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ACL tears are one of the most common injuries for sports people that involve running and changing direction. The ACL (anterior cruciate ligament) is a ligament that provides stability for the knee and stops the thigh bone sliding too much over the shin bone.

There are certain factors that predispose someone to getting an ACL tear. Some of these factors you cannot help such as being female, having ligament laxity, playing on synthetic turf and for those who are interested in women’s health (Me!) being in your phase of your cycle before ovulation also increases the risk of an ACL tear. There are risks that you CAN change that can also determine the risk of a tear such as poor hip and trunk control, your propensity to land with a relative straight knee as well as a knee that points inwards, weak quads and gluts as well as poor timing of your quads.

This leads to why physiotherapy is so important in preventing tears as well as rehabilitation before and after surgery.

Exercises need to target range of motion particularly if surgery is involved, strength, correcting movement patterns, balance, jumping and running exercises as well as learning about the common mechanisms for injury. This program needs to be graded according to the needs of the particular client. Ignoring an ACL injury can increase your risk of osteoarthritis and cartilage wear. ACL tears are not to be ignored. Book in with your physiotherapist as soon as you can.

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Pelvic Pain is often caused by one or a multiple combination of systems of your body such as your digestive system, your musculoskeletal system and your reproductive system. Often when one system has been not working right, it can spread to other systems too and cause dysfunction or inflammation in surrounding systems. Chronic pelvic pain can lead to lots of lifestyle changes like not being able to work, play sport, enjoy sexual activity or enjoy other aspects of life the way a person did before. The sad fact is, that when people have chronic pain, they are less likely to seek professional help compared to if the pain was located somewhere else.

There is more and more awareness in the general public about issues such as endometriosus that can often lead to chronic pelvic pain. With 1 in 10 people affected by endometriosus, it justifies the need for more information filtering through to be able to empower women to know that periods are not meant to be excessively painful and it is okay to seek help.

A women’s health physiotherapist can help with pelvic pain when it is of a musculoskeletal component or if the pain is extenuated into their muscles even though the original problem may have been from an organ like their bladder or from their endometriosis. There is lots to learn from a physiotherapist of how to deal with pain especially when it becomes chronic.

If you or someone you love is suffering from pelvic pain which can be a very debilitating condition, encourage them to seek help from their GP, pelvic floor physiotherapist or specialist.

There are links here that can give some more information on pelvic pain:

https://www.pelvicpain.org.au/

https://jeanhailes.org.au/news/pelvic-pain-know-the-differences-and-when-to-seek-help

https://www.mayoclinic.org/symptoms/pelvic-pain/basics/causes/sym-20050898

https://www.racgp.org.au/afp/2015/july/management-of-persistent-pelvic-pain-in-girls-and-women/

https://pelvicguru.com/

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Where your foot lands can make a big impact on your pelvic floor when you run. If your foot lands horizontally further away from the centre of gravity which typically is under your hips, then there is more ground reaction force going up to your pelvic floor which can cause you to leak or increase your prolapse symptoms. Sounding too scientific?? What this means is that the further your foot is reaching out in front of you, the more stress is passed up your body to the pelvic floor.

What can you do about this you ask? Well there are a few strategies that you can adopt to change this. First of all, you can try increasing your step rate so you are running at the same speed but are taking smaller steps. This is the easiest alteration you can make.

The other option is to change your running style. If you can imagine the road is moving rather than you are moving while you are running. Instead of pulling the road towards you, you are leaning slightly forward from the ankles so you are landing more under yourself so you can propel yourself by pushing the ground behind you. This could potentially change the pressures to your pelvic floor by half. Hence, causing less leakage or prolapse symptoms.

It is advisable, that if you are running and have any symptoms of leakage or prolapse (heavy or bulging sensation in the genitals) you should seek a pelvic floor physiotherapist appointment. This is not normal and can be treated. At Inspired Physio we can do a running assessment on our treadmill to show you whether you have a heel strike or mid foot strike run, where you body leans when you run and adjust the cadence to make your running style more efficient.

