Telehealth appointments available and a guide to covid -19 for our special pregnant clients – stay well and be kind everyone

Please find attached a (17.3.2020) guide on Covid-19 from rcog (Royal College of Obstetricians and Gynaecologists) for our treasured pregnant clients. Our best wishes to you all.

Please note Telehealth appointments are available to anyone who needs an appointment but is unable to attend the clinics.

Call INP 90896666 CHP 94861918 CHP&R 9481 2955 for more information

Keep being kind to each other and looking out for those around you who may need your help, or a few loo rolls. We will be limiting our social media presence in the immediate future to allow essential info to be disseminated. We wish you and your loved ones all good health and calm through this process we are all in together.

https://www.rcog.org.uk/globalassets/documents/guidelines/coronavirus-covid-19-infection-in-pregnancy-v2-20-03-13.pdf

ENDOMETRIOSIS-PHYSIOTHERAPY CAN HELP

The month of March is the nominated month for raising awareness for endometriosis around the world.

Endo is a relatively common condition and statistically affects up to 1 in 10 women.

Did you know that physiotherapy can help improve your journey living with endometriosis?

Endometriosis is a condition where, for reasons still unclear to medical researchers, endometrial tissue starts to grow in other areas in the pelvis, and outside of the uterus (where it normally would be found). Some symptoms include pelvic and abdominal pain, sometimes described as very severe period cramps, and in some cases can affect fertility. Other associated symptoms can be bladder and bowel dysfunction and pain with sex.

Treatment of endometriosis is a case-by-case basis and requires a good team care involving the Gynaecologist and other healthcare practitioners including the physiotherapist.

The Physiotherapist can help by managing the contributions from the musculoskeletal system around the pelvis, abdomen and hips. Understanding and improving pelvic floor muscle function is essential for good bladder, bowel and sexual function, but can also make a change in how your body reacts to pain.

The diagnosis of endometriosis often mean that someone may have experienced chronic pain for several years. The physiotherapist can help educate to understand how pain works and what to do about it. It helps to retrain the way the brain connects to the involved areas and muscles in the abdomen and pelvis, towards more helpful neural pathways and pain management strategies – rather than the classic “brace against pain” and “fight or flight” responses our bodies often resort to.  Physiotherapy alongside medical management can help you build and implement effective strategies to manage and reduce the impact of endometriosis on daily function and enhance quality of life.

So, if you have been diagnosed with endometriosis, or know someone who suffers from endometriosis, call one of our wonderful Pelvic Health Physio’s to learn more.

Adriane Khablyuk  B Sc (Physio)  Post Grad Cert (Pelvic Floor Rehabilitation)

Adriane graduated from Curtin University (Perth WA) in 2013. She has worked in the private practice setting since and developed experience in treating a wide variety of musculoskeletal disorders.Adriane has a special interest in Women’s Health and completed her Postgraduate Certificate in Pelvic Floor Rehabilitation in 2018. She is passionate about helping women return safely to an active lifestyle post-natally. She loves treating pregnancy related musculoskeletal conditions, including pelvic girdle and SIJ pain, and pelvic floor dysfunction. She also has special interest in treating all continence issues, pelvic pain  and pelvic floor dysfunction in women of all ages.

We are excited to announce our new Aquatic Physiotherapy classes with Daniel starting in March

One of our fabulous physios, Daniel Zeneurt is now offering aquatic physiotherapy sessions (hydrotherapy run by a trained physiotherapist).

Being in thermoneutral water is a fantastic environment to exercise in. For some conditions, certain exercises on land are simply not possible, whether because of weakness, pain or otherwise. Aquatic physiotherapy can be a great option to get you moving better with less pain and more range of motion. The buoyancy and heat of the water can assist joints and muscle to stretch further than they would normally on land.

Some conditions that can benefit are:
Osteoarthritis
Osteoporosis
Orthopaedic injuries
Musculoskeletal injuries
Chronic pain
And many others!

