‘fash-ee-i-tis’)).

What is plantar fasciopathy?

Plantar fasciopathy is an overuse condition affecting the plantar fascia. The plantar fascia is a layer of soft tissue that stretches along the bottom of the foot, from the heel bone to the metatarsal bones in the front of the foot. It helps to provide stability to the arch of the foot. It is similar in make-up to a tendon (the things that attach muscle to bone). If too much stress is placed on it over time the tissue can degenerate, weaken, and give you pain. The pain is commonly felt where the plantar fascia attaches into the heel bone.

Risk factors

Scientific research suggests there are a few groups of people who are more prone to developing plantar fasciopathy. These include:

  • Runners
  • People who are over-weight and lead a sedentary lifestyle and/or spend long periods standing for work (e.g. a factory worker)

Important things to consider with these at-risk groups include:

  • Foot alignment and arch height: Having a very low or high arch or having excessive or not enough movement in the foot joints can lead to the development of this problem.
  • Amount of training: Increased levels of training can place greater stress on the plantar fascia more regularly.
  • Footwear: Wearing certain types of footwear when training can lead to an increased risk of plantar fasciopathy. For example: wearing athletics spikes, or the wrong footwear for your foot type).
  • Muscle strength and flexibility: Decreased strength in the muscles that control toe movement, as well as weakened and tight calf, hamstring and gluteal muscles.

Signs and symptoms

The signs and symptoms of plantar fasciopathy include:

  • Pain at the bottom of the heel
  • Pain that appears as a gradual onset
  • Pain felt first thing in the morning (i.e. taking those first steps out of bed in the morning is classic!)
  • Pain that decreases with activity, but increases again afterwards (early stages)
  • Pain that increases with activity and pain felt at night (latter stages)
  • Pain felt after periods of prolonged rest during the day (i.e. being sat at your desk for 2-3 hours and then getting up again)
  • Tight calf, hamstring and gluteal muscles
  • Weak muscles that help to support the arch of the foot
  • Stiff or over-flexible foot and ankle joints

Diagnosis and treatment

First things first, if you have heel pain that sounds similar to the picture we have painted above, make an appointment with us now (you know what to do… call us on 02 4655 5588. Once we have asked the relevant questions, performed the necessary tests, and are convinced that the issue stems from the plantar fascia, we will formulate a plan with you with short and long-term goals to reach within a set time.

Initial hands-on treatment will include a combination of massage, joint mobilisation and manipulation, and dry needling of the lower limb muscles with the aim of correcting any mechanical issues that are playing a role in this issue. Depending on the presentation, we may also use tape around the foot and ankle to provide support and reduce the stress being placed on the tissues. Other treatment will include advice on weight loss (if required), training regimen, footwear, and exercise prescription that helps to lengthen and strengthen tight and weak muscles. Some cases of plantar fasciopathy may require a foot orthotic or in-sole to provide extra support to the foot whilst wearing shoes. We can advise on footwear too, and may even get you back into our favourite type of thongs

Plantar fasciopathy is a tricky condition to treat which may require ongoing treatment for several months. We will endeavour to get you pain-free in the shortest time possible, so we recommend following all advice to a T, which may include a reduction in the amount of training you are doing at present. When you start to hit goals and we see improvements being made, we’ll have you back up to your full training program before you can say “plantar fasciopathy”.

Imaging?

People regularly ask if they need imaging for such an issue, but the majority of cases of plantar fasciopathy can be diagnosed with a thorough case history and physical assessment. This is where we excel! Imaging is there for cases that do not respond to treatment and for those instances where we need to rule out a more serious problem.

If you need help with heel pain, please call us today on 02 4655 5588 to book your appointment. Let’s have you putting your best foot forward, ASAP! 👌

References
1. Thompson, JV. et al. 2014. Diagnosis and management of plantar fasciitis. Journal of American Osteopathic Association. 114 (12). Available from: https://jaoa.org/aoa/content_public/journal/jaoa/933660/900.pdf
2. Brukner, P. et al. 2017. Clinical Sports Medicine. 5th ed. Australia: McGraw Hill Education
3. Harvard Health Publishing. 2007. Easing the pain of plantar fasciitis. [Online]. Available from: https://www.health.harvard.edu/newsletter_article/Easing_the_pain_of_plantar_fasciitis. [Accessed 15 Jul 2020]
4. Orthoinfo. 2010. Plantar fasciitis and bone spurs. [Online]. Available from: https://orthoinfo.aaos.org/en/diseases–conditions/plantar-fasciitis-and-bone-spurs. [Accessed 15 Jul 2020]

Strong bones

Weight bearing exercise

Exercises for ageing bones

Are you in (or approaching) your latter years and are wondering what you can do to ensure you maintain strong bones through the next period of your life? As we age it is common to begin feeling the effects of years of ‘life’ on your body. Diseases like osteoarthritis (i.e. degeneration of joints) and osteoporosis (i.e. weakening of bones) are more common in the elderly population. But just because the figures show this, it doesn’t mean these diseases will affect your ability to lead a full and active life.

