sharelle

Athletes : the importance of switching on the pelvic floor-Clifton Hill Physiotherapy

CFA Bridge magazine with spoke to former Australian Netball Captain, Sharelle McMahon about incontinence amongst netballers and how she learned how to engage her pelvic floor.

An award-winning research reveals that 30 percent of women netballers experience urinary incontinence while playing Australian women’s most popular team sport. Nearly half of the women that had had babies leaked. They concluded that the prevalence of leakage while participating in netball was similar to other high impact sports and that screening for leakage within netball clubs may assist symptomatic women to receive effective treatment.

Elite netballer, Sharelle McMahon remembers the day well. She was at a training session with the ANZ Championship team, the Melbourne Vixens when a physiotherapist used an external ultrasound to track how well the players were switching on their pelvic floor. “Only one of us in that group was actually activating our pelvic floor correctly, and that one wasn’t me,” said Sharelle. “The team’s physio was quite shocked. When we went through our training we were frequently asked to engage our core and our pelvic floor – that was part of the training program. So while that was a focus, we weren’t actually doing it very well.” The exercise was done about 10 years ago, and prompted Sharelle and her teammates to take action. She said the issues surrounding a weak pelvic floor do not necessarily start after having a child. The ultrasound exercise was used on her team about four years before she had her first child. Sharelle was referred to another physiotherapist, a pelvic floor specialist, who did an internal ultrasound to further identify how she was switching on her pelvic floor, and help her correctly engage the muscles.

Sharelle has participated in the pinnacle of the game, representing Australia in the Commonwealth Games between 1998 and 2010, winning gold in 1998 and 2002, and silver in 2006 and 2010. She played 118 games for Australia, won two World Championships, and was the Australian flag bearer for the opening ceremony of the 2010 Commonwealth Games in Delhi. In 2016, she was inducted into the Australian Sport Hall of Fame. She currently works as a specialist coach for the Melbourne Vixens and commentates on the sport for Channel 9.

Elite athletes such as netballers, basketballers, gymnasts, trampolinists, tennis players and runners are at increased risk of developing pelvic floor problems. This is because of the constant and excessive downward pressure that these sports place on their pelvic floor.

Sharelle believes the prevalence of continence-issues for netballers is likely due to the sport’s high impact activity involving jumping and running. “And the people playing are mostly female, so rather than it being an issue necessarily specific to netball, it’s likely something happening more broadly and it just happens to be that netball by its nature is one of those activities that has those high impact movements and a high number of female players,” she said. Sharelle returned to elite level netball about three months after she had her first child, Xavier. “So I went back into high level training pretty quickly,” she said. “Particularly with training, I had some pain associated with my pelvic floor which presented as pelvic pain and back pain. So in that year after having Xavier, I had a lot of treatment to help relieve the symptoms but also to work on strengthening my pelvic floor in particular. I was wearing a pelvic band to give myself a bit more stability as well.”

Sharelle said her session with a pelvic floor specialist helped her to properly engage her pelvic floor while she was exercising. This resulted in her being able to strengthen her pelvic floor muscles and reduce her symptoms. “You can see it on the screen and get a sense of that’s the feeling when you’re switching it on properly,” she said. Sharelle said she thought it was sad that research showed many affected by continence-related issues just resort to wearing pads or stop playing netball altogether. “For me personally, going to see someone to help in that space was incredibly beneficial. You don’t have to live with the symptoms of a weak pelvic floor. There are people who can really assist in that space,” she said. “It’s something that a lot of people are dealing with and just dealing with the symptoms is not the answer – it can lead to some much worse issues down the track.

Addressing the cause can really help.” She advises anyone going through any continence-related issues, or any issues related to pelvic or back pain to begin with seeing a physiotherapist. “Get advice to ensure you’re switching on the pelvic floor muscles correctly,” she said.

Gill, N.; Jeffrey, S.; Lin, K-Y; Frawley, H The prevalence of urinary incontinence in adult netball players in South Australia. Australian & New Zealand Continence Journal . Summer 2017, Vol. 23 Issue 4, p104-105. 2p. 1 Chart.

