‘GEMs’, Blogs and stuff

 GEMs: Need to know Blogs

This is a NEW section that we intend to bring you hot tips, current thoughts and anything ‘well-being’ that we feel YOU might be interested in. Watch this space!

Want to catch up with one of our favourite mentors in the industry?
This is what makes us different.

Check out this little interview with the one and only Dr Perry Nickleston from Stop Chasing Pain.

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Healthcare vs sickcare. When is the right time to seek GEM Holistic Health and Wellness physiotherapy input?

Healthcare is changing. With increased knowledge about how we as humans deal with pain and injury, and how movement patterns tell the story of previous injuries and reveal risks of potential future injuries – we are now more effective than ever at optimising our health and wellbeing. So when is the right time to seek physiotherapy?

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Injuries are either traumatic (due to an incident) or non-traumatic i.e they seemingly show up for no reason! Regardless of their nature, injuries have the ability to stop you in your tracks. It’s true, the body has the phenomenal ability to adapt and self-heal so when IS the best time to seek help from a physiotherapist?

Well the answer is simple – the sooner the better.  While many may think to themselves ‘of course you’d say that!”… there is indeed oodles of conclusive evidence that ‘early accurate assessment and prompt appropriate treatment is much better than delay’. And, thankfully we are really starting to see a change in mindset around self-care.  The ambulance at the bottom of the cliff approach is so last generation and in the long run will cost you more…more money, more energy, and more time sidelined out from the things you love to do the most.

Physiotherapists are specifically trained to diagnose and manage musculoskeletal injuries both acute injuries (usually traumatic) and those annoying niggles (which usually after a long time brewing become out of nowhere injuries!) that are insistent on letting you know they exist. When we leave an injury to ‘see if it will get better’ your body will adopt a compensatory pattern which serves a purpose in the interim. However, if not corrected – this protective pattern will become what is termed ‘dysfunctional’ and pain eventually will result and often in a completely different part of the body. Go figure!

So – don’t wait to seek intervention. At Evolve, we see the best results from an acute or new injury when we see people in the first 24-48hrs. And, if you only have ‘niggles’ which are simply annoying at this stage, get yourself a physical WOF and address the ‘handbrakes’ on the system sooner rather than later. Your future self will thank you for it!

How to get a handle on gnarly neck/shoulder tension with this simple exercise.

Neck ‘tension’, aches and pains in or around your upper back and shoulders become a regular part of your life? Have you tried massage, acupuncture or other treatments only to experience temporary relief before that the gnarly gnawing pain comes back again?

Neck pain be gone? Read on...

Advancements in human technology are out of this world and way beyond what many of us would have predicted however it also means that most of what we do day to day is in front of us. Just think about it! We sit in front of a computer, a steering wheel, a smart phone – the list goes on! And as a result, we end up with our head forward and chin poked.

Even when you are sitting with good posture that incredible noggin of yours weighs around 4.5-5kgs. With a little help from gravity and some leaning hunched over a laptop, desk or mobile phone that beautiful head of yours weighs closer to 25+kg! Crikey – that’s as heavy as a 10-year-old child! No wonder your neck and shoulders feel tired, tense and painful.

You see, ‘tight’ painful muscles aren’t tight for no reason and stretching them or ‘rubbing them’ out is unlikely to have a lasting result because tight muscles are often protecting the body from an underlying structure that has lost its function. Poor posture such as ‘Tech neck’ where your head sits forward of where it is designed to be aligned lends to a loss of function particularly of the lower cervical (neck) spine. Our software (central nervous) system interprets this as a system breach and triggers a protection mode which varies in its presentation from person to person but generally manifests itself as tight muscles around the base of the neck, upper back area with or without arm pain.

At Evolve, one key mindset message we believe in spreading far and wide is this which is adapted from the systems that we specialise in:

You need to know why are you releasing something tight. Do you know the area is tight because it’s overworking or tight because it’s weak and the brain has ordered the surrounding muscles to shorten to protect that area? Just because a muscle is tight doesn’t mean it’s over active either! Don’t release a tight muscle unless you know first if it’s over or under working. If you release/roll/stretch that short tight muscle, you are potentially creating a bigger problem. Neck pain is often also commonly linked to dysfunctional breathing patterns (it doesn’t make you a bad person!).  Assess – don’t guess. Understand the why of the what of any presenting problem…OWN YOUR WORLD.

