SHIN SPLINTS BLOG by Senior Physiotherapist Daniel Browne

Blog post 2022- Shin Splints

With Covid still ripe in the community, I have seen an influx of patients who are transitioning their exercise space to being either at home or outdoors rather than in large public gymnasiums.  Consequentially, (and perhaps in part due to a few new pairs of Nike’s under the Christmas tree), I have been seeing a sharp increase in the number of patients experiencing ‘shin splints’. This blog post will focus on how and why you get shin splints, as well as some general advice in the management and prevention of this often niggling injury.

WHAT IS IT?
Shin splits aka ‘Medial Tibial Stress Syndrome’ is when additional stress is placed on the front inside part of the shin for extended periods of time and often will involve a degree of increased impact. The most important thing to acknowledge with shin splints is load management – it is often this load that has recently been sharply spiked which has caused the shin splints in the first place. A change in load can come from a few commonly overlooked sources – for example recent increase in running/walking either recreationally or post-surgery, a change in walking surface (footpath to sand), new shoes (different sole density, style, support levels), the change from runners to sport specific footwear (runners to footy/soccer boots with studs) or even repetitive trauma from impact (for example shin strikes in hockey).

HOW DO WE MANAGE IT?
The first step is to take a detailed history and determine where the change in load has come from as outlined above. From here, we will look at any additional biomechanical components that may be contributing (e.g. tight hip flexors effecting gait when walking or running), and then utilise a combination of manual therapy and corrective exercises to get you back on track. In certain situations medication may also be required at which point we would liaise with your GP, however this is not always the case.
Note: very rarely would we ever consider a complete rest from exercises (we do not want to de-condition the entire limb!) – normally you will be safe to continue some gym based strength training, walking within reason, as well as low impact cycling or swimming – this is of course person dependent however.

WHAT CAN I DO TO STOP SHIN SPLINTS OCCURRING?
– If you are going to change footwear, then mix in your new and old footwear. Trial one day old, one day new for the first week or so whilst you ‘wear in’ your new shoes.

– Similarly, when it comes time to pull on the studded shoes for sport, you may consider one night a week still wearing runners for the first couple of weeks.
– Consider a general mobility/recovery routine that includes stretching out the calves, hip flexors and lower back. Suggestions of exercises can be found by viewing our previous blog posts below.
– Complete strength training unilaterally (one sided) – this will help address natural imbalances (although these are still expected to a degree), it will limit ‘favouring’ especially when under fatigue.
– If you are unsure on your technique (whether that be running, cycling, lifting weights), spend the time to train with someone who has the experience to talk you through your specific task. They will be able to pick of on technical errors and steer you in the right direction, improving both performance and decreasing your risk of injury simultaneously– a small investment up front will save you a lot of time and energy down the track!

Finally, if you do find that your shins are sore, you’re limping, you’ve tried resting but whenever you increase the load your symptoms return, then book in to see your local physiotherapist – your load management expert!

Senior Physiotherapist Daniel Browne

Headache Information by Senior Physiotherapist Daniel Browne

HEADACHES

A headache is one of the most uncomfortable sensations a person can experience. Headaches can vary from a transient ache to  perceivably crushing unrelenting pressure. When treating a headache, physiotherapists must first establish whether or not we are dealing with a primary or secondary headache.

Primary headaches can include migraines which can be described as episodic (i.e. they periodically come and go) lasting anywhere from a few hours to a few days, ‘tension type headaches’ (the most common type of primary headache) which can also be considered episodic and have a more chronic (long term) nature to it, as well as the subcategory of ‘cold’ headaches relating to a sensitivity of being outside in colder temperatures (think from the exposure to direct cold (ice pack) or experienced in the consumption of cold –  like a brain freeze when eating an icy pole!).

Secondary headaches on the other hand are generally more common and are a result of either too much or too little load on the musculoskeletal system (particularly the head, neck, shoulders, and thoracic spine) coming from prolonged poor ergonomics (work postures), an injury playing sport or in the community (such as whiplash), as well as neural referral from issues such as pain in the jaw (TMJ, teeth clenching or grinding at night) or inner ear pathologies (vestibular headaches) – not to mention the age old situation of not wearing your glasses when you should!

