NB: This is a blog of our personal opinions, and is provided as a brief overview of things we think you might find interesting.

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  • Massage 14 December 2018 | Comments (0)

    What actually is massage?

                            

    Massage is a natural therapy involved with soft tissue manipulation and has evolved over thousands of years. From ancient China to present-day Europe, it has been used for the promotion and restoration of health. Massage is a non-invasive, non-threatening and natural therapy.

                                 

    Remedial Massage

    The term "Remedial Massage" refers to a variety of techniques specifically designed to relax muscles by applying pressure to them against deeper muscles and bones, and rubbing in the same direction as the flow of blood returning to the heart. This also includes the use of deep tissue strokes, to help more chronic (long-standing) problems of the muscles, tendons and fascia.

    This type of massage helps you de-stress and relax whilst loosening muscle tissue and releasing toxins from the muscles themselves.

     

    Sport massage

    Sports massage is typically used before, during, and after athletic events. The purpose of the massage is to prepare the athlete for peak performance, to drain away fatigue, to relieve swelling, to reduce muscle tension, to promote flexibility and to prevent injuries.

    Vigorous pre-event massage helps reduce sports-related injuries by warming, stimulating and preparing muscles and joints for increased activity while more restful post-sport techniques relieve sore, overworked muscles. Note: this does not need to be pitch-side.

    Maintenance sports massage can be considered a more vigorous remedial massage.

    Like any other massage at Back In Action, the treatment will be tailored to the individual.

     

    Or just for relaxation

    People often seek massage for stress, tension, feelings of fatigue or general weariness. Massage is excellent at promoting relaxation when used in conjunction with exercise and other activities which promote physical and mental well-being.

     

    You can find out more here:

     

    www.physio-pedia.com/Massage

    www.sportsinjuryclinic.net/treatments-therapies/sports-massage

    Massage

    Massage

    Massage

     

    At Back In Action we also offer free consultations. This will take about 10-15 minutes where we can talk in general terms about your condition, and see if we can point you in the right direction for treatment. Whether that is with ourselves, someone else, or on your own at home. Call today to schedule your free no obligation consultation.

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    Upper Core 07 December 2018 | Comments (0)

    Let’s take a look at core strength and stability for the shoulder girdle and neck.

     

    First of all – what is meant by your Core Musculature? Well, this largely depends on who you ask. As physical therapists, we mean the deep muscles that stabilise your body, and allow other, larger muscles to create movement from a firm base – the foundations if you like. The 2 most important areas for this core stability are for the pelvic girdle and lower back; and for the shoulder girdle and neck (the subject of this post).

     

    As humans, we’re evolved originally to be 4 legged animals, with pillars (arms), our spine suspended from here by lower shoulder stabilisers (rhomboids, lower trapezius), some animals (typically those which do not hold their body off the ground with their forelegs, eg apes, birds, aquatic mammals) further reinforced this structure by bracing from below (clavicle). The lower shoulder stabilisers are therefore postural in nature and, in bipeds, provide stability of the shoulder girdle, for the arms and neck that use that as a base. This is doubly important as the clavicle provides stability at the front upper quadrant; whilst these muscles provide stability at the lower rear quadrant of the shoulder girdle; which is great for stability. However, most of us have poor strength and control here, as our bipedal posture prefers to use the upper trapezius and levator scapula muscles to resist the downwards pull of gravity, so that muscular stability comes from the upper quadrant, alongside the clavicle; whilst the core stabilisers waste away.

     

    You can find out more here:

    www.physioadvisor.com.au/exercises/strengthening-joints/shoulder-blade

    www.sportsinjuryclinic.net/rehabilitation-exercises/shoulder-exercises/wobble-board-for-shoulders

    Muscles of the Upper Core / Shoulder Girdle

    Wall Angel Exercises to Stabilise the Upper Core / Shoulder Girdle

    The Interscapular Muscles shoulder act as a Suspension Bridge

    At Back In Action we also offer free consultations. This will take about 10-15 minutes where we can talk in general terms about your condition, and see if we can point you in the right direction for treatment. Whether that is with ourselves, someone else, or on your own at home. Call today to schedule your free no obligation consultation.