Jen Langford taken from article by Bridge magazine | Autumn 2018 | continence.org.au

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Welcome Josh Neeft

We warmly welcome Josh Neeft to our team at Clifton Hill Physiotherapy. Josh is a Physiotherapist with over 12 years experience in private
practice. Josh graduated from the University of South Australia with a
Master Of Physiotherapy (Graduate Entry) in 2005 after previously
completing a Bachelor of Podiatry in 2001.
Josh incorporates a distinct focus on manual and exercise therapy and
holistic care, placing great emphasis on having his clients be an
active participant in their therapy to optimise their treatment
outcomes.
Josh has undertaken further training in the fields of Cranio Sacral
Therapy and Visceral Manipulation which looks to address correction of
connective tissue restrictions throughout the body and the
implications they have on dysfunction of the musculo-skeletal,
nervous, vascular, cardio-respiratory, digestive and endocrine
systems.
Josh’s special interest areas include pelvic and spinal disorders,
lower-limb problems due to his background in Podiatry, headaches and
migraines, jaw problems and chronic pain syndromes.
In his spare time Josh is an avid music collector, movie watcher and
Adelaide Crows supporter.

 

For further enquiries email Josh:

josh@innernorthphysiotherapy.com.au

 

LEAP

LEAP STUDY RESULTS -Physiotherapy benefits in Gluteal tendinopathy

Finally the results of the LEAP study we were involved in have been published. The study was investigating management of gluteal tendinopathy and it showed convincingly that physiotherapy, which includes education and exercises, is superior to cortisone and control not only at one year but even at the short time point at 8 weeks. The Global Rating of Change was the main outcome , but the Pain outcome for physiotherapy was less at 8 weeks. (just finished the 8 week treatment program ) than 52 weeks which suggested a drop-off of benefit on pain when active treatment stopped ie they have to keep it up !!!
Well done Henry who co-authored the paper published this week and thanks to our Physios involved for their help in what was a massive task.
We have attached the paper-you can check out the pretty cool infographics with the main findings.

https://doi.org/10.1136/bmj.k1662

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YOUR BABY’S DEVELOPMENT

 

Not all babies develop at the same rate, and sometimes they will not develop in the same way, or the way some would consider standard. There are a number of factors that may impact on a baby’s development, including significant illness, prematurity, difficulty with or a lack of tummy time practice, and a child’s motivation to get moving. There are various milestone dates which have been developed to provide assistance to parents and health professionals when assessing a child’s progress. An example of this type of resource can be found here

https://www.betterhealth.vic.gov.au/healthyliving/babies-and-toddlers-0-3

(click on the growth and development tab on the left hand side of the page).

If you have any concerns regarding the development of your child, a paediatric physiotherapist is well placed to assess your child, and to provide advice on how to improve and maximise their development.

Our paediatric physiotherapist Brendan has been assessing and treating babies with developmental issues for 23 years at the Royal Children’s Hospital and in private practice, and has the necessary experience to provide the appropriate advice for your child.

For all enquiries call us on 9486 1918

 

BRENDAN EGAN

B App Sc (Physio) Grad Cert (Health Services Management) MBA

Brendan is an experienced paediatric Physiotherapist having spent over 23 years working at the Royal Children’s Hospital and privately treating children and adolescents with a range of conditions. He has presented at national and international conferences and is co-author and editor of a book on sporting choices for boys with Haemophilia.

Brendan’s particular expertise is paediatric musculoskeletal issues such as anterior knee pain and sporting injuries, however he also has many years experience treating children with persistent pain, haemophilia and juvenile arthritis. Other interests include advising families on developmental issues regarding concerns such as flat feet, knock-knees and torticollis/wry neck. Children and adolescents requiring rehabilitation following trauma, fractures and surgery would also benefit from Brendan’s expertise and also has experience with complex conditions such as scoliosis and burns management.

 

powertrak

PhysioFIRST study and Powertrak training at Clifton Hill Physiotherapy/Clifton Hill Pilates & Rehab

On Friday some of our Physios met with Dr. Joanne Kemp, researcher from La Trobe University, for some additional training related to the PhysioFIRST research project that is running at Clifton Hill Physiotherapy.

The study compares the effects of two different Physiotherapy protocols for patients with femoro-acetabular impingement (i.e. hip pain) and recruitment is open now!

We also brushed up on the latest in the use of power track for hip pain, great technology that enables us to easily and accurately assess your muscle strength. Using power track we can track progress and accurately design the best exercise program for your condition.

 

Contact Dr Jo Kemp for further details regarding study participation and we will keep you up to date with the study outcomes.

J.Kemp@latrobe.edu.au

 

 

Logo-GLAD-1

GLA:D (Good Life with Arthritis from Denmark) Program at Clifton Hill Physiotherapy/Clifton Hill Pilates & Rehab

 

Logo-GLAD-1An exercise and education program for people with hip or knee osteoarthritis (OA) symptoms.

 

The GLA:D program is an exercise and education program developed by researchers in Denmark for people with hip or knee osteoarthritis symptoms.