Our aquatic physiotherapy sessions are run by Daniel Zeunert, one of our physios at Inner North Physiotherapy. Daniel is an experienced aquatic physiotherapist and completed his aquatic physiotherapy training through the Australian Physiotherapy Association.

Interested? Ask your physio or call 9089 6666 about getting moving in the water!

Details:
Reservoir Leisure Center
2A Cuthbert rd, Reservoir VIC
Wednesdays 4-5pm and 5-6pm, 1 hour session.
Group sessions (max 4 per hour)

Daniel Zeunert
B Health Sc, M Physio Prac
9089 6666

Medial tibial stress syndrome- an update from Adriane

Shin Pain – an insight into the condition and its rehabilitation.

Medial tibial stress syndrome presents as pain along the shin bone and is often referred to as “shin splints”. It is a relatively common injury and can affect athletes involved in impact sports, and up to 35% of runners.

The cause of shin pain is usually related to a sudden increase in load as one increases training intensity in view of an upcoming running event or game. This means an increase in either kilometer distance achieved, or pace and speed, or type of terrain (concrete vs grass vs soft sand etc), or tackling more hills or inclines. In some situations, it can even be caused by a sudden change in training shoes, which results in different biomechanics and way of loading the lower limb.

It is hypothesised that pathology of medial tibial stress syndrome involves dysfunction in the muscles that attach along the shin bone (tibia), namely posterior tibialis and flexor digitorum longus muscles. It is thought that that increase in load can result in increase in tension within these muscles, causing greater shear forces at the attachment sites of these muscles on the tibia. This in turn may result in symptoms such as pain, swelling and edema. In some severe cases, medial tibial stress syndrome can even lead to micro-fractures along the periosteum of the tibia if left untreated and aggravating triggers are not addressed.

Novice runners who have just picked up running as a new year resolution, for example, are particularly likely to develop this type of injury as their body has not conditioned and adapted to the demands of the new activity yet. Runners with higher body mass index (BMI), decreased hip strength and increased foot pronation were also found to be at higher risks. Females were also more prone to developing this type of injury due to having a larger pelvis and its implications on the biomechanical function of the lower limb.

So, what do I do if I have shin pain? – Does this mean I have to stop running?

Nope. Not necessarily…

Treatment of medial tibial stress syndrome involves an array of different approaches, including reducing load. This does not however mean that you should stop running altogether. It may be essential in some situations to have a temporary break from running until the acuteness and severity of your symptoms diminish to allow you to start a rehabilitation program towards starting to run again. But in most cases, it is a matter of allowing a relative reduction in load – run less distance, run smarter – and start a strengthening and conditioning program to address the biomechanical deficits identified by your physiotherapist.

In the early stages, the physiotherapist may treat the surrounding musculature to reduce any potential tension along the tibia and teach you some useful stretches and management techniques.

The physiotherapist will assess your biomechanics range of motion and strength, review your training volume (kilometers distance achieved per week), help you break down the intensity of your training and assess your running technique.

Overall, you will learn to train smarter, run better and understand how to work the fine line of challenging your body towards improving your performance, and also allowing adequate room for your body to strengthen, condition and adapt accordingly to prevent resurgence of injuries.

So, do not hesitate to see one of our friendly physiotherapists for an assessment and start your journey to fitness and wellness.

 Adriane Kabhlyuk , Physiotherapist and Pilates instructor

References:

Collins, N, Bisset, L, McPoil, T, Vicenzino, B. (2007). Foot orthoses in lower limb overuse conditions: a systematic review and meta-analysis. Foot & Ankle International; 28:396–412.

Geoffrey, J. (2014). Dynamic foot function as a risk factor for lower limb overuse injury: a systematic review. Journal of Foot & Ankle Research: 7: 53.

Janice and Reiman (2017). Lower Extremity Kinematics in Running Athletes with and without a History of Medial Shin Pain. International Journal of Sports Physical Therapy: 7(4): 356-364.

Luedke et al. (2016). Influence of Step Rate on Shin Injury and Anterior Knee Pain in High School Runners. Medicine and Science in Sports and Medicine; 48(7): 1244-50.

