19/6/2020 0 Comments DRY NEEDLING....Dry needling has become a frequently used treatment modality in Physiotherapy clinics. It is used to treat pain and movement impairments across a number of body regions. The technique involves using a 'dry' needle, being one without medication or injections which is inserted through the skin into the underlying muscles. During dry needling, physios aim to target painful 'trigger points', which are taut bands of skeletal muscle, located within a larger muscle group. The dry needling allows therapists to target tissues that are not manually accessible. Although physiotherapists use acupuncture needles during dry needling, this treatment modality is a part of modern Western medicine and is different to the traditional Chinese medicine practice of acupuncture. There have been a number of research studies investigating the efficacy of dry needling for different pain presentations. Results vary across the studies with no clear evidence that dry needling is more effective than existing therapies (1). There is evidence that dry needling performed by physios is better than no treatment (or sham dry needling) for reducing pain in the immediate to 12 week follow up period. However, when compared to other physical treatments, dry needling does not improve functional outcomes (2). Most studies recommend further research into the usefulness of dry needling for musculoskeletal pain. At Physio4athletes, dry needling is one of a number of treatment options that your physiotherapist will consider for managing your injury presentation. It is not a 'stand alone' treatment and will be used, with your consent, in conjunction with other modalities such as exercise prescription and manual therapy. References: (1)Trigger point dry needling for musculoskeletal pain and disability: a systematic review of comparative effectiveness research Jackson MD, Rowe K, Davenport TE, Orthopaedic Physical Therapy Practice 2016;28(3):178-187 (2) The effectiveness of trigger point dry needling for musculoskeletal conditions by physical therapists: a systematic review and meta-analysis [with consumer summary],Gattie E, Cleland JA, Snodgrass S, The Journal of Orthopaedic and Sports Physical Therapy 2017 Mar;47(3):133-149
0 Comments
By Helen....
Early on in the COVID-19 pandemic I embraced telehealth physio consults as a safe, accessible and 'known' tool for providing patients with the ongoing care they needed. I was confident with the change as I've had comprehensive experience delivering online SKYPE consults to patients with knee pain, as part of a University of Melbourne research project. My experience with telehealth treatments has been overwhelmingly positive. I have "travelled" widely on this telehealth journey, working with patients in suburban Melbourne, regional Victoria and unexpected locations such as Malaysia! I've 'virtually visited' homes,offices, home gyms & pools and parks. I've been surprised by the myriad of tools you can use for resistance training or balance work - full milk containers, a back pack with weights, a chair, a rolled up towel, as well as the usual culprits - weights and stretch cords! I've conducted rehabilitation sessions for jockeys in their barns and implemented mechanical horse riding "sets" to get them back riding. I've put cyclists through their paces developing core strength and worked with swimmers 1 on 1 to develop better movement patterns. Everyone loves a group exercise session and I've continued to deliver mat pilates to the swimmers. Thankfully, the virtual setting is no impediment for my bad jokes! I thank all of my patients, returning or new, for embracing this technology and being open to some change and innovation. Many have liked the convenience of a physio treatment session in their home or workplace. For me, telehealth is definitely here to stay. I look forward to the opportunities it will bring for people in regional areas who'd like to connect with sports physios. For our patients who drive a long way to see us, it is a godsend. Hence the slogan "Telehealth physio, from our workspace to your location". Helen Right now, with everyone participating in social isolation we have two types of people: those that are taking this opportunity to spend time productively, deciding to make good on their New Year’s Resolutions and get fit or athletes who are now stuck inside trying to work out how to keep fit and prepare as best they can for their next competition.