 

Results from the GLA:D program in Denmark have shown:

  • Symptom progression reduction of 32%
  • Less pain
  • Reduced use of joint related pain killers
  • Less people on sick leave
  • High levels of satisfaction with the program
  • Increased levels of physical activity 12 months after starting the program

 

On the success of the GLA:D program in Denmark, this program has been implemented in other countries, and most recently it has been launched in Australia.

 

The GLA:D Australia program consists of:

  • Two education session which teach you about OA, how the GLA:D Australia exercises improve joint stability, and how to retain this improved joint stability outside of the program
  • Collection data on your current functional ability
  • Group neuromuscular training sessions twice a week for six weeks to improve muscle control of the joint which leads to a reduction in symptoms and improved quality of life

 

OA is the most common lifestyle disease in individuals 65 years of age and older, but can also affect individuals as young as 30 years of age. Current national and international clinical guidelines recommend patient education, exercise and weight loss as the first line of treatment for OA. In Australia, treatment usually focuses on surgery. The GLA:D Australia program offers a better and safer alternative. The GLA:D program is unique in that the education and exercises provided can be applied to everyday activities. By strengthening and correcting daily movement patterns, participants will train their bodies to move more effectively, prevent symptom progression and reduce pain.

At Clifton Hill Physiotherapy we started offering the GLA:D Australia program as one of our services just after Easter 2017, making us one of the first practices in the country to implement this program which reflects the latest evidence in OA research.

We have had 15 participants complete the program so far, and our graduates have consistently achieved good gains in their physical functioning, high levels of satisfaction with the program. Preliminary analysis of the outcome measures collected from our cohort doing the program at Clifton Hill Physiotherapy have shown an average of a 15% reduction in pain levels, and mean improvements of 10% and 27% in walking speed and sit to stand functional test performances respectively three months after starting the program. We have also been very pleased to see that our graduates have made active steps towards maintaining their gains and setting new goals either by continuing with the GLA:D sessions as an ongoing program, or by adherence to a progressive home exercise program of both specific neuromuscular control exercises as well as general exercise.

We are currently running the exercise sessions for this program at 10.30am on Mondays, Thursdays, and Fridays. We are looking to launch some extra session times outside of normal work hours soon in response to demand. All GLA:D sessions at Clifton Hill Physiotherapy are currently run by Physiotherapists who have officially trained in the GLA:D program including Cathy Derham, Billy Williams, and David Thwaites.

Be sure to get in touch with our team at Clifton Hill Physiotherapy to find out more about the program if you experience any hip and/ or knee osteoarthritis symptoms, regardless of severity.

CATHY DERHAM

B Physio (Hons)

M Physio (Sports Physio)

Cake

The 2017 CHP/CHPR Masterchef competition is heaing up!

The stakes are high and the Master Chef competition is taken very seriously here at Clifton Hill Physiotherapy/Pilates and Rehab.

Paul is pictured tucking into Issy’s delicious Rose Petal-topped Persian Love Cake, on the same day Australia voted ‘yes’ to love.

Ali is chowing down on Dave’s luscious mousse ice creams.

The standard is high and food is judged by fellow staff.

The Grand Final is coming up next month with the leader board fighting for a spot of glory in the grand final and the tile of CHP/R 2017 Master Chef!

Ali Paul Cake

Shoulder

Wanted: volunteers for shoulder rehabilitation study

With our ongoing commitment to best practice we are excited to be part of a study investigating shoulder rehabilitation.

Subacromial Pain Syndrome is a common shoulder condition that affects both men and women and is associated with
pain on the anterior and lateral aspect of the shoulder, affecting many activities of daily living, especially lifting the arm up and out to the side. Other terms used to describe this condition include subacromial
impingement, supraspinatus tendinopathy, bursitis, a partial tear of the rotator cuff or rotator cuff tendinopathy (or degeneration).

Although surgery is often performed to help the symptoms associated with this condition, current research suggests that a structured exercise program delivered by a Physiotherapist may, in many cases, reduce the need for this.

This study seeks to investigate which exercises are the most effective in the treatment of this type of shoulder disorder, enabling a faster improvement in pain and function.

  • Do you havepain in your shoulder or upper arm?
  • Haveyou been told by your treating heath practitioner that you have sub-acromial pain syndrome.

Don’t forget, they may have used any of the terms listed above such as subacromial impingement, supraspinatus tendinopathy, bursitis, a rotator cuff tear or tendinopathy/tendinitis.