Newman, P, Witchalls, J. Waddington, G, Adams, R. (2013). Risk factors associated with medial tibial stress syndrome in runners: a systematic review and meta-analysis. Journal of Sports Medicine; 13(4): 229-241.

Saeki et al. (2017). Ankle and toe muscle strength characteristics in runners with a history of medial tibial stress syndrome. Journal of Foot and Ankle Research; 10: 16

Saeki et al. (2017). Muscle stiffness of posterior lower leg in runners with a history of medial tibial stress syndrome. Scandinavian Journal of Medicine & Science in Sports.

Winkelmann, Z.K. et al. (2016). Risk Factors for Medial Tibial Stress Syndrome in Active Individuals: An Evidence-Based Review. Journal of Athletic Training. Dec;51(12):1049-1052.

Zachary et al. (2016). Risk Factors for Medial Tibial Stress Syndrome in Active Individuals: An Evidence-Based Review. Journal of Athletic Training; 51(12):1049-1052

Born Ready

We are excited to introduce Born Ready…. 

In collaboration with our friends at the The Physiotherapy Clinic in Bondi Junction in Sydney and Inner North Physiotherapy, our own physio Ali is bringing Born Ready to Melbourne.  A course designed by physios, with informed choices and better birth experiences in mind!  This is a 4 hour workshop covering sections on pregnancy, birth and the post-natal period. 

Born Ready evolved out of the desire to empower those giving birth with more information, physical skills and practical tools to navigate their pregnancy, birth and post-natal journey. 

Born Ready equips you with the knowledge to be an active part of decision making, prepare your physical body for the task ahead, allow you to realise there is no ‘right way’ for birth, and allow for a positive experience no matter what happens on the day.

Our physiotherapists are experts in movement and biomechanics, the musculoskeletal system, and pelvic floor function and therefore are well placed to educate those giving birth on these components of delivery and recovery. 

The courses for this year will be run in March, June and September and are recommended for those between 20-36 weeks of pregnancy.  Partners are welcome and encouraged to attend. 

For further information and to book please head to:

https://bornready.com.au/dates-cost-booking/  OR https://www.facebook.com/physioclinicbornready/

Or contact Ali on:

 ali@innernorthphysiotherapy.com.au for any questions.

We look forward to further supporting you and your body through this powerful journey!

Choosing your running footwear- all you need to know !

Did you know Josh trained as a Podiatrist before becoming a  Physio? 

Here are his expert tips on choosing your running footwear:

As Physiotherapists we are asked for advice on appropriate running footwear several times each day. Footwear companies often make exaggerated and misleading claims about the wondrous properties of their shoes, which can make it difficult to determine what type of running shoe is right for you.

In recent times ‘Barefoot’ or ‘Free’ running has gained popularity. Advocates will argue that because cavemen would have run barefoot this is a more natural way for our body to function when moving, and is more in line evolutionarily with how our foot and ankle are meant to be used.

The reality for present day adults is that a good degree of conditioning and adaptation is necessary for our bodies get used to running without footwear. Cavemen didn’t have to contend with surfaces such as hard bitumen or concrete. The right shoes play a critical role in reducing the shock caused to our bodies by these surfaces.

Numerous studies have demonstrated a marked change in loading patterns (how weight and pressure are distributed) through the feet and legs during running with and without shoes. Rapid change in any exercise training does not allow our bodies enough time to adapt, and adaptation is important for injury prevention. If you wish to trial barefoot running it should be a transition that is quite structured and measured so as to minimise the associated risk of injury. As this is a complicated process, it is best to seek the advice of a trained practitioner with specific knowledge and understanding of the biomechanics of running.

At the other end of the scale to bare feet, is footwear that does not permit normal functioning of the foot. Our feet and ankles are intricate in their design and function very well in normal situations to assist smooth and strain free patterns of movement through the body. Footwear that is rigid and does not accommodate foot motion can have equally detrimental effects to running without shoes.

So what does this all mean?