As you can see, there can be many contributors to a headache. Often, unfortunately, the longer the headache is left to brew – the worse it gets. A physiotherapist will firstly  gather a detailed history to help ascertain the contributing factors. From here, a combination of manual therapy, individualised exercises, as well as ergonomic advice and pain-relieving strategies will comprise the first session.

Everyone’s headache experience is different and here at Select Physiotherapy and Pilates we pride ourselves on offering each of our clients a tailored and evidence-based solution fit to their situation.

We look forward to helping you soon!

A return to outdoor activity – 3 tips to keep you injury free over summer!

By Daniel Browne

Senior Physiotherapist

1) FIND A WARM UP THAT WORKS FOR YOU

You will hear different schools of thought ranging from static stretching all the way to a more dynamic warm up and perhaps even no warm up at all! Ultimately you need to figure out what’s best for you – more often than not, what we recommend is that when in doubt begin by completing the movements that you will be about to do but at a much lower intensity to prepare your body for a more intense effort. For example, if you were to play football, then you would have a ‘kick to kick’, tennis – a light hit, and basketball – you could do some light shooting.

2) STAY HYDRATED

A simple and effective strategy for not only keeping you out on the court/pitch longer but also significantly reducing your risk of injury related to cramping and fatigue. Moving into the warmer weather you want to assure that you are firstly drinking that little bit more due to the hotter days, but then also acknowledge that your body is perhaps not up to the same vigour of exercise as last time you hit/kick. Sipping water throughout the session rather than waiting until you are dying for a gulp is generally a better strategy. Likewise, having a glass of water before you head off can be a nice way to increase your chances of being adequately hydrated.

3) SOMETIMES LESS IS MORE

I think it’s fair to say we perhaps have all had an extended ‘off season’. The first session back is always going to be a little rough! As a general rule, you want to walk about from the exercise effort thinking “I could have done a little more’ rather than “I did too much!!”. Not only will this allow you to then turn up again shortly for another round of your desired activity, but it will be more likely to facilitate the building of an exercise routine – which as we know, will have many long-lasting positive health benefits.

The above advice is general in nature and if you have any more specific questions, please do not hesitate to contact us here at Select Physiotherapy and Pilates.

 

3 things you can do in lockdown to maintain your physical health and fitness

1) MOBILITY
– Spend some time working on the controlled movements of your limbs – particularly those that may be of heavy focus in your sport i.e. shoulders for throwing sports, hips for running sports. What is old is new again, and “CAR’s” or “Controlled Articular Rotations” are making a comeback in the vernacular of sporting clinician. A CAR, as the name suggests, involves taking your limbs through slow and controlled range of motions or movements representative of your sport so as to develop a smoother more refined quality of movement.
A gentle CAR’s routine can be found via the link below:
https://www.youtube.com/watch?v=AyJ3omVBIho

2) SOFT TISSUE EXTENSIBILITY
– Depending who you talk to they will either swear by or swear against things like foam rollers, massage balls and the new(er) Thera guns – you name it, there’s a passionate camp either side. Does it really change ‘fascial length’, does it really ‘break up scar tissue’ or ‘adhesion’ – it remains to be seen. What I can see from both anecdotal patient experience as well as my personal experience, is that I have seen promising results relating to recovery – especially if you have had either a large training session or conversely you haven’t moved around a great deal for the day – perhaps shackled to the couch watching Netflix. Foam rollers and massage balls in particular are a cheap and non-invasive method used by athletes around the world. I think it’s worth giving it a go!
An example of a foam rolling routine can be found below:
https://www.youtube.com/watch?v=aTcRYJsuhkI

3) BODY WEIGHT EXERCISES
– The beauty of body weight exercises is that you don’t need any equipment (other than perhaps a bar overhead if you want to do some pullups), you don’t need a lot of room, they can be done indoors or outdoors (great for winter), they can be grouped together for a high intensity interval session if that’s your thing and they are easily scalable (progressions/regressions).