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    The rotator cuff is a group of 4 muscles which hold your arm to your shoulder blade. Despite their group name they do not cause much movement of the joint, rotation or otherwise; rather they stabilise and control the movement caused by other, larger muscles.

     

    These muscles are particularly prone to overuse or repetitive injuries, traumatic tearing, or impingement from other structures. It can be cause by any repetitive action of the shoulder, fall onto the shoulder, or simply the process of aging. Often, the pain associated with this condition is experienced as an ache in the shoulder that increases to a sharper pain or catching pain with certain activities. Occasionally, pain may also be experienced in the upper arm, shoulder blade, upper back or neck. Weakness or a feeling of instability for the shoulder or arm, is often a hallmark of this condition. The POLICE protocol for tissue healing should be applied; with ice massage and the optimisation of the tissue load (rest, massage, gradual strengthening) being particularly useful forms of treatment for these conditions; whilst unresponsive cases may require steroid injections or even surgery.

     

    You can find out more here:

    www.physioadvisor.com.au/injuries/shoulder/rotator-cuff-tear

    www.sportsinjuryclinic.net/sport-injuries/shoulder-pain/rotator-cuff-strain

    www.physio-pedia.com/Calcific_Tendinopathy_of_the_Shoulder

    Right shoulder from the front

    Testing for a possible rotator cuff tear

    At Back In Action we also offer free consultations. This will take about 10-15 minutes where we can talk in general terms about your condition, and see if we can point you in the right direction for treatment. Whether that is with ourselves, someone else, or on your own at home. Call today to schedule your free no obligation consultation.

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    Sciatica 16 November 2018 | Comments (0)

    Let’s take a look at sciatica.

     

    Sciatica is the term given to symptoms experienced from compression or irritation of the sciatic nerve; it is not a diagnosis so much as a collection of symptoms; so a diagnosis will still be needed before starting treatment. The sensation of sciatica will be familiar to anyone who’s banged their “funny bone”; but located in their buttock, leg, foot and sometimes the back. Different diagnoses result in different treatment plans and different expectations for recovery, same may resolve in days, whilst others may never resolve completely.

     

    Whilst most cases resolve within a couple of weeks; for those that do become chronic, the best thing you can do to improve the prognosis, is to start treatment sooner; which is a bit of a catch 22. As a rule of thumb, if the sciatica is significantly reduced after 5-6 days, then you shouldn’t need any treatment; if it is barely improved, or still worsening, then treatment might be a good idea, even if it’s just in the form of advice on how to manage the pain at home, and prevent it coming again.

     

    You can find out more here:

    www.chiro-trust.org/back-pain/low-back-and-leg-pain-is-it-sciatica

    www.nhs.uk/conditions/sciatica/Pages/Introduction.aspx

    Sciatica

    Pain from Sciatica

    Managing low back pain and sciatica

    At Back In Action we also offer free consultations. This will take about 10-15 minutes where we can talk in general terms about your condition, and see if we can point you in the right direction for treatment. Whether that is with ourselves, someone else, or on your own at home. Call today to schedule your free no obligation consultation.

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    Medical Imaging 09 November 2018 | Comments (0)

    Yesterday was the International Day of Radiology, so let’s take a look at medical imaging.

     

    First of all, I love a good X-ray or an MRI / CT scan.

    However, they are not always appropriate, and just like opioids, or statins, they have been overprescribed recently, and making the news.

    Medical imaging will show you the gross anatomy, and whether it is “normal” or “abnormal” or even “normally abnormal”. It will not tell you whether what it shows is clinically relevant; it just adds to the overall clinical picture.

     

    Imaging carries risks, whether the risks of radiation (X-ray / CT scan) or just the risk of false-positives; that is, an abnormal finding that is irrelevant to the patient’s wellbeing – until they find out, at which point it becomes a negative to the patient’s perception of their wellbeing.