The long and short of this, if you’ll pardon the pun, is that there is no one-size-fits-all approach to selecting footwear. We each have distinctive running patterns and anatomical variations of the foot and ankle that mean we each need shoes with different features.

It is hard to know where to start with such a vast array of options available. When you walk into your local shoe store, even the staff may have little idea as to the features of each shoe, which is not to denigrate them, but shows how complex the technical components of shoe design and manufacture are.

Reputable brands and stores will have various styles with different features to enable selection of footwear that is appropriate to your own foot type and biomechanics. Remember that cost does not always equate with quality; the most expensive shoe may not work well for you personally. It is much more important that you have a shoe suitable to your foot type and your running regime than it is to spend a lot of money.

There are some common mistakes made when it comes to choosing running shoes.

Always measure shoe size while standing, and allow approximately the width of your thumbnail from your longest toe (which for some people is the second toe, not the big toe) to the end of the shoe. This allows for expansion of the foot during exercise, which is especially important in warmer weather. The width of the shoe is equally important. A good guide is to pinch the top of the shoe over the widest part of your foot. A small amount of the material should bunch between your index finger and thumb. A sign that the shoe is too big is that your whole foot will feel like it slides back and forth in the shoe.

If you wear orthotics, always ensure you wear them when fitting new shoes. You may find you need to go up a full size to accommodate the orthotic device.

Make sure the heel counter, the stiff part at the back of the shoe that covers your heel, is deep enough. If your heel feels like it loses contact with the sole of the shoe when you walk you may need to adjust the arrangement of the lacing of the shoe, or failing that, choose a different style of shoe that offers more depth. This is very important because the position of the back of your foot influences how well the front of your foot functions. Particularly with shoes that have in-built rear-foot control features, such as running shoes, it is essential that the heel sits right on the insole and snugly against the back of the shoe

Lastly, select a shoe that allows your mid-foot and fore-foot to move easily. To check this pick up the shoe with one hand cupping the heel, and the other cupping the toes. Twist the shoe gently between both hands. The first two-thirds of the shoe should twist under pressure and the heel should stay relatively stiff. The flex point of the shoe, where it bends most easily, should be where the ball of your foot would be, ideally around the first third of the shoe. It’s best to avoid shoes that bend in half, as your foot does not bend naturally at this point.

I hope this has provided some food for thought when it comes to running and footwear. Remember there can be a large degree of trial and error when choosing footwear, but a good retailer will have a more in-depth understanding of appropriate shoe types for you, so don’t be afraid to ask questions and do your homework.

 

Josh Neeft

M Physiotherapy (GE), B. Podiatry

Inner North Physiotherapy
734 High Street
Thornbury VIC 3071
P: (03) 9089 6666
F: (03) 9089 6644
E: josh@innernorthphysiotherapy.com.au
W: innernorthphysiotherapy.com.au

Clifton Hill Physiotherapy
111 Queens Pde
Clifton Hill VIC 3068
P: (03) 9486 1918
F: (03) 9486 5650
E: josh@innernorthphysiotherapy.com.au
W: cliftonhillphysiotherapy.com.au

BOOK CLUB WITH A DIFFERENCE

In an endeavour to mix up our education and share knowledge, this morning our enthusiastic Team Pelvis met up over breakfast for Book Club. Each of us presented on a different book

  • A Headache in the Pelvis (Issy)
  • Ending Female Pain (Adriane)
  • Mindfulness (Rosie and special guest the beautiful Emilia)
  • The Gut (Kiera)
  • The Body Keeps a Score (Trauma) (Jen)

It was super fun with a delicious breakfast and got our brains working hard early on a Monday morning. Well done girls, I have learnt plenty and look forward to our next breakfast for Podcast Blitz!