Below I’ve outlined a couple of pathways of progressions and regressions to keep your exercises interesting.

LOWER BODY
Double leg bridge à Offset bridge à Single leg bridge
Double leg hip thrust à offset hip thrust à single leg hip thrust
Sit to stand à Offset sit to stand à Single leg sit to stand
Offset Romanian deadlift à single leg Romanian deadlift
Double leg calf raise à single leg calf raise

UPPER BODY
Incline push up à kneeling push up à push up on toes à decline push up
Let me up/inverted row à chin up à parallel grip pull up à regular pull up

Daniel Browne – Commonwealth Games Physiotherapist.

Daniel Browne – Commonwealth Games Physiotherapist.

From the 4th to the 15th April in 2018 Select Physiotherapy and Pilates Senior Physiotherapist Daniel Browne worked at the XXI Commonwealth Games held on the Gold Coast. Below Daniel reflects on some of his experiences working with elite athletes.

 

 

 

 

 

During Autumn of 2018 I was fortunate enough to be afforded a position at the 2018 Gold Coast Commonwealth Games as a Physiotherapist at Carra Sports and Leisure Centre. Within this role I formed part of the medical team which included fellow international physiotherapists, sports doctors and emergency medicine physicians, myotherapists and strength and conditioning coaches. Our role in essence was to provide care both before, during and after competition to optimise athletic performance. My direct role had me working both on the field of play and in the warm up area for wrestling, weight lifting, badminton, para weightlifting and athletics.

Having experience myself as an athlete at an international level, I had always felt I had a good understanding of what would be expected and appreciated from the medical team. What is unique about the Commonwealth Games however, is the level of competitiveness seen between athletes despite notably disparities in socioeconomic status. This became clearly evident in even the warm up area with large nations bringing an army of medical personnel to support their athletes, with others being seldom able to afford to bring a coach. It was these athletes, the ones who didn’t have access to elite sports performance facilities, 24 hour rehabilitation monitoring programs or 5 star hotels when travelling abroad, that I really enjoyed working with the most.

 

For many of these athletes, sport provides a means of focus and hope for a better life. One such instance of the games remains clear in my mind – I was treating a young athlete from Uganda. It was his first time overseas, and the first time he had spent more than a week away from his family. During the warm up he had rolled his ankle badly and was scheduled to compete the following afternoon. I had managed him acutely, spoken to the general access sports doctor and discussed a plan of management. We had decided to re assess the following morning and see where the athlete was at. The next morning he presented to me and immediately broke down into tears. He was from a small rural village, that had needed to fund raise for 2 years to assist with paying for a plane ticket and accommodation and now he may not even get his chance to compete. I am pleased to say this story had a happy ending all things considered, the athlete was successful through the first round and then lost the second – but in his own words ‘ I made my country proud’, and he did. Walking away from this I felt good knowing that I had assisted in some way to help this young man live out his dream, and make his community proud.

 

That night reflecting I felt a little disappointed that I hadn’t taken a photo or something to remember him by. The next day when I turned up for my shift one of the staff members approached me and handed me an envelope. The young man had left his countries pin for me in a way to say thanks. For those who don’t know. There is a currency at the commonwealth and Olympic games of ‘pins’. Each athlete gets a set amount that they then trade and barter with other athletes the idea being you try and collect a set. I received a couple during my time on the Gold Coast, but this one was particularly special.

 

Daniel is available for appointments as follows:
Tuesday- 10:30am-7:00pm
Thursday- 11:00am-6:30pm

TELEHEALTH EXPLAINED by Senior Physiotherapist Daniel Browne

TELEHEALTH

What is it and how can it help?

WHAT IS IT?
Telehealth is a means of healthcare delivery whereby the participant and the clinician are not physically in the same space. The consultation will be completed over the internet via a secure platform called Cliniko or alternatively via a phone call.

WHAT DOES THE RESEARCH SAY?
As we are thrust into yet another lockdown, more than ever Telehealth is emerging as a necessary means of delivery for healthcare practice. Current research suggests the implementation of telehealth can provide cost effective, readily accessible care when face to face in person care is not a viable option.