The good news is, there is plenty you can do now to reduce the risk of bone-related problems down the line. Read ahead for a few exercises you can perform regularly to keep you and your bones in tip-top shape!

Weight-bearing and resistance are key

It is widely accepted that to increase bone health, we need to stress the bones of the skeleton. The best way to do this is through weight-bearing exercises (i.e. exercises performed in an upright position with our legs impacting the ground). Resistance-type exercises are also beneficial in protecting the skeleton against the effects of ageing. ‘Resistance’’  implies an exercise that is performed against a force acting on the body. A simple example would be to compare walking through your house to walking through strong head-on winds. The wind pushing against the body is the resistance aspect.

When we exercise, forces acting on our muscles help to build strength. The forces placed upon the skeleton through the muscles help to activate special bone-building cells within the bones, and these help to maintain or build strong bones depending on the intensity of the exercise. In order to increase bone strength, we need to regularly push our bodies beyond the intensity of simple everyday tasks, like walking.

Age is a factor

Now, if you’re worried, we’re going to suggest a new gym membership and intense weight lifting program, then rest easy. There are lots of things to consider, and age (as well as medical history) is a big factor when it comes to prescribing exercise. Someone who is 80 will need a different exercise regime compared to someone who is 55 when it comes to targeting bone health.

Exercises to try

The following are simple weight-bearing exercises you could have a go at doing:

  • Walking or jogging uphill
  • Hiking across the countryside
  • Stair climbing or step-ups
  • A friendly game of tennis, badminton or squash
  • Aerobics or dancing

You can add resistance to your exercise program by:

Osteoperosis
Woman training with exercise band during rehabilitation
  • Lifting weights (always start light so as to not overload the body)
  • Exercising using cables or resistance bands (again, use light resistance to begin with)

Everyone has different requirements, so we suggest giving us a call on 4655 5588 or book in now so we can create an individual program that is perfect for you.

References

  1. Hong, AR. and Kim, SW. 2018. Effects of resistance exercise on bone health. Endocrinology and metabolism. 33 (4). 435-444. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6279907/
  2. Benedetti, MG. et al. 2018. The effectiveness of physical exercise on bone density in osteoporotic patients. BioMed research international. v. 2018, 4840531, 10 pages. Available from: https://www.hindawi.com/journals/bmri/2018/4840531/cta/
  3. Osteoporosis Australia. 2013. Exercise – consumer guide. [Online]. Available from: https://www.osteoporosis.org.au/sites/default/files/files/Exercise%20Fact%20Sheet%202nd%20Edition.pdf. [Accessed 06 Jun 2020]

Fracture: Let’s ‘break’ it down

fracture

Have you ever broken a bone? We hope you haven’t, but it’s a common injury that happens to people every day! Any break in the structure of a bone is known as a ‘fracture’. We’ve written a quick guide to understanding all the lingo relating to fractures below. Let’s check it out!

Causes

Fractures are usually caused in one of three ways:

  • Excessive force: This can be through either a direct force to a body part (i.e. a high tackle in football which breaks the shin-bone) or an indirect force (i.e. having your foot planted and twisting your leg which leads to a fracture of the shin-bone).
  • Repetitive stress: These result from repetitive, strenuous activities like running or jumping.
  • Other disease: These are fractures secondary to another disease process in the body which leaves the bone more prone to breaking. This may be a hereditary disease like Osteogenesis Imperfecta (aka Brittle bone disease) or as a result of cancer or infection.

Types of fracture: General description

Fractures are broadly classified into two main types:

  • Closed: The bone fractures and the overlying skin remains intact.
  • Open: The bone fractures and protrudes through the skin exposing the bone and other tissues to the elements. These types of fractures are prone to becoming infected, which complicates everything.

We can also classify fractures on whether they are:

  • Complete: A clean break of a bone into two or more pieces
  • Incomplete: The bone is not completely broken with some of the outer structure of the bone remaining intact.

Types of fracture: Now let’s REALLY break it down!

Each fracture can also be given a more specific description based on where exactly the bone is broken and in what way it has broken:

  • Transverse: A horizontal break across the shaft of a bone.
  • Linear / fissure: A vertical break along the shaft of a bone.
  • Oblique / spiral: A diagonal, or as the name suggests, spiral type fracture around the shaft of a bone.
  • Greenstick: One side of a bone has broken but the other side remains intact. This is common in children where bones are much more flexible than adult bones.
  • Comminuted: The bone is broken into more than two pieces, possibly into several fragments
  • Impacted: Two parts of a bone fracture are forced into one another
  • Crush: Usually seen in the spine caused by vertical and forward bending forces down through the vertebrae
  • Hairline: A tiny crack in the bone — these are so small that they are commonly missed on an x-ray!
  • Avulsion: A piece of bone is ripped away from the main bone by way of tendon or ligament injury. (Remember tendon attaches muscle to bone and ligament attaches bone to bone).