Right-o…now for the gold standard exercise that most people who bring this into their life love us for evermore!

  • Position yourself as tall in your chair as possible with your head facing straight ahead.
  • Tuck your chin (very slightly) and slide your head straight back as far as it will go.
  • Apply a touch more oompf by pushing your chin backward with both hands.
  • Hold this position for a second or two
  • And repeat this motion 8-10 times per session.
  • Perform six to eight sessions throughout the day.
  • NB – discomfort during is generally ok.

 

As always, if this doesn’t work for you – consult your health provider for a thorough assessment.

Your future health will thank you.

Acute injury management - new information or forgotten wisdom?

Read on...

How does best practise change over time and what warrants and triggers adoption of new approaches? The salience of professional desires to provide current and relevant treatment to musculoskeletal injuries as well as increased public demands for accountability and the drive for better services and health outcomes is growing. Global emphasis on performance evaluation and evidence-based decision making regarding best practise management also rightfully challenges traditionally accepted practises – those which are embedded and ‘common knowledge’.

Let’s take the R.I.C.E or P.O.L.I.C.E approach for example.

Icing as soon as possible is the mainstay treatment approach to an acute injury with the rational to reduce swelling, pain, reduce tissue metabolism and facilitate recovery. You only need ‘google’ that question and ice always wins in terms of acute injury management – at least in the Western paradigm. But just because it has always been done, does that mean that we blindly accept it for the tradition that it has become?

Hats off to the researchers in the medical field who are on the ever quest to confirm beliefs or to re- evaluate outcomes in order know better and provide future improvements. Studies have demonstrated that during the early phase of muscle regeneration heat stress indeed facilitated secondary degeneration at the injury site faster, including macrophage migration, and satellite cell proliferation and differentiation. Findings suggest that applying heat to an acute injury accelerates necrotic fibre degeneration processes and promotes skeletal muscle regeneration and inhibit collagen deposition. They also found that icing immediately after injury promoted an increase in collagen deposition. It was concluded that intermittent application of heat facilitated muscle mass recovery, protein content, and muscle fibre size. Results suggest that heat may be beneficial in acute injuries for successful skeletal muscle regeneration by way of reducing fibrosis. These studies support that despite being a generally accepted practise in acute injury management, icing may not be the optimal therapeutic treatment for muscle injuries as previously thought. There are some shortcomings in these studies mainly that they were conducted with animal skeletal tissue and therefore possess certain limitations. However, regardless – the findings certainly contradict what we have promoted as best practise management in acute injuries for decades.

Could it be that this apparently new light on heat application or ‘hyperthermia’ to acute injury is not actually new but possibly forgotten or lost knowledge as evidence exists that the ancient civilisations as early as the Egyptians utilised heat therapy for muscle injuries, aches and pains.6 Greek philosopher Parmenides (ca. 540 – ca. 470 B.C.) believed in the effectiveness of hyperthermia: “Give me the power to produce fever and I will cure all diseases”. Followers of ancient healing traditions believe there is never a good reason to use ice on an injury. Hot sand bathing was common practise in ancient the medical pantheon because of the sands high heat capacity and was used therapeutically to aid musculoskeletal and arthritic pain/inflammation. Presently, several clinical trials are being conducted with the intent to evaluate the effectiveness of hyperthermia in cancer treatment – did you even know?!?!

According to WHO “multiple forces converge to create specific pathways through which research enters into the policymaking environment”. What determines when and how do we start to effect change? Perhaps it begins with the awareness of the magnitude of the benefit of such knowledge permits. Less fibrosis in healing because of applying heat in lieu of ice can only have positive implications. So, my question to all clinicians providing management advice for acute musculoskeletal injury is the above information sufficient to deviate from the “Never apply heat to an infection or fresh injury?”

Acute injuries are generally not life threatening and some may not even consider them high priority in healthcare. But when your career is delivering or depending on performance results driven care and research is suggesting that we consider changing age-old beliefs at the very least this research ought to get you thinking! While I believe further studies in this field are warranted to effect change, I think that as practitioners one of our biggest challenges ahead may well be the challenge within ourselves of acknowledging some of the practises we may have been incorrectly advising all this time. Like the old sit ups and things…(may be time for a another blog!)…

If you’re as buzzed about this as we are and would like more info… References are available on request!  – just email us 😀