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.

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 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

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!

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.

WE’RE OPEN FOR ESSENTIAL CLINICAL CARE

Essential clinical care is defined as:

# to prevent a significant change/deterioration in functional independence which would result in an escalation of care needs (e.g. an increase in frequency of treatment needed, an increased need for prescription medication due to a significant increase in pain, requirement for specialist input or review, an increase in care needs, and/or a substantial increase to anticipated recovery time associated with a delay in receiving services)

# to provide assessment and diagnostic services to clients/patients whose care have been delayed as a result of previous restrictions, with any further delay likely to result in deterioration in functional independence or adverse health outcomes (including access to diagnostic imaging services or assessment for prescription of assistive equipment and technology)

#to provide services that are essential as part of a broader plan of care with a medical practitioner (e.g. fitting a brace post-surgery)

#to provide services that are part of a conservative management plan to avoid or delay elective surgery (as agreed with treating team)

#to provide services immediately following elective surgery that prevent secondary complications or aid functional recovery (as agreed with treating team).

ALL STAFF AND CLIENTS AT ASPENDALE GARDENS MEDICAL CENTRE ARE NOT TO NOT ENTER THE BUILDING IF THEY HAVE COLD OR FLU SYMPTOMS. MASKS ARE COMPULSORY

If any of the following apply to you, as directed by DHHS, please undertake Covid-19 testing. We are unable to treat until you are symptom free and have a Covid-19 negative test.

1. Experiencing cold/flu-like symptoms inclusive of:

• Fever
• Cough
• Sore throat
• Running nose
• Lethargy/fatigue
• Shortness of breath

2. Been in close contact with someone diagnosed with COVID-19

MEASURES WE ARE TAKING AT SELECT PHYSIOTHERAPY AND PILATES:

• Implementation of a Covid-Safe plan and adherence to the guidelines outlined by the DHHS
  
• Keeping up to date with best practice to prevent the spread of the virus.
• Stringent hand sanitisation for staff and clients
• Sanitising benches, chairs, massage beds, door handles and all equipment after each use.
• Practicing social distancing when appropriate
• Physiotherapists wear PPE as directed by the DHHS

Thank you for your patronage. We appreciate your support!

Kind Regards,

Kate Meakins
Director and Principal Physiotherapist Select Physiotherapy and Pilates

BY SENIOR PHYSIOTHERAPIST DANIEL BROWNE

School holidays are over and Eastlink once again grinds to a standstill, primary and secondary school aged students have begun their long awaited(?) return to study. With this – a slew of new textbooks, workbooks, the latest graphics calculator and a new pair of kicks will undoubtably all find their way into meticulously “Tetrised” packed backpack. Cries of “man feel the how heavy my back pack is’ and competitions of who’s backpack can fit into the top locker soon fill the halls with rampant discussion. But how much is too much? How should your child wear their backpack? Is there a greater underlying issue at play here? Below we seek to break down some of these questions and consider the wider implications. But first a reflection on the current government guidelines.

The national guidelines for physical activity recommend that for children between the ages of 5-17 at least an hour of moderate to vigorous physical activity each day, with strengthening or weight-bearing activity occurring three times each week (ADH, 2019).  Of note, according to a recent Australian Physiotherapy Association article (APA, 2017), ‘over the past 40 years, Australia has seen a 42 per cent decline in children walking or riding to school, with no signs of this decline slowing down’. So, the question then becomes, where are children getting their loading? Is running around at lunch time sufficient? Do we need an increase in participation rate into recreational after school sports/outdoors activities?

4 QUICK TIPS ON CHOOSING A BACKPACK

Padded back support of the spine throughout

Wide shoulder straps so as to not dig into the front of the shoulders

Option of supportive straps across the chest and waist to disperse weight

Choose an adjustable back pack that fits – not one the child will grow into!

 

HOW SHOULD THE BACKPACK BE WORN?

 

 

CONCLUSION

If indeed back packs are being worn correctly as demonstrated by the diagram above,  is it the increasingly common sedentary lifestyle of many of our youths over the summer break that is causing the back pain or is it the sudden influx of load as they lug an assortments of textbooks and alike to class for the start of the school year? In reality it’s likely a combination of both – the difference being one issue is transient (that being the heavy load of books comes and goes), the other more omnipresent – the lack of weightbearing activities.

My opinion, don’t overload the backpack – considered splitting up the load of books across days and only take the books you will really need in class. More importantly, in the long-term parents and guardians must consider how much exercise your child is doing both at school and on the weekends. Consider the use of screen time as a reward rather than a given activity, and where possible encourage play that has an increased load baring element to it e.g. running and jumping.

If your child is experiencing any stiffness or soreness upon returning to school, if you would like advice regarding safe exercise to encourage healthy development or even a back pack fitting, please do not hesitate to contact us here at Select Physiotherapy and Pilates.