Jen

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

An 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 and Pilates and Rehab we were one of the first practices in the country to implement this program which reflects the latest evidence in OA research. We have now been offering the program for more than two years and have had more than 30 participants complete the program. 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 the following improvements 3 months after starting the program:

  • A reduction in pain levels
  • Mean improvement of 7% in walking speed
  • Mean improvement of 20% in sit to stand functional test performance
  • Significant improvements in quality of life measures

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 have also had a few participants complete the GLA:D program at our center as a result of being referred via the trial currently being conducted by La Trobe University on the delivery of the GLA:D program. This trial is still actively recruiting participants, and if you are interested be sure to check out the following link:

http://semrc.blogs.latrobe.edu.au/knee-pain-clinical-trial/

At Clifton Hill Pilates we are currently running the exercise sessions for this program at the following times:

  • Mondays at 10.30am
  • Tuesdays at 3pm
  • Thursdays at 10.30am
  • Fridays at 11am

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 Adriane Khablyuk.

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

Built for walking – Made to walk! Low back pain and exercise

Wondering about low back pain?

Why does it hurt?

Why do so many people in Melbourne have low back pain?

 

Human beings are designed to move! It may sound simple, but think back to your high school science classes. Apart from making all sorts of misuses of the Bunsen burner, do you remember learning about all those muscles attached to the bones of the human body? They’re everywhere! Unfortunately in the smartphone age, the most commonly used muscle is our adductor pollicis (ie. scrolling up with your thumb). But do you know what the main intended uses of your muscles is for? That’s right, you guessed it: walking! Plain and simple walking.

Now, many of us use our bodies in ways that it is not made to be used (think: sitting at computer nine hours a day then spending the evening scrolling through overwhelming Netflix options). What this does is put abnormal stresses on our body, in particular your lower back, which can result in low back pain. So actually, in most cases of low back pain, there’s not a lot of mystery involved in why it hurts. Backs just simply are not made for the sustained stresses that we put them through.

So if walking is the most basic movement that our bodies are designed for, then it’s no surprise that walking is an excellent remedy for low back pain. Research shows that a simple walking program can be the most effective way of reducing low back pain.

Of course there are limits to abide by, and low back pain is different for everyone, so guidance from your physio in starting a walking program is essential. If you are having trouble, our Physiotherapists  can guide your exercises and address work with you on your low back pain issues.

When it comes to low back pain, most people are looking for a quick fix. Well, this is it! Strap on those Nikes, and take to one of the many lovely tracks Melbourne has to offer.

You won’t regret it!

 

Daniel Zeunert

Physiotherapist

Daniel is passionate about achieving the best outcomes for his patients by keeping up with the latest evidence-based research in physiotherapy. He uses a combination of exercise and manual therapy, operating under a biopsychosocial approach to patient care.

Masterchef 2019 has kicked off to a delicious start!

Continuing with the successful format from last year, our in-house Masterchef comp has a “lucky dip” for the budding chef to pick the feature ingredient. Each dish is judged on taste, presentation, and how well they showcased the feature ingredient.

For an additional twist this year, some new ingredients have been added to spice things up- anchovies, olives, and lemongrass (yummm!)

As the reigning winner from Masterchef 2018, I kicked off the season with the ingredient almond, and made a ‘Chinese almond jelly with goji berries and lychee’. Unfortunately, this did not turn out to be as delicious as I hoped, so it looks like the Masterchef title is up for grabs!

We have had delicious savoury dishes such as Billy’s ‘Mini Baked Potatoes with Mushroom Topping’ and Adriane’s “Cheese Sable Biscuits’.

Some current front-runners are Debbie’s ‘Passion Fruit Slice’, which was the perfect balance of sweet and tart. Ali’s ‘Lemon Sensation Tart’ (pictured) let lemon be the star. Brendan E also dished up a ‘Salted Caramel Brownie Slice’, which was demolished within seconds. Amanda’s ingredient mint was creatively used in a ‘Mint Slice Cheesecake’, which was presented as a giant replica of a Mint Slice! A mint and chocolate lover’s dream come true!

Strong contenders so far, everyone’s waistlines are looking suspicious and we are looking forward to the upcoming delicious creations!

Sonja Tun 

Physiotherapist

Pilates instructor

Masterchef CHP/CHPR/INP Champion 2018