    For example, a researcher called Brinjikji in 2014 found that, if you took MRI scans of a completely healthy people, ½ of all 30 year olds will have a degree of “disc degeneration”; ½ of 40 year olds would have a “disc bulge” and ⅓ of 50 year olds would have some “facet degeneration” (AKA osteoarthritis). This proves that these things can be completely normal, and not lead to any problems – which doesn’t mean that they can’t, just that it’s normal, and doesn’t have to be acted upon.

     

    Imaging of biomechanical complaints should NOT be done “just in case” or “to have a look”; imaging should NOT be done to reassure the doctor or the patient. For non-traumatic, non-complicated cases, the image is highly unlikely to change the treatment plan for the better; but might well change it for the worse. You may feel that your doctor isn’t listening to you when they opt not to send you for imaging, but it will generally mean that they’re simply following current guidelines.

    Imaging absolutely SHOULD be done in cases where there are red flags for a serious pathology (such as unexplained weight loss; loss of swallowing/bowel/bladder control; high fever; or loss of feeling/strength in the legs or arms). It SHOULD be done in patients who don’t recover as expected (such as failing to improve with less-invasive care; or failing to improve significantly after 2 months duration).

     

    You can find out more here:

    www.choosingwisely.co.uk

    www.choosingwisely.org/patient-resources/imaging-tests-for-back-pain

    Reliability of Reading MRI Scans for Low Back Pain

    Incidence of False Positive Findings in the MRI Scans of Symptom-free Individuals

    Colour MRI Scan of the Neck

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    Let’s take a look at tension headaches.

     

    Tension headache is a neurological disorder characterized by a predisposition to attacks of mild to moderate headache with few associated symptoms. This is the most common type of primary headache: its lifetime prevalence in the general population is estimated at up to 70-75%. The pain from tension headaches typically comes from muscle tension, often the muscles of chewing, or those which hold the head stable at the top of the neck. Consequently there is a large overlap between tension headaches and cervicogenic headaches (where the pain originates in the neck, but is felt in the head); where the same headache could be correctly classified both ways simultaneously.

     

    Tension headaches typically last anywhere between a few hours to several days; and are usually caused by stress or tension; whether one feels like a “stressy” person or not. Most cases are episodic; but they can become chronic, or be just a one-off; the key to this is to address the cause of the stress/tension in the first place; this can be through relaxation strategies, or through identification and elimination. The pain is often felt on both sides of the head; in a band-like distribution, and is often coupled with sleep disturbance, and/or tightness in the shoulders, neck or jaw (other physical manifestations of stress). The severity is usually mild to moderate; and they are not associated with any visual or auditory disturbance or sensitivity.

     

    You can find out more here:

    www.nhs.uk/Conditions/headaches-tension-type/Pages/Introduction.aspx

    www.chiro-trust.org/headaches/tension-type-headaches

    Tension Headache

    Muscles of the Skull

    Different Headache Types - Tension Headaches

    At Back In Action we also offer free consultations. This will take about 10-15 minutes where we can talk in general terms about your condition, and see if we can point you in the right direction for treatment. Whether that is with ourselves, someone else, or on your own at home. Call today to schedule your free no obligation consultation.

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    Let’s take a look at plantar fasciitis.

                   

    Plantar fasciitis is the most common cause of heel pain, accounting for around four out of five cases.

    The plantar fascia is the thick band of tissue that connects the heel bone with the rest of the foot, forming the arches of the foot, and is essential in the spring mechanism when toeing off in gait. The plantar fascia can become damaged and thickened either by trauma, or through the micro-trauma of gradual wear and tear. The plantar fascia share fibres with the achilles tendon, and it is often a good idea to look at both of these areas for treatment, along with things like footwear, gait etc.

     

    The symptoms of plantar fasciitis can come on over the course of several hours to several days; and will often get worse with time; potentially leading to the formation of heel spurs. Patients typically experience sharp pain and tenderness in the heel, or sole of the foot; which can be aggravated by activity, or by prolonged rest. There are many, many potential causes of plantar fasciitis; and getting to the root cause of the issue for an individual can often be the single most useful piece of information for treating them. However, treatment with the POLICE principal of Protection, Optimal Loading, Ice, Compression and Elevation; specifically with ice massage, stretching and strengthening the muscles of the foot and ankle are also useful in most people; but they may have limited use on preventing recurrence.