HOW CAN IT HELP?
Through Telehealth, we can provide a detailed subjective examination with a therapist guided objective assessment. With this information we can then provide the patient with a diagnosis, goals, specific education and tailored exercise all without them needing to attend the clinic in person. In addition to this, we can still review any imaging online and liaise with other health care professionals involved in the care of the patient in a timely and efficient manner.

WHAT IF I STRUGGLE TO USE TECHNOLOGY AND I WOULD STILL LIKE TO SEE SOMEONE IN PERSON?

Currently (correct as of 1/6/2021), should you have a condition that will deteriorate without care resulting in either additional treatment or medication being necessitated, then you can still attend face to face consultations. If you are unsure if you meet this criteria, then please feel free to give us a call.

3 REASONS WHY ATHLETES DO CLINICAL PILATES AND WHY YOU SHOULD TOO!

By Daniel Browne, Senior Physiotherapist

BACKGROUND

What is the difference between Clinical Pilates and Pilates?

Clinical Pilates, also referred to as clinical exercise, is an exercise session delivered by an Allied Health Professional with post graduate training specifically in exercise and rehabilitation. The Clinical Pilates session includes tailored exercises specific to your condition and goals. Regular Pilates classes are generally conducted by a fitness professional and will provide a general exercise class through the use of Pilates equipment – some of these sessions can include floor-based exercises, reformer or ‘bar’ Pilates. Fundamentally, the difference is specificity verses the generalist nature of the exercises prescribed. From a costing perspective, it is important to note that Clinical Pilates/Clinical Exercise is claimable under code 560 when run by a Physiotherapist with most private health providers, whereas general Pilates is not.

So which one is right for me?

– If you want a quick 30-minute burst of non-specific exercise to get your heart rate up and a sweat and currently have no significant injuries, then a generalist Pilates class may well be appropriate for you.

– If you have any recent or long term injury, you’re looking both for a workout as well as a degree of education and an actionable home exercise program trailered specifically to your needs, then Clinical Pilates is the way to go.

REASON 1: Clinical Pilates facilitates strength training with low levels of joint impact whilst still targeting required muscle groups– both in the athletic and non-athletic population having improved strength will allow you to function within your given tasks in a safer and more efficient manner. For athletes with a high training load, ensuring that there is ample time to recover between sessions is important from an impact loading perspective (running/jumping/tackling), likewise our general population needs time to recover from repetitive tasks performed at work (lifting/standing/bending). By utilising apparatus such as the trap table or reformer we can build strength in and around these tired joints without adding excessive compressive and jarring loads.

REASON 2: Clinical Pilates focus on neurodynamic control and proprioception i.e. balance and quality of movement. Fundamentall,y being able to quickly find or regain balance will give athletes the competitive edge – think reaching wide to return a tennis serve or kicking a football after being bumped off line. Likewise, in non-athletic population groups, being able to lean further forward to trim the hedges, pick up objects from the ground or even transition more safely in and out of the shower will serve to improve not only confidence but function in the more balance demanding aspects of our daily lives.

REASON 3: Group Clinical Pilates provides a social engagement opportunity with like-minded people. Working in a small group creates accountability, builds friendships and foster internal motivation. As ‘they’ say (who ’they’ are I’m still not sure!) it takes a village to raise a child, and there’s no I in team – Athlete’s will work in conjunction with their physiotherapists to develop specific exercises for specific conditions in order to optimise their performance before completing their exercises in a group setting under the watchful guise of the Physiotherapists. Similarly, In the community setting, patients will set goals one on one with the physiotherapists and receive both a clinically structured home exercise program, as well as a progressively challenging group exercise program which will be often completed within a small group situation.

At Select Physiotherapy and Pilates we offer both 1-1 and small group exercises classes for private, compensable and DVA clients.

If you would like to know more about Clinical Pilates please do not hesitate to give us a call on 97731100.