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Inspired Physiotherapy by Kristy Norvall - 3M ago

Cancer

Cancer describes a disease in which abnormal cells multiply and divide without control. Cells in the body form tissue and organs that typically aid in growth and healing in the body. However, during cancer, cell death and replacement do not occur normally allowing tumours to grow in once healthy tissue, or for some cancers, accumulating a build-up of abnormal cells in the blood stream. There are over 100 different types of cancer with prostate cancer, bowel cancer (colon and rectal cancers), breast cancer, melanoma and lung cancer accounting for approximately 60% of cancers diagnosed in Australia.

While surgical removal of cancer remains the primary treatment for most cancers, radiation therapy, chemotherapy and other drug treatments are also frequently used as primary or adjunct treatments. Advances in treatment have led to more effective therapies. However, treatment-related side effects are still common and may persist for long-term survivors. Some of these may include weight gain/loss, fatigue, reduced bone mineral density and muscle mass, neuropathy, mood disorders, incontinence and lymphoedema.

Exercise and cancer prevention

Research has shown strong evidence that exercise plays an important role in the prevention of cancer, especially breast, colorectal and endometrial cancer. Emerging evidence shows exercise is associated with a reduced risk of other cancers such as prostate, lung and ovarian cancer.

Why is exercise important for cancer survivors?

Cancer survivors can participate in exercise both during and after treatment, with emerging evidence indicating that exercise after diagnosis may improve long-term survival rates for breast and colon cancer. The benefits for exercise during and after treatment are:

Improve/ Preserve Reduce
Muscle strength, mass and power
Physical function
Range of motion
Immune function
Chemotherapy completion rates
Body image, mood and self-esteem
Duration of hospitalisation
Psychological and emotional stress
Depression and anxiety
Number and severity of symptoms and side effects (e.g. fatigue, pain, nausea)

What type of exercise is best?

Exercise must be individualised according to a range of factors including exercise history, previous and planned cancer treatment, disease and treatment-related risk factors; the presence and severity of symptoms in addition to the client’s goals, barriers to exercise and personal likes. Overall the goal is to meet the physical activity guidelines recommended for the general population. However, after surgery and during treatment, these guidelines may be unrealistic. Here a gradual introduction of physical activity or return to activities of daily living is more appropriate. To achieve this, the below exercise goals can be implemented:

  • Limiting sedentary behaviours, such as sitting or lying down
  • Maintaining or gradually returning to usual activities of daily living
  • Gradually introducing planned, aerobic-based exercise such as walking, cycling or swimming.
  • Including 2 sessions per week of resistance-based exercise for the major muscle groups.

To help achieve these goals an Accredited Exercise Physiologist (AEP) can help to design an individualised exercise program that incorporates the many variables that effect an individual’s participation in exercise both during and after cancer treatment. They will know what level of exercise to start with and when and how it should be progressed. An AEP’s professional support can ensure exercise is done safely, particularly for people experiencing fluctuating treatment-related side effects and new side effects, those who have little or no history of exercising, those with suppressed immune systems and those at increased risk of cardiovascular events or fracture. An AEP can help address common barriers to exercising during and after cancer treatment and provide exercise modification when needed.

Tips to remain active

  • Avoid inactivity and progress exercise gradually.
  • Understand why being active during and following cancer treatment is important.
  • Recognise your barriers to exercise and find solutions to overcome these.
  • Goal-setting is important – you should plan both short-term and long-term goals.

If you are undergoing cancer treatment or have had previous treatment and would like some assistance with returning or continuing exercise, call the clinic on 9674 5596 to book in your initial exercise physiology consult or email me at kristy@inspiredphysio.com.au for more information.

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What is an Exercise Physiologist?

Accredited exercise physiologists specialise in exercise and movement for people with acute or chronic medical conditions, injuries or disabilities. Exercise physiologists will develop exercise-based interventions with the aim of managing or restoring a person’s health and function. They may also provide health and physical activity education and lifestyle modification to achieve long-term behavioural change.

When should I see an Exercise Physiologist?

  1. If you are at risk of developing a specific condition or injury that requires prevention
  2. If you have been diagnosed by your GP or other allied health professional with a medical condition, disability or injury.