     

    You can find out more here:

     

    www.physioadvisor.com.au/injuries/foot/plantar-fasciitis

    www.sportsinjuryclinic.net/sport-injuries/foot-heel-pain/plantar-fasciitis

    Plantar Fasciitis

    Self-Care for Plantar Fasciitis

    What Plantar Fasciitis feels like

    At Back In Action we also offer free consultations. This will take about 10-15 minutes where we can talk in general terms about your condition, and see if we can point you in the right direction for treatment. Whether that is with ourselves, someone else, or on your own at home. Call today to schedule your free no obligation consultation.

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    Osteoporosis 19 October 2018 | Comments (0)

    Tomororw is World Osteoporosis Day so let’s take a look at Osteoporosis.

     

    Osteoporosis is a metabolic condition where the calcium leaches out of the bones, leaving them less dense, more porous and brittle; leading to an increased risk of fracture. Bone density is only really built up in the first 25 years of life, held stable for the next 15 or so, before reducing naturally with time; more rapidly with the menopause. Thus it is important for later-life health that teenagers and young adults have a diet higher in calcium (dairy, collards etc) and partake in regular weight-bearing exercise, preferably with a degree of impact (eg. running, boxing, dancing etc); as this will help stockpile calcium in the bones to start with. The same advice, with additional vitamin D and vibration training can help slow the leaching of the bones in those aged over 45.

     

    NB: Whilst chiropractic and massage cannot treat osteoporosis, or the fractures it can result in; this does not mean that we cannot treat you. You will need to let us know that you suffer from osteoporosis, so that we can make allowances within the treatment plan.

                   

    You can find out more here:

    www.iofbonehealth.org

    www.nhs.uk/conditions/Osteoporosis/Pages/Introduction

    www.physio-pedia.com/Osteoporosis

    Osteoporotic Changes Visible on X-Ray

     

    Bone Health Over Time - Osteoporosis

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    We're coming to the end of National Arthritis Week; whilst today is World Arthritis Day. So this week, let’s take a look at degenerative joint disease (DJD).

    AKA Osteoarthritis, Spondylosis, or even “Wear and Tear”.

     

    DJD is a normal part of aging - just like grey hairs; and is not painful in and of itself; but can cause other structures to become symptomatic. Consequently, whilst medical imaging (X-ray, MRI) can confirm that DJD is present or not; the severity of change on the image tends not to be in proportion to the severity of symptoms the patient is experiencing; and therefore imaging is RARELY appropriate or necessary to diagnose or assess DJD.

     

    It is caused by an excess of movement or load – whether briefly in the case of traumatic onset; just a little every day, for decades; or through carrying too much weight every day for several years. DJD symptoms include joint pain with stiffness and increased muscle tension as the body try to stabilise the area; eventually growing new bone to buttress the joint.

     

    Treatment typically involves pain control by medication or other measures; controlled mobilisation of the joint, through exercise and/or manual therapy; and strengthening of the muscles which support the joint, through exercises like pilates or rehab. If you are overweight, weight loss can often help improve DJD symptoms, but is unlikely to be a “golden bullet” unless combined with increased activity and fitness.

     

    NB: There is no way to treat DJD itself, and any treatment plan can only have the aim of relieving symptoms, which can only be temporary (though “temporary” may mean anything from hours to decades). Consequently, we talk in terms of “management” rather than “cure”; and it may be a good idea to consider maintenance based treatment whilst feeling pain free and mobile, to keep you that way.

     

    You can find out more here:
    www.nhs.uk/Conditions/Osteoarthritis/Pages/Introduction

    www.physio-pedia.com/Osteoarthritis

    Affect of Osteoarthritis on a joint

    Osteoarthritis Target Joints

    Osteoarthritis as seen on X-ray

    At Back In Action we also offer free consultations. This will take about 10-15 minutes where we can talk in general terms about your condition, and see if we can point you in the right direction for treatment. Whether that is with ourselves, someone else, or on your own at home. Call today to schedule your free no obligation consultation.