 

Daniel Browne

Senior Physiotherapist

TELEHEALTH (REMOTE ONLINE PHYSIOTHERAPY)

TELEHEALTH EXPLAINED

Telehealth uses digital technology that’s readily available on your computer or phone to receive treatment from our Physiotherapists.  We use a secure network which meets Australian privacy standards. Research has found Physiotherapy Telehealth  to be safe and effective.

Our Physiotherapists are able to  assess, diagnose and treat a wide range of conditions online.  To diagnose your condition,  your Physiotherapist will ask a series of thorough questions then  guide you through a safe set of movements and tests. Your Physiotherapist will then educate you with regards to your diagnosis plus provide advice on managing your condition independently . As an example, this advice will likely include information on pain relief, control of inflammation, avoidance of aggravating activities, graduated return to exercise/activity, postural correction,  treatment techniques you can try on yourself plus a graded individualised home exercise/rehabilitative program.

ACCESSING YOUR TELEHEALTH APPOINTMENT

  • You will receive an email with a link to access your online appointment. The link to your Telehealth appointment will begin working 10 minutes prior to the start of your appointment. Just wait until then and you’ll be able to join!
  • After you click on the link please press the Connect to the call button!
  • You will then see a prompt from your browser asking if you will allow Cliniko to access your microphone and camera. You will need to allow this, otherwise your practitioner won’t be able to see or hear you: If your practitioner is not yet there, you’ll see a screen that says ‘Waiting for [practitioner’s name] to join the call’. Once they arrive, you’ll see the video of them in the big screen and you’ll be in the little screen in the lower corner:

BEFORE YOUR APPOINTMENT AND TROUBLESHOOTING

  • CHECK YOUR WEB BROWSER IS UP TO DATE- If using your computer, supported browsers include recent versions of Chrome and Firefox and Safari 12 or higher.
  • PHONE – You can also use your iPhone or Android device to join your Telehealth appointment.☝️Note: If you’re on an iPhone, Safari is the only browser that will work. Chrome or Firefox on your iPhone will not work for Telehealth appointments.
  • AUDIO AND VISUAL. Please make sure your computer or phone camera is set in a steady location to capture you on screen and that the volume setting on your computer/phone is switched to maximum.
  • ENVIRONMENT – please make sure your surrounding floorspace is free of any objects/hazards so that you can stand up and move as needed.
  • CONTACT DETAILS – please have your phone on hand incase we need to call you to fix any technical difficulties.

We look forward to connecting with you online and helping you to manage your condition/injury.

If you have any further queries, please don’t hesitate to email us at enquiries@selectphysiopilates.com.au or call the clinic on 9773 1100.

Tips to stay fit and healthy whilst working from home by Senior Physiotherapist Daniel Browne

TIPS TO STAY FIT AND HEALTHY WHILST WORKING FROM HOME

With the unprecedented impact COVID19 is having on our workforce, many industries are opting to transition employees to a work from home model. Below are a few tips and tricks to make sure you optimise your home office set up whilst staying fit and health!

COMPUTER POSITION

Working from home will likely include a fair portion of desk-based work with many hours spent sitting behind a screen. Unfortunately, not all homes are set up to accommodate these large periods of time behind a desk. Where possible, one option is to access a sit stand desks and endeavour to switch between sitting and standing every 45-60 minutes. If this is not feasible and your set up will not allow you to change your body position regularly, then the image below describes a recommended set up to promote good upper and lower body postures. If you do find that you start to stiffen up through the neck and back, then firstly take a break! Secondly please see below for 6 key mobility exercises.

Below is an image taken from the Worksafe QLD website demonstrating a desk set up and seat position when utilising one or two screens

https://www.worksafe.qld.gov.au/__data/assets/pdf_file/0006/83067/guide-ergo-comp-workstations.pdf

 

TAKING BREAKS


Make sure you get up and move! Movement will refresh your mind, allow you to retain concepts or ideas easier and will break up the monotony that surrounds being desk bound. Ultimately this will decrease stress and improve productivity – a win-win situation for you and your employer. Where possible, aim to get outside for some fresh air and Vitamin D –  not only is it good to change up your physical environment, but Osteoporosis Australia recommends 10 minutes of sun each day to maintain strong bones and tissues.