Which type of fracture have you had in the past? We hope this guide will help you work it out. Next time you come across a fracture (fingers crossed you don’t) you’ll know exactly what the doctors are talking about!

Stay safe, we’re here if you need any assistance.

References

  1. Brukner, P. et al. 2017. Clinical Sports Medicine. 5th ed. Australia: McGraw Hill Education
  2. Xui, P. 2012. Pathology. 4th ed. UK: Elsevier Mosby
  3. Tortora, G. and Derrickson, B. 2011. Principles of Anatomy and Physiology. 13th ed. Asia: John Wiley & Sons

Injury blog: Winging of the shoulder blades

Winging of the shoulder blades

Hey everyone! We hope you are keeping well. We’re carrying on with life as close to normal as possible, so here is your monthly reading material. Perfect time for a tea or coffee we say! This month we’re taking a close look at the shoulder, specifically a condition that affects the shoulder blade. Do you have, or have you ever seen someone whose shoulder blades stick out on their back and look a little bit like wings? This condition is aptly named ‘winging’ of the shoulder blades.

Anatomy

Osteopaths love a bit of anatomy! The shoulder blade or ‘scapula’ is a largely flat bone that sits on the back of the rib cage and is an important ingredient in what makes up the various joints of the shoulder. As well as the larger flat part, a few extra lumps and bumps makes for a very odd shaped bone when looked at in isolation. One of the bony protrusions actually makes up the ‘socket’ part of the ball and socket joint in the shoulder. The ‘ball’ part being made from the head of the upper arm bone (aka the ‘humerus’).

Interesting fact… There are 18 muscle attachments on the shoulder blade. It is through fine balancing of these muscles which keeps the shoulder blade stabilised and flush to the back of rib cage, and allows us to move our shoulders through an extremely large range of motion. As you can imagine, keeping all of these muscles in full working order takes a bit of co-ordination. And with so many players involved, there is room for dysfunction to creep in and movement to become affected. Sometimes the dysfunction is great enough to cause the shoulder blade to flip outwards from the rib cage, and this is what we refer to as ‘winging’.

Causes of winging

The causes of shoulder blade winging can be broadly broken down into:

  • Muscular: As we previously mentioned, lots of muscles are responsible for controlling the position and movement of the shoulder blade. Injury to these muscles, or an imbalance in the strength, length and function of the muscles over a prolonged period may lead to this issue. The main muscles involved here are the Serratus Anterior (a muscle which attaches to the ribs and the underside of the shoulder blade), and the Trapezius (a kite shaped muscle which covers the back of the neck, shoulders and upper back… Aka ‘traps’). It’s more complex and there are more muscles involved, but these are the key players when it comes to winging.
  • Neurological: Muscles require a nerve supply in order to move, so if any of the nerves that supply the key players (i.e. Serratus and Traps) are injured, this can stop the muscles from being able to perform their job. Nerves can be injured through entrapment, where something presses on a nerve as it travels from the spine down to the muscle it supplies. Other causes may be from acute traumas as seen with car or sporting accidents where the shoulder takes a direct blow while the arm or neck are suddenly pulled.

Other ways these injuries may come about include prolonged wearing of a heavy backpack, complications following surgery, or as a result of a viral infection that affects the nerve.

Signs and Symptoms

The main sign is a shoulder blade that doesn’t sit snug to the rib cage, particularly when trying to move the arm upwards in front of the body or out to the side. Many people with scapula winging feel no pain whatsoever, but this can be a very painful condition if the cause is from a severe nerve injury. Another key sign is the inability of a person to lift their arm above their head.

Treatment

The treatment of shoulder blade winging very much depends on the cause. If the shoulder blades are winging because of a muscular imbalance, these are a little easier and faster to rehab. After careful assessment of your shoulder, neck and other spinal movements, we will aim to restore full functioning of the muscles that control the position and movement of the shoulder blades. This might include techniques which aim to lengthen short or tight muscles which are pulling the shoulder blade out of position. If there is a weakness to a particular muscle or group of muscles, we will also prescribe you strengthening and movement re-training exercises which aim to return the shoulder blade to its functional position.

Winging caused from nerve entrapment or injury is notoriously harder to treat. If entrapment of the nerve is caused by muscular tension in another part of the body, or because you’ve been carrying a heavy backpack for too long, then we will work on the relevant muscles and nerves to release the entrapment and pressure. We might also need to adjust how you wear your backpack and how much weight is inside while we focus on improving your physical impairments. Nerve-related injuries can take much longer to resolve. Winging caused by paralysis of the nerve which supplies the Serratus Anterior muscle has been known to take up to two years to resolve. The good news is, most people will make a full recovery in this time with surgical procedures saved only for more complex or unresolved cases. Which if you ask any Osteo, is always the goal!