Such conditions may include but are not limited to:

  • Cardiovascular conditions (high blood pressure/cholesterol, heart attack, heart surgery, heart failure)
  • Pulmonary conditions (asthma, chronic obstructive pulmonary disease)
  • Metabolic conditions (overweight/obesity, Type 1 & 2 diabetes, metabolic syndrome)
  • Neurological/ Neuromuscular conditions (stroke, spinal cord injury, Parkinson’s disease, cerebral palsy, multiple sclerosis, & dementia)
  • Musculoskeletal conditions (osteoarthritis, osteoporosis/osteopenia, pain & injuries)
  • Mental health conditions (depression & anxiety disorders)
  • Cancers (breast and prostate cancer)
  • Other (chronic pain and fatigue, post-surgical rehabilitation)

What services do Exercise Physiologists provide?

  • Assessment of strength, fitness and functional capacity
  • Prescription of individualised exercise programs
  • Pre and post-operative rehabilitation
  • Behavioural change strategies to increase incidental activity & reduce sedentary behaviour
  • Education and lifestyle modification strategies

How do other health services differ from an Exercise Physiologist?

  • Exercise Physiologists are specialists at using exercise to help manage a range of health conditions, disabilities and injuries or to prevent their onset.
  • Physiotherapists are specialists at diagnosing, treating and managing acute injuries and pain using manual therapy and rehabilitative exercises.
  • Exercise Scientists use exercise to improve health, well-being and fitness for healthy populations and recreational/amateur athletes.
  • Sports Scientists use exercise to improve sporting performance for elite, high fitness & athletic performance and professional sport.
  • Personal Trainers use exercise to improve health, well-being and fitness for healthy populations as an exercise scientist (ES) would. However, an ES has further clinical training and an in-depth understanding of human physiology and the body’s response to exercise for healthy populations.

If you suffer from any of the above conditions and would like some assistance with getting healthy and active again, call the clinic on 96745596 to book in for your Initial Exercise Physiology consult.

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Emily Seebohm continues to encourage people to talk about endometriosis as she opens up about how endometriosis has affected her life in particular the 2016 Rio Olympics. Emily found out that she might have endometriosis the year she was training for the Olympics. She had to delay her surgery and suffer through her symptoms until after the Olympics.

Endometriosis affects 1 in 10 women. It is when there are cells that should be in your uterus are outside your uterus, commonly growing on your ovaries, fallopian tubes, bowel and other structures in your pelvis. It can affect fertility. Symptoms can be very individual. Emily had massive cramps, low back pain, headaches and constant fatigue. She had to go to bed between her sessions so she could have enough energy to perform at night. Her sugar cravings were so strong she could not resist choosing unhealthy foods and put on weight.

She is now an Ambassador for Endometriosis Australia and says “I’d love to see programs go into schools and actually educate girls on things properly because when I was going to school it’s almost like you just don’t talk about it.”

She had laparoscopic surgery in December 2016 to be able to confirm and take out the endometriosis. She put up on Instagram a picture of her recovering in hospital to encourage girls who may also have endometriosis. The best way to treat endometriosis is keyhole surgery. It can be hard to identify and locate. It is important to find the surgeon who is very experienced, in order to find and take all of it out the first time to prevent further surgeries in the future. Endometriosis is commonly coupled with pelvic pain that can be treated by a women’s health physiotherapist. Emily has made a good recovery and feels that she has restored her energy levels back to normal. She says talking about it with other women has helped her better cope and manage her endometriosis. More information can be found on :

www.endometriosisaustralia.org

www.jeanhailes.org.au/health-a-z/endometriosis

www.pelvicpain.org.au/for-women/endometriosis/

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Rayka Zehtabchi and Melissa Berton have won an Oscar for Best Documentary (Short Subject) about the taboo of menstruation in ‘Period. End of Sentence’. It is set in a rural village outside of Delhi, India and speaks about the restrictions girls and women have with their period. Menstruation is often seen as something that is “dirty”. Even women who have had it for years do not understand why they are bleeding each month. Some believe it to be a curse. The stigma of menstruation can stop girls from going to school to the point of dropping out of school, women from going to work, worshipping at a temple or being totally isolated from their community. It can be a source of shame for a lot of girls and women.