https://www.osteoporosis.org.au/sites/default/files/files/vitdconsumerguide.pdf

NUTRITION

At a time where we are becoming increasingly sensitive and vulnerable to respiratory illness, it is important that we give our body the adequate fuel that it needs. Referring to the Australian Guide for Health eating, make sure you are getting enough water, fruit and vegetables into your diet. This will help keep your immunity strong, and work to fight off potential illness.

https://www.eatforhealth.gov.au/guidelines/australian-guide-healthy-eating

A QUICK NOTE ON EXERCISE

Exercise is essential for our day to day health. Exercise helps us build strength and mobility, prevents injury and allows us to improve our function with everyday activities. Additionally, exercise serves as a way to build our immunity and boost our immune system to aid in fighting off any potential illness we may have or are at risk of being exposed to. When unwell, it is important we still perform some level of exercise, albeit to a lesser intensity/degree – this may be something as simple as a light walk or gentle stretching. Please see below for examples of low intensity and low impact strengthening and motility exercises that you can perform at home.

STRENGTHENING EXERCISES TO DO AT HOME

With many social organised community sporting events rapidly closing their doors as well local gyms and fitness studios now closed, you will need to perform some of your own resistance training at home. Please see  our blog entitled ‘Exercise whilst travelling’ where we have detailed a number of resistances strengthening exercise you can perform with only 2 exercise bands! If you do not currently have this equipment, they can be purchased either in person or online from your major retailers – Kmart, Big W, Rebel sport or from Select Physiotherapy and Pilates

MOBILITY EXERCISES FOR AT HOME

When we talk about movement, being strong is half of the picture. The other half is mobility – this is the degree in which we can bend, twist and straighten our body allowing us to move with purpose through a variety of different positions that reflect the needs of our day to day lives.  Below are simple mobility-based exercises everyone will benefit from – but particular those are spending an increased time at their “home” desk.

 Middle back rotation
– Thoracic open book stretch/archer stretch

 

Middle back extension
– long lay on foam roller/arching over foam roller

 

Anterior hip stretches
– kneeling hip flexor stretch/couch stretch

Shoulder blade retractions
* Note that the shoulder blades come together and slightly down, you are NOT shrugging

If you are finding that the change in ergonomics working from home is causing a stiff neck or back or perhaps you want some tailored options for a home based exercise program – then feel free to drop us a line. At Select Physiotherapy and Pilates our experienced physiotherapists are here to help keep you mobile and productive in all situations! Also, stay tuned for upcoming information regarding opportunity’s for Telehealth (online) consultations.

From the team at Select Physiotherapy and Pilates, stay happy and healthy and don’t forget to wash your hands!

COVID-19 POLICY – MEASURES WE ARE TAKING AT SELECT PHYSIOTHERAPY AND PILATES

We’re open for business and here to help with your aches and pains as we all manoeuvre through the Covid-19 reality. For your peace of mind, here’s a snapshot of the MEASURES WE ARE TAKING AT SELECT PHYSIOTHERAPY AND PILATES to keep our premises, staff and clients virus free.

#All staff are vaccinated and boosted when eligible

#All clients with cough, cold or flu symptoms and clients who have been exposed to someone who has Covid-19 or are awaiting test results are NOT to enter the clinic and offered a telehealth consultation instead

#Unvaccinated clients are required to wear an N95 mask purchased at their own expense

# Implementation of best practice to prevent the spread of the virus.

# Washing hands and sanitising between all patients (as per usual)

# Sanitising benches, chairs, massage beds, pilates and rehab equipment after each use.

# Supplying hand sanitiser for clients and staff

# Practicing social distancing when appropriated

# Physiotherapists to wear PPE as required under current government regulations directed by the DHHS

TELEHEALTH – “remote online physiotherapy” appointments are available. Please see our “Telehealth Explained” blog for further information.

If you have any queries, please don’t hesitate to call the clinic on 9773 1100 or email enquiries@selectphysiopilates.com.au

#physio #coronavirus #covid-19 #painrelief #physiotherapy