If you notice winging of the shoulder blades, or difficulty with achieving full shoulder range of motion, then get in touch today on 46555 5588. We would love to chat to you about your issue in a phone or video consult and get you on the road to recovery as soon as possible. You can also book an appointment here.

References

  1. Brukner, P. et al. 2017. Clinical Sports Medicine. 5th ed. Australia: McGraw Hill Education
  2. Snell, R. 2012. Clinical Anatomy by Regions. 9th ed. USA: Lippincott Williams & Wilkins
  3. Magee, D. 2008. Orthopaedic Physical Assessment. 5th ed. USA: Saunders Elsevier

To brace an injury: when it is helpful and when it isn’t

To brace an injury: when it is helpful and when it isn’t

A very common question we get asked at Completely Aligned is “Do I need to wear a brace to help with my injury?” Well this is very much a ‘depends’ sort of answer. It depends on the injury, where along the injury process you are and your personal circumstances.

Let’s first outline the advantages of wearing a brace and give some examples of when you might need to wear one.

Braces are items we place on a body part, usually over and around a joint, to provide extra stability to that area. They come in different forms but are generally quite flexible and elastic to ensure they move with the body, whilst being strong enough to protect the joint simultaneously.  Some braces are quite movable whilst others can lock a joint in a particular position.

When is it helpful?

The advantages of bracing include:

  • Providing stability to an injured body part to aid with treatment, rehabilitation and return to sport or work scenarios
  • Allowing faster healing by limiting movement at an injured body part
  • Reducing pain by de-loading injured structures
  • Can be easily put on and removed for any given situation
  • Are widely available and affordable

A common injury where you may need to use a brace is in the early stages of a moderate to severe medial collateral ligament (MCL) sprain of the knee. Imagine your knee has been forced inward whilst your foot is planted on the ground. If the force is great enough, the ligament stretches, tears and the stability of the knee is compromised. In this case, a brace is helpful to stop the knee from falling inwards again, which would interrupt the healing of the ligament. As healing progresses, the brace can be used less frequently or removed altogether to allow for more movement and activity. Other examples where a brace may be required include:

  • Wrist and ankle sprains
  • Tennis or golfer’s elbow (see recent blog for more info)
  • Knee cruciate ligament sprains
  • Pelvic instability (these are particularly helpful during pregnancy)
  • For stabilisation and re-training of scoliosis cases (i.e. abnormal spinal curves)

When isn’t it helpful?

One of the most common negative effects of bracing that we see is over-reliance. When someone has injured their ankle playing netball, part of the rehab process to get them back on the court quickly may be to wear a brace to provide them with the confidence to play to their full potential without fear of re-injury. This is all well and good as long as they wean off using the brace as rehab progresses. Many people end up wearing the brace as a safety net for 6 months, a year, or even longer because they are scared of re-injury. If you rely on a brace for support, it means the body part that was injured won’t have the necessary forces placed through it to ensure a full recovery to a pre-injury state. This could affect many factors including muscle strength, ligament stability and the body’s ability to know where the joint is in space (a.k.a ‘proprioception’). In order to return to that state, it’s necessary to move and exercise completely unaided.

Other disadvantages include:

  • Failure to achieve full joint range of motion post-injury
  • Possible muscle wasting
  • Increased loads placed on other body parts, which can risk another injury elsewhere

Our best advice to you is to never see a brace as a replacement for good movement and rehab. Always follow the advice of your practitioner as to when you should and shouldn’t wear a brace. If you have any doubts or questions, please call us on 02 4655 5588 to discuss, or book an appointment with one of our Osteo’s here. 

References

  1. Chen, L. et al. 2008. Medial collateral ligament injuries of the knee: current treatment concepts. Current reviews in musculoskeletal medicine. 1 (2). 108-113. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684213/
  2. Brukner, P. et al. 2017. Clinical Sports Medicine. 5th ed. Australia: McGraw Hill Education

Putting a stop to incontinence

Putting a stop to incontinence

Do you leak when you laugh? Its time to raise awareness for the 5 million+ Australians who experience bladder or bowel incontinence. Yes, it really is THAT common! This can be a very debilitating condition, but unfortunately, a lot of people suffer in silence through fear of speaking out, due to the embarrassing nature of the problem.

What you may not realise is that the majority of incontinence cases can be treated, and a lot of the time, stopped completely. So, to try and help break the silence surrounding incontinence, we are going to give you a little run down on what it is, who it affects, and some tips on what you can do to help.

WHAT IS INCONTINENCE?