In short, this means we have a lot of people at home doing exercise they are not used to which may sound like a good thing to you but to a physiotherapist this sounds like an opportunity for injury. Whilst at physio4athletes we want to make sure everyone is able to keep as fit and active during these tough times, we want to ensure that you do so safely and smartly and that includes monitoring how much exercise you do on a daily, to weekly, and monthly ratio. Although it is ok to do the occasional long run and regular shorter jogs when training for a marathon for example, it is important to continue to monitor how much exercise you are doing via your acute:chronic ratio. When monitoring how much you are exercising there are four elements that you need to be aware of:
Now I am sure that to the person making true on their new year’s resolution this sounds way more complicated than just getting fit but to a physiotherapist or an elite athlete, this is what is needed to ensure you don’t end up ‘over-training’ or ending up with a tendinopathy. For those of you who don’t know- a tendon is a flexible but inelastic cord of collagen that attaches a muscle to a bone and a tendinopathy is basically a fancy way of saying a disorder of the tendon that results in pain, swelling and impaired function which is typically worse with movement. Tendons are very sensitive to changes in load and this is why the acute:chronic load is so important for any active person to monitor how much you are doing. So what is the acute: chronic ratio you ask? It is the ratio of how much exercise you have completed in the past week: the average of what you have completed in a week over the past four weeks. For example, you normally run twice a week for 5kms, but now in isolation over the past week you have gone for a 5km run every day. This means in the past four weeks you have ran 10kms, 10kms, 10kms and 35kms making a total of 65kms over the past four weeks. This means the acute: chronic ratio is 35 : 16.25 or a 215% increase in your weekly load. This may make some people think they are getting more fit and that may be the case but the greater the increase of load each week, the greater the risk of tendinopathy. As a general rule, once into consistent training you want to aim to have a weekly training load that stays within 10% of your average chronic weekly load. Does this all sound a little complicated to you? Well let us put it simply for you with a few steps of advice:
If for some reason even with this advice you still manage to get injured during this time, don’t hesitate to contact us at physio4athletes and book in for a telehealth consult and we will be there to help you! 19/3/2020 0 Comments telehealth now here.........Introducing Telehealth consultations at Physio4athletes
During these uncertain times Physio4athletes wants to ensure you that we are still here to assist with your physiotherapy needs. With the government recommending self-isolation, Physio4athletes is introducing online physiotherapy consultations. Online physiotherapy consultations or “telehealth conferences” can be used for people who have musculoskeletal injuries yet have trouble accessing ‘in person’ physiotherapy care. We are now introducing a 30-40 minute online telehealth consultation to all clients which will allow physiotherapy management from the comfort of your own home. Studies have shown that physiotherapy via online communication can be an effective form of treatment. Most people believe the majority of the treatment they receive from physiotherapists is the ‘hands on’ treatment however this is actually only a small part of the role that our therapists provide. Many of the assessment techniques can be performed via video. As always your verbal injury history in conjunction with this assessment will give our physiotherapists a working diagnosis from which to plan your treatment. This usually happens in a face to face consult, however is easily replicated with video communication. Physio4athletes staff have been involved in University studies that have shown that education, exercise prescription (with visual monitoring), training/exercise modification and therapist-guided trigger point therapy can help people recover from their injuries. Unfortunately at this point in time these video consultations are not covered by private health insurance rebates. Given the unusual circumstances, this may change. As the situation evolves, physiotherapy clinics may be unable to continue face to face consultations, however, continuity of care or existing treatment plans and assessment of new complaints will be provided by video “telehealth consults”. If you have any further questions please don’t hesitate to contact us or book online via the booking portal. Consultation fees for telehealth appointments will be $50.00 for 30 minutes. 12/3/2020 0 Comments Shoulder pain treatmentA recent systematic review of published research has shown that physiotherapy exercise treatment for subacromial area shoulder pain is as effective as cortisone injection therapy in the short term; and as effective as decompression surgery in the long term (1). Further, exercise therapy has general health benefits.
Physiotherapy manual therapies which include soft tissue massage to the shoulder muscles & joint stretches or mobilisation are strongly recommended to assist with pain reduction and increased mobility (1). Exercise therapy should include targeted strengthening of the rotator cuff and scapula stabilisers, based on an individual's presentation. Please contact us if you require treatment for shoulder pain or would like to read the patient information based on this journal paper. 1. Pieters et al 2020, An update of systematic reviews examining the effectiveness of conservative physical therapy interventions for subacromial shoulder pain, Journal of orthopedic and sports physical therapy, Feb 29, Volume 50(3) page 131. |
Archives
June 2020
Categories |