For additional information regarding suggested activity levels across the lifespan please review the Australian Department of Health’s website link below:

https://www1.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg-phys-act-guidelines

With the summer season of tennis and the Australian Open in full swing, we’re starting to see an influx of tennis related injuries. Today we’re going to focus on some of the key exercises surrounding shoulder rehabilitation in our overhead athletes. Notably, by implementing the exercises below in a structured program, when performed correctly, you will decrease your risk of many of the common tennis/overhead racquet and throwing sport type injuries –you may even improve your backhand!!

1. Building a base- the middle back
In order to build a good base for shoulder movement we need to create both strength and mobility through our upper and middle back.

Middle back rotation
– Thoracic open book stretch/archer stretch

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

Shoulder blade retraction/row
– double arm banded rows/ single arm banded rows

2. Developing strength and mobility overhead
Racquet and throwing sports require both strength and mobility overhead – this requires excellent control and synchronisation of the muscles of the shoulder blade/upper back region, along with the muscles of the shoulder

Overhead band pull apart

 

Band resisted shoulder raises

 

3. Bullet-proofing the rotator cuff
The rotator cuff is a collection of four muscles that attach to the shoulder. It plays an  important role in lifting the arm out to the side, turning the shoulder in and out and serves key roles in stabilising the shoulder in a fixed position (such as when performing a push-up). Of note, these muscles (and corresponding tendons) are commonly worn out/injured after many years of repetitive movement (particularly overhead).

Banded external rotation with scapula set at 0 degrees abduction and 90 degrees abduction

 

Banded internal rotation with scapular set at 0 degrees abduction and 90 degrees abduction

Push up position plank/ side plank on outstretched arm

Disclaimer: It is important to note every injury is a little different and the following should be used as a guide rather than absolute advice. For a full assessment of your shoulder function or for specific exercise relating to an injury, please do not hesitate to contact us here at Select Physiotherapy and Pilates where we’ll work with you and your coaches to get you back out onto the court sooner!

PHYSIOTHERAPY AND GARDENING SPRING 2019

by Daniel Browne

With the arrival of spring, many of us are extending our gaze outside to find an overgrown garden bed, a tree that needs pruning or perhaps a plot of land that’s due for reinvigoration! Whatever the motivation, gardening is a great way to maintain mobility, build strength and get back in touch with mother nature. Below are a few tips and tricks to make sure the gardening experience you have is a fruitful one!

Warming up

Gardening is exercise and we know that doing a good warm up will prevent injury and optimise our performance. Whether you’re working at ground, waist or overhead level, making sure you have good movement through your hips, lower and middle back will go a long way to keep you out in the spring air! Below are a two of key stretches to help get you moving.

1) Kneeling hip flexor stretch.

2) Thoracic open book stretch.

Digging

When digging a hole, it is important to pick a shovel that’s the right height . Too long and the lever arm (handle) will be awkward to manoeuvre, placing extra strain through your shoulders and neck.Too short and you’ll find yourself hunched over, putting undue stress through your lower back.  When picking a shovel, it’s important to pick one that will serve its purpose – think of the shape of the shovel head (more/less dirt vs ability to cut into the finer spaces) and the ergonomics of the handle (is it rubber supported/wood/steel). When measuring the shovel, a good length is approximately just above you hip bone – this way once you get into your split stance position, your back can remain straight and you can generate adequate force through your legs and torso. Another simple tip is not to overfill the shovel, think 2/3 of the total head and consider utilising a wheelbarrow so that you don’t need to cart the dirt around – this also saves mess!

 

Kneeling

For those who get knee pain when kneeling, trialling a soft matand/or knee pads can be a quick and cost-effective solution. Alternatively, going into a split stance (one leg up, one down similar to the kneeling hip flexor stretch listed above) will give the knees an opportunity to take a break from the load. If you’re someone who tends to lose track of time in the garden (like me!), at times you may notice your feet or lower leg may feel like it goes to sleep. In general it is important not to hold any sustained body posture too long whether that be seated/kneeling or otherwise. I’d suggest getting up and moving a little every 20 minutes or so – this will keep you mobile and give you an extra opportunity to stand back and admire all your hard work!

Trimming overhead

As we all know, the trees aren’t going to trim themselves nor drop branches in a nice even pattern! Spending extended periods of time working overhead can lead to issues with your neck and shoulder,potentially causing pain and stiffness. A simple solution here is to make sure you get yourself close to the level of cutting utilising a ladder (make sure to check the level of the ground first!). Alternatively, you could invest in an extender arm for the trimming which will allow you to operate the machine from chest-waist level and take the strain off the shoulders and neck.

Personally, I’m excited to be back in the garden. As with all physical activity, it’s important that we start slowly and build up. By following some of the tips and tricks above, not only will you be able to spend more time tending to the garden, but you’ll be giving your body that extra little bit of healthy exercise and sunlight we’ve all been missing!

https://select-physiotherapy-and-pilates.cliniko.com/bookings#service