Incontinence is the term used to describe the uncontrollable loss of urine from the bladder or faeces from the bowel. It ranges in severity from losing only a very small amount of urine, to a complete void of the bladder or bowel. If you’ve never experienced this, you can only imagine how distressing this must be. There are different types of urinary incontinence, including:

  • STRESS INCONTINENCE, where small amounts of urine leak due to small increases in pressure on the bladder during physical activity, or from coughing, sneezing or laughing.
  • URGE INCONTINENCE, where you get an unexpected, strong urge to urinate with little to no warning. This is usually as a result of an overactive bladder muscle.
  • INCONTINENCE ASSOCIATED WITH CHRONIC RETENTION, where your bladder cannot empty fully, and you get regular leakage of small amounts of urine. There are many causes for this, including an enlarged prostate in men, or prolapsed pelvic organs in women, as well as medications and certain conditions, such as diabetes and kidney disease.
  • FUNCTIONAL INCONTINENCE, where you are unable to get to the toilet, possibly due to immobility, or wearing clothes that are not easy to get off in time.

Faecal incontinence is when you have a lack of control of bowel movements and you may accidentally pass a bowel movement, or even pass wind without meaning to. This may be due to weak muscles surrounding the back passage (Unfortunately ladies, this is common following pregnancy and childbirth), or if you have severe diarrhoea.

TAKING THE STRESS OUT OF INCONTINENCE

For all those suffering in silence, it is time to speak out.  There is no need to be embarrassed, it is surprisingly common – and like we have already mentioned, help is out there! You may not need to look very far. Being your local Osteopath, we may be able to help.

The most common type of incontinence that we see and treat is stress incontinence. Although seen across both sexes, women are three times more likely to experience it than men. It is very common in women following pregnancy and childbirth (when the pelvic floor muscles get over-stretched, and sometimes even damaged), during menopause (due to hormonal changes) and in the elderly. It commonly affects men who have had prostate surgery.

The pelvic floor muscles sit at the bottom of the pelvic bowl, spanning from the pubic bone to the tailbone (front to back) and from one sitting bone to the other (side to side). Imagine a tarpaulin stretched out with a person holding each corner and you kind of get the gist. When these muscles are strong, they help to support our internal pelvic organs (i.e. the bladder, bowel and the uterus in women) and wrap around the openings of the front and back passages, allowing us to control when we decide to do a number one or two. Following pregnancy for example, they may become weak and dysfunctional, and we can lose that ability to control voiding. It only takes something as small as a cough, or an activity like jumping or running (things many of us take for granted) that may cause a person to lose a small amount of urine.

WHAT WE CAN DO TO HELP

The most important thing to point out is that not all types of incontinence will improve or resolve with just strengthening of weak pelvic floor muscles. So, it is very important to get an accurate diagnosis, because there will likely be other factors that need addressing too. For instance, losing weight, stopping smoking, and making other lifestyle changes are just as important in the management of these conditions, if relevant to the person of course. Some people may also require release of tight and over-active muscles.

Once you have your diagnosis, then strengthening may well be a part of your therapy. In order to strengthen, you need to know where the muscles are, and how to activate them. Below is a little step by step guide to getting a grip on those pelvic floor muscles (we don’t mean literally!):

  1. Get in a comfortable position – try sitting or lying on your back and take a few breaths to relax.
  2. Imagine you are trying to stop yourself from urinating mid-stream by squeezing for about a second. If this is not easy to feel, next time you are on the toilet emptying your bladder, have a go at stopping mid-stream and then relaxing again to finish emptying (don’t hold it for too long please – just enough to feel which muscles you need to use).
  3. Do the same as step two for the back passage – this time imagine you are trying to stop yourself from passing wind by squeezing.
  4. Do these quick squeezes 3 x 20 reps a day. Once you’re comfortable, you can do it sitting or standing. Make it routine… Do it when you’re brushing your teeth, eating lunch, or in the ad breaks of your favourite TV show.

These two contractions together form the basis of what you need to be able to do to begin your pelvic floor muscle training. If you struggle to feel this, then ask for help from your therapist. They will be able to help you perfect the activation of the correct muscles.

We hope you have found this blog interesting and helpful. If you, or someone you know is looking for answers to questions and advice on the management of these conditions, then please get in touch. We are ready to offer advice and/or treatment. 

References

  1. Continence Foundation of Australia. 2019. World Continence Week. [Online]. [Accessed 07 May 2019]. Available from: https://www.continence.org.au/events_calendar.php/482/world-continence-week
  2. Continence Foundation of Australia. 2019. Laugh Without Leaking. [Online]. [Accessed 07 May 2019]. Available from: http://www.laughwithoutleaking.com.au
  3. Continence Foundation of Australia. 2019. Key Statistics. [Online]. [Accessed 08 May 2019]. Available from: https://www.continence.org.au/pages/key-statistics.html
  4. Milsom, I. and Gyhagen, M. 2018. The Prevalence of Urinary Incontinence. Climacteric. 22(3). 217-222. DOI: 10.1080/13697137.2018.1543263
  5. Continence Foundation of Australia. 2019. Pelvic Floor Muscles in Women. [Online]. [Accessed 08 May 2019]. Available from: https://www.continence.org.au/pages/pelvic-floor-women.html

Five tips for digestive health

Irritable bowel poor gut health

June is bowel cancer awareness month, so we’re here to give you tips on how to keep improve your digestive health and reduce the risk of disease.