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    This week has a number of awareness event relevant to us. The whole week is both BackCare Awareness Week by BackCare; and also National Arthritis Week with Versus Arthritis (formerly Arthritis Research UK); with World Arthritis Day on Friday.
    Consequently, I'll be trying to make 3 blog posts this week, with arthritis coming on the 12th.
    So for today, let’s take a look at chronic low back pain (Chronic LBP).

                                               

    Low back pain that has been present for longer than three months is considered chronic. More than 80% of all health care costs can be attributed to chronic LBP. Nearly a third of people seeking treatment for low back pain will have persistent moderate pain for one year after an acute episode. Almost by definition, anyone suffering with chronic pain will also suffer an altered perception of pain, and the brain retrains itself, and becomes very good at feeling pain – whether it needs to or not.

    Chronic pain is always a complex condition, involving tissue damage, adaptation strategies, altered pain perception, altered psychology (depression, sleep disturbance etc) and usually secondary complaints brought about by the adaptations – in fact, the original condition can often be resolved at presentation, but the cascade of reactions is still continuing to cause the problems. This makes chronic pain very complex to treat, and means that we need to use manual therapy, home advice and psychological support all at the same time, to get the best results. There are no short cuts when it comes to dealing with chronic pain; and it can be hard work, for both the clinician and the patient.

     

    You can find out more here:

     

    www.chiropractic-uk.co.uk/back-pain

    www.chiro-trust.org/back-pain/chronic-low-back-pain-treatment-effective

    www.physioadvisor.com.au/injuries/lower-back

    Life Tips to Avoid Low Back Pain

    Chiropractic Maintenance Care

    Chronic Low Back Pain

    At Back In Action we also offer free consultations. This will take about 10-15 minutes where we can talk in general terms about your condition, and see if we can point you in the right direction for treatment. Whether that is with ourselves, someone else, or on your own at home. Call today to schedule your free no obligation consultation.

    Read more ›

    This coming week has a number of awareness event relevant to us. The whole week is both BackCare Awareness Week; and also National Arthritis Week; with World Arthritis Day next Friday.
    Consequently, I'll be trying to make 3 blog posts this week, with arthritis coming on the 12th.
    So for today, let’s take a look at acute low back pain (Acute LBP).

    LBP is the fifth most common reason for physician visits, which affects up to 85% of people at some point. The exact cause of the acute low back pain often remains unknown, though thorough examination can reduce the number of possibilities. The back pain can come on suddenly after lifting things, or gradually through overuse, or even for no easily identifiable reason. Many cases will resolve within a few days and minimal intervention (reduced loading, ice and movement). It is rarely serious; though it can be debilitating; and rarely needs imaging – except in cases of direct trauma, suspected inflammation, or medical red flags.

    Acute vs chronic are measures of duration, not severity; with Acute being anything that has lasted less than 8 weeks; with Chronic being more than 8 weeks. Between 6-8 weeks duration is often labelled as Subacute.

    Whilst most cases resolve within a couple of weeks; for those that do become chronic, the best thing you can do to improve the prognosis, is to start treatment sooner; which is a bit of a catch 22. As a rule of thumb, if the back pain is significantly reduced after 5-6 days, then you shouldn’t need any treatment; if it is barely improved, or still worsening, then treatment might be a good idea, even if it’s just in the form of advice on how to manage the pain at home, and prevent it coming again.

     

    You can find out more here:

    www.physio-pedia.com/Non_Specific_Low_Back_Pain
    www.chiropractic-uk.co.uk/back-pain
    www.sportsinjuryclinic.net/sport-inju…/low-back-pain/lumbago

    Maintaining a Healthy Back

    Acute Low Back Pain

     

    Reduce your Risk of Surgery after a Back Injury

    At Back In Action we also offer free consultations. This will take about 10-15 minutes where we can talk in general terms about your condition, and see if we can point you in the right direction for treatment. Whether that is with ourselves, someone else, or on your own at home. Call today to schedule your free no obligation consultation.

    Read more ›
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