 

Study Aims:

Assess the effectiveness of three different structured shoulder rehabilitation programs for improving pain and function in people diagnosed with subacromial pain syndrome/rotator cuff tendinopathy.

Eligibility:

To be eligible for involvement in this research project you need to be:

  • Aged18-80 years
  • Experiencingpain in the shoulder/upper arm that does not also involve numbness or tingling in the arm or hand
  • Painon lifting the arm upwards or out to the side or when lying on the shoulder at
    night
  • Noprevious trauma or surgery to the affected shoulder
  • If youhave had a diagnosis of osteoarthritis in the shoulder

 

Contact:

If you feel that you are eligible to be involved please contact Rosie Purdue or Paul Jackson on 9486 1918.

Further Details:

Shoulder

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The Pelvic Floor – it’s more than just kegels!

Women’s Health week is celebrated every year to promote and create further awareness around common issues affecting women.

This year I was delighted to be invited to speak at the Epworth Freemason’s on pelvic floor health to both staff and those suffering from pelvic floor dysfunction.    I covered a number of topics, including pelvic floor function and anatomy, pelvic floor appropriate exercise, and why pelvic floor health is not just all about pelvic floor strengthening exercise.

Something that we find very commonly in many women who have had some form of pelvic floor dysfunction or injury is that the muscles may not be working effectively.  A healthy muscle needs to be able to relax as effectively as it can contract, and the pelvic floor is no exception!

One of the most important things in pelvic floor rehabilitation is that we fully assess the pelvic floor function and retrain all of the components appropriately.  This may mean we need to teach the muscles how to relax first before we can strengthen them.  This is called down-training and there are a number of different techniques we can use to teach the muscles this skill.

Another important factor is to consider all of the other muscles that are involved in optimal pelvic floor strength.  These include; your lower back muscles, abdominal muscles, groin and glut muscles, and the diaphragm.  Did you know that even the way you breath may affect how the pelvic floor muscles function!  By looking at all the different components of a health functioning pelvic floor we are able to assess and address those contributing factors, often leading to a more successful outcome!

As you can see there are a large number of areas to investigate when it comes to pelvic floor dysfunction and this is why a thorough assessment with a specialised women’s health physiotherapist is of paramount importance!  So pop in for an assessment if this applies to you and get started on appropriate pelvic floor rehab!

 

ALISON HARDING
B Physio Grad Cert (Pelvic Floor) 

Clinical Pilates Instructor image022

 

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Pain in Children and Adolescents

Pain in Children and Adolescents

Children are often seen in the Clifton Hill Physiotherapy clinic with complaints of pain in varied parts of their body – back, knees, ankles or feet are just some of the places children will present with pain. Often the examination will find a specific condition, or changes to strength and flexibility, due to growth or previous injury, that can be rectified with an exercise programme of strengthening and stretching activities.

However, this is not always the case, and we do see children who experience pain that is often felt in the absence of any tissue damage, or muscle weakness or tightness. Our improved knowledge of the way our brain works can provide us with an explanation for how a child can experience pain in the absence of any damage to the body’s tissues.

Factors that can influence a child’s pain include

  • Previous experiences of pain
  • Exposure to pain within the family or school environment
  • Fear of movement causing tissue damage
  • Anxiety
  • Other stresses at home or school including
    • Bullying
    • Academic achievement
    • Performance expectations

The team at Clifton Hill Physiotherapy has extensive experience managing children’s pain, and identifying when the above factors might be contributing to your child’s pain. The assessment of the child’s musculoskeletal status, plus investigating any psychosocial issues that maybe present will allow us to make the best recommendation for your child. Our assessment will also include asking special questions that will identify if further tests are required. Often education regarding pain, including reassurance and de-threatening the child’s movement and activity, is enough to manage and resolve the pain. If the pain has been more persistent and the child has reduced their activity for an extended period, this needs to be in conjunction with an exercise programme that helps to gradually condition the body to normal activity.

Brendon Egan, Physiotherapist

 

About Brendan

Brendan is an experienced paediatric Physiotherapist having spent over sixteen years working at the Royal Children’s Hospital treating children and adolescents with a range of conditions. He has presented at national and international conferences and is co-author and editor of a book on sporting choices for boys with Haemophilia.

Brendan’s particular expertise is paediatric musculoskeletal issues with many years of experience treating children with persistent pain, haemophilia, juvenile arthritis, scoliosis and burns management. Other interests include advising families on developmental issues such as flat feet, knock knees and torticollis/wry neck. Children and adolescents requiring rehabilitation following trauma, fractures and surgery would also benefit from Brendan’s expertise.