Whether you are a professional soccer player, a tradie or an office worker, a healthy digestive system is key to you being able to function and carry out your daily tasks. Our bodies break down the food we eat into energy and this is what allows us to kick a ball, drill a hole, or sit and type on the computer. Now, your digestive system will only work properly if you feed it the right stuff… So don’t expect to last the 90 minutes and be at the top of your game if all you do is gorge on deep fried or fast food. That’s just a fast track to the subs bench and unhappy insides!

Try out these little gems of advice to ensure your digestive system stays healthy, so you can give 100% every single day:

1. DRINK LOTS OF WATER: We’ll make this one nice and simple… Your body needs water for almost everything! From maintaining the health of every cell in your body, to keeping your blood fluid – you can see it’s pivotal for life to exist. Water is also needed for creating your digestive juices used to break down food and preventing digestive complaints like constipation.

2. EAT A HIGH FIBRE DIET: Fibre is basically all the parts of plant-based foods that we are unable to breakdown and digest. There are different types. ‘Soluble’ fibre (found in fruits, vegetables & legumes) helps to keep you feeling fuller for longer and helps to control blood sugar levels and lower cholesterol. ‘Insoluble’ fibre (found in the skin of fruits and vegetables, wholegrain breads/cereals, and nuts and seeds) absorbs water helping to bulk out and soften our stools and aids in the regulation of bowel movements. Having a good mix is important to prevent diseases such as constipation, bowel cancer, diabetes, and heart disease.

high fibre diet

3. EAT A PROBIOTIC: Probiotics are the bacteria found living in our gut. They are responsible for providing the ideal environment for getting the most nutrients out of the food we eat. They also protect us from the effects of nasty bacteria that may show their faces at different points. Without them, we wouldn’t exist. Sometimes our stores of bacteria can be put under threat, like when we are ill, stressed for long periods, or after a course of antibiotics. Having a poor diet can also be bad for them. Luckily, we can eat foods like probiotic or ‘live’ yoghurt and kefir daily to help keep our gut well-populated with these little soldiers.

4. GET PLENTY OF EXERCISE: The benefits of exercise are endless! When you move, it helps to promote movement of food through your gut, which keeps everything functioning well and helps to reduce the risk of digestive problems like constipation. So, move every day because your gut doesn’t tend to go on holiday for days here and there. It is always working hard for you!

5. LIMIT INTAKE OF ALCOHOL AND SMOKING: Too much of anything is a bad thing, but the effects of too much booze and cigarettes on the digestive system are well documented. Heavy, long term intake may lead to conditions such as reflux, digestive ulcers, and possibly more severe disease such as oesophageal, stomach and bowel cancer.

Remember, you really are what you eat. Gut health is so important for you to do the things you want to do – work, playing with the kids, sports, everything! So don’t be surprised if your practitioner throws in some questions regarding digestive health when they’re treating you. It’s much more than just muscles and bones. We will delve deep if we need to, to make sure you are at the top of your game. Contact us now for an appointment on 4655 5588.

References

  1. State Government of Victoria. 2014. Water – a vital nutrient. [Online]. [Accessed 03 May 2019]. Available from: https://www.betterhealth.vic.gov.au/health/healthyliving/water-a-vital-nutrient
  2. Nutrition Australia. 2014. Fibre. [Online]. [Accessed 03 May 2019]. Available from: http://www.nutritionaustralia.org/national/resource/fibre
  3. Webster-Gandy, J., Madden, A., Holdsworth, M. eds. 2012. Oxford Handbook of Nutrition and Dietetics. Oxford: Oxford University Press
  4. Enders, G. 2015. Gut – the inside story of our body’s most under-rated organ. Melbourne: Scribe Publications
  5. Drinkaware. 2019. Is alcohol harming your stomach. [Online]. [Accessed 04 May 2019]. Available from: https://www.drinkaware.co.uk/alcohol-facts/health-effects-of-alcohol/effects-on-the-body/is-alcohol-harming-your-stomach/
  6. State Government of Victoria. 2019. Smoking – effects on your body. [Online]. [Accessed 04 May 2019]. Available from: https://www.betterhealth.vic.gov.au/health/healthyliving/smoking-effects-on-your-body

Living with diabetes – It affects more of us than you think.

Living with diabetes – It affects more of us than you think.

Are you living with Diabetes? It can be very overwhelming managing this condition, particularly in the early stages following diagnosis. We’ve put together a little fact sheet and given some tips on things you can do to manage your condition and live well with Diabetes.

WHAT IS DIABETES?

In a nutshell, Diabetes (or correctly named – Diabetes Mellitus or DM) is a condition characterised by increased levels of sugar in the blood, resulting from the body’s inability to either produce or correctly make use of a hormone called Insulin. Insulin helps move sugar (called ‘glucose’) in the blood into the cells around the body so we have energy to function. There are a few different types of DM:

  1. Type 1: The body does not produce enough insulin due to cell damage of the pancreas – the organ in the body that produces insulin.
  2. Type 2: The body is unable to sufficiently use and respond to the insulin produced by the pancreas.
  3. Gestational Diabetes: This form affects pregnant women who have no prior diagnosis of DM. This condition usually resolves after delivery of the baby.

Each form is treated slightly differently. Type 1 requires the person to take insulin, usually via self-injection. Type 2 can predominantly be managed through diet and exercise, but may require medication and possibly insulin, depending on how advanced the condition is. Type 2 is the most common form of the condition and what we’re going to focus on.

WHAT CAN YOU DO TO HELP?

The most common cause of Type 2 DM is a combination of excess body weight and lack of exercise. So it is fitting that one of the best ways to control your blood sugar levels, and reduce the risk of complications (such as heart, kidney, eye and nerve disease) further down the line, is to reduce body weight and exercise regularly.

DIET

Dietary recommendations for people with DM are not too dissimilar to those for any other person. The following tips can be helpful to follow:

  • Eat regular meals and consume healthy snacks spread across the day
  • Eat high fibre, complex carbohydrate foods such as whole grain breads, cereals and pastas, beans, lentils, fruit and vegetables (i.e. foods that have a low glycemic index and won’t spike your blood sugar levels quickly)
  • Be mindful of the amount of fat you eat, especially saturated fats, found in takeaway food, fried food, cakes and biscuits
  • Keep alcohol intake low as a general rule, and ensure you have plenty of alcohol-free days
  • Keep energy balance in mind. If you consistently consume more energy than you burn off in a day, you will gain weight
Exercise Rigth
Diabetes

EXERCISE

It is recommended that people with Type 2 DM participate in both aerobic and resistance-based exercise regularly and consistently. These forms of exercise have been shown to improve insulin action and overall quality of life. And they help decrease blood pressure, heart complications, fat levels and risk of death.

Please remember that these are basic guidelines, and we always recommended that you seek help from a health professional such as your GP, DM specialist, or your local osteo before making any big decisions on diet and exercise to help manage your Diabetes.

References

  1. Diabetes Victoria – https://www.diabetesvic.org.au/diabetes-and-me?tags=Left-Mega-Nav%2FDiabetes%20and%20nutrition%2F&bdc=1
  2. American Diabetes Association – http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/making-healthy-food-choices/?loc=ff-slabnav
  3. Harvard Health – https://www.health.harvard.edu/diseases-and-conditions/living-well-with-diabetes

What pain relief is right for you?

What pain relief is right for you?

Pain has been an ongoing topic for research and discussion for a long time. Nearly everyone feels it (I say ‘nearly’ because there is actually a very small minority of people with a special condition that does not allow them to feel pain), and it varies in character and severity depending on what part of the body is implicated. And for the most part, none of us like being in pain. When we feel pain, normally the first thing we do is to look for a way out of it (or as some of you like to, ignore it – tut tut!). It’s a bit of a minefield knowing where to go for good pain relief. Some of us like a quick fix, others are more interested in fixing the problem long term by putting the hours in to do the rehab. Luckily for you, we are here to help with both stages!

When it comes to the body, we usually feel pain because our body is sending us a signal letting us know something is not quite right. That might be down to a simple muscle imbalance or joint restriction, which is leading us to walk or run differently. Or it might be down to something more serious like a tear of a muscle or tendon, changes in the nervous system or a problem with an organ deep inside the body – the list of causes is long and complex.

Regardless of the cause, when in pain it’s human nature to want to know how to get rid of it. Some of you turn to the experts (i.e. like your local Osteo/Myo/TCM practitioners, and other professionals like doctors), and some prefer to self-diagnose using www.DrInternet.com (how’s that been working out for you?!).

Some of the most common and well-known forms of pain relief include manual therapy, use of temperature, medications, supplementation and diet – you’ll find a brief overview of each below:

Manual therapy

We as humans have been using our hands to treat the body for a very, very, very long time! If you walk into a clinic in pain, be it you have a swollen ankle or the inability to lift your arm above your head, your practitioner will get to work on you using a whole host of techniques (after they have carefully and correctly diagnosed you of course!). Soft tissue massage and myofascial release techniques are widely used in the management of musculoskeletal pain and evidence suggests you aren’t wasting your time by getting the help of your local therapist. Your practitioner may also utilise other techniques, including joint mobilisation and manipulation, to correct your problem and to help get your pain lowered and under control. Usually you will also be given some form of flexibility or strengthening exercises to perform between treatment sessions to back up what happens in the treatment room.

Sore shoulder necl
Heat pack

Heat and cold therapy

If you’ve hurt yourself in the past, there is a good chance you’ve tried some form of treatment relating to temperature to help relieve the pain. Cold therapy can help to reduce pain, blood flow, swelling, muscle spasm, and inflammation. Heat therapy can help to relieve pain, increase blood flow, and tissue elasticity. It’s worth getting advice for the best approach for your problem.

Medication

There are countless different medications out there that can help with pain relief – these are called analgesics. Without getting too complicated, they can generally be split into Non-opioid and Opioid analgesics. Non-opioid analgesics include your well known and easily accessible medications such as aspirin, paracetamol, and anti-inflammatories (such as Ibuprofen) – these are generally good for the control of musculoskeletal pain. Opioid analgesics are there for cases of more severe pain, and include codeine, tramadol and morphine (you won’t be able to get these ones over-the-counter though!). Remember it’s always safest to consult a medical professional before using any form of medication.

Supplementation & Diet

There is no shortage of nutritional supplements available to assist you in the non-pharmacological management of pain also. From anti-inflammatory herbs like Curcumin (derived from Turmeric), Boswellia and Ginger to Fish Oil and Glucosamine and Chondroitin. Similarly, diets high in Berries, Fatty fish like Salmon or Sardines, Green Tea, Avocadoes and Broccoli can assist with reducing inflammation. In conjunction with the avoidance of sugar and highly processed/refined foods, alcohol and trans fats.

If you are injured or in pain or would just like to know more about pain and the many ways to manage it we recommend you to book a consultation with one of our practitioners today so they can talk through your problem, assess you thoroughly, and then advise the best course of action for you.

Our aim is to help get you out of pain and moving better again! Say ‘au revoir’ to pain! 🙂

Rectus Diastasis (Abdominal Separation)

Rectus diastasis physiotherapy
What is it?

Ask any woman who’s been pregnant and she’ll tell you that the bigger the baby grows the harder even the simplest tasks become (try putting your socks on with a basketball strapped to the front of you sometime!). With foetal growth and uterine expansion there is a widening and thinning of the gap between the two sections of the rectus abdominis muscle (AKA the 6-pack muscles). This gap is called rectus diastasis. The muscles have not “torn”, simply separated. The split occurs in the mid-line collagen structures of connective tissue at the front of the abdomen.

An easy way to check if you rectus diastasis in if you have a ‘pooching’ or ‘doming’ of your stomach, especially when coming up from a lying position on your back. Women often describe looking several months pregnant, many months after the birth of their child.

Whilst rectus diastasis most commonly occurs during pregnancy, women are not the only ones to suffer it. Newborn babies can also have a diastasis. Men can also experience a diastasis as a result of yo-yo dieting, an incorrect technique of doing sit-ups or weightlifting. This is most commonly linked to poor internal abdominal pressure control and biomechanics. It means you can be fit, and still have a diastasis.

Is it common?

Yes! 2 out of 3 women will experience some degree of rectus diastasis in the first two trimesters of pregnancy and 100% of women have a diastasis during their 3rd trimester. A staggering 66% of women with a diastasis will also have some level of pelvic floor dysfunction and 75% of women will suffer from a pelvic organ prolapse. Although common, this is not normal and can be improved with correct exercise.

Signs to look out for:

• Looking pregnant even though back to pre-pregnancy weight

• Pooching or doming of your stomach

• Weak core and pelvic floor

• Lack of strength and stability in the entire pelvic region and midsection

Why is this so important to fix?

Healing the connective tissue and reducing your diastasis is important as these muscles are what protects our internal organs and back. Other areas where you can be at increased risk of if not fixed include:

• Lower back pain

• Constipation

Incontinence

• Breathing difficulties

• Hernias

• Pelvic organ prolapse

What should I avoid and what should I do to heal or prevent rectus diastasis?

Exercises to avoid include those that place a huge load on your back and excessive forces through your pelvic floor like:

  • running,
  • jumping,
  • sit-ups,
  • deep lunges and
  • some pilates movements.
  • Holding your breath when lifting heavy objects (including your toddler) should be avoided also.

The majority of cases can be greatly improved as well as prevented through specific core and breathing exercises, correct lifting technique and posture, as well as wearing a splint.

Walking, swimming and stationary cycling are all safe forms of cardiovascular exercise you can partake in with rectus diastasis.

For an assessment of your diastasis and a comprehensive exercise rehabilitation program call 02 4655 5588 or book an appointment now to see one of our Osteopaths.