In the documentary, which is available on Netflix, it talks about a project www.thepadproject.org started in California, USA where some high school kids started fundraising for villages to setup a machine that makes biodegradable pads. The materials are sourced from the local area at the cost of 5c per pad. Currently, females are using dirty rags, leaves, newspaper which can lead to infection. It is hoped by winning this Oscar, that this project has an enormous platform to be better promoted as well as raising awareness about the inequality that is still so evident worldwide. What is now argued to be the quote of the Oscar night by the Producer Melissa Barton exclaiming “A period should end a sentence not a girls’ education!” The picture below is the village in the documentary celebrating the win. Congratulations on raising awareness about what should be a normal part of a female’s bodily function that is so essential in bringing wonderful life into the world!

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Belly breathing is taught to people to relax the body, to meditate, in yoga, to manage anxiety to list a few things. A lot of people coming into the practice have been told that in order to breathe properly, you need to belly breathe? I question whether that is true or not?

As a women’s health physiotherapist, I look at people’s pelvic floors while they breathe. When people belly breathe, there is a lot of downward pressure that goes into the pelvic floor. This is not ideal for people who have stress incontinence or prolapse. Yes our pelvic floor does move when we breathe, however, we need to be able to breathe in order not to place excessive pressure onto our pelvic floors.

The principle behind why people are encouraged to belly breathe is to engage their diaphragm.

However, the diaphragm is a dome-shape muscle sitting at the bottom of our ribcage. When we breathe, the dome flattens. Yes our belly should come out but the ribcage should also move outwards and backwards. So next time you breathe, try and move the ribcage in all directions as well as the belly breath. You will then minimise those pressures onto the pelvic floor but also engage the diaphragm more fully to be more efficient at something we do so many hundred times a day. If this is hard to do, this can cause other muscles to compensate and contribute to back or hip pain, movement dysfunction, pelvic floor leakage or prolapse. At Inspired Physiotherapy we can assess your breathing as well as real time ultrasound how this is impacting your pelvic floor. You can make an appointment to see how.

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From the 1 April 2019 Private Health Funds will no longer cover some natural therapies including ‘Pilates’ sessions. How does this affect Inspired Physio? The Australian Physiotherapy Association has fought and negotiated for physiotherapists to continue to be able to conduct individual and group exercise sessions which include some exercises drawn from Pilates.

What does this mean for you?

New clients joining our group exercises classes – now called ‘Physiocise’ will need to have an individual session with one of our physiotherapists to ensure they are prescribed suitable exercises to be done in class which cater for their needs. Some of these exercises may be drawn from Pilates based exercises and combined with evidence based rehab exercises. From there, they may join one of our classes and we will continue to use the Private Health Fund code 561 so that you’re able to claim from your private health fund.

What is Physiocise?

Physiocise is a combination of Pilates inspired exercises combined with clinically appropriate exercises that are evidence based for improving function. These exercises may involve some Pilates equipment but are conducted within a therapeutic framework.

Visit the Physiocise page for dates and times of classes!

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Watching the tennis, I can’t help but notice Nick’s posture is particularly different to most other tennis players. Yes I should be watching the tennis but my physiotherapist eyes drag me to his side profile and can’t help thinking his posture could be so much better. I do admit that he is a really good tennis player and I am not trying to criticise him. However, he walks with his head dropped more than most and when he stands or sits he has a much more curve to his upper back and neck. Could this be affecting his tennis I wonder? Could this expose him to potentially more injuries?

I look around in shopping centres and public places and yes my physiotherapist eyes are open and I see so many people who are aged 25 and under with similar postures to Nick. I really do blame the use of our phones and laptops that have really contributed to this generation. Yet, I take to the beaches and look at lifesaver postures or anyone else who are athletic tend to have straighter postures. This has supported my belief in the importance of physical activity and the need to get off our devices more.

If you have children who are on screens, please take care of their postures. Suggest to them to bring the phone up rather than constantly drag their head downwards to the screen. Even better, have their device sitting on something like a laptop raiser (like the one pictured by Logitech) or a pillow if on their phone for an extended period of time.

I believe that it will save them from fixed poor postures as they age. Yes, I believe these hunched back, poked neck, head down posture expose them to more chances of neck, back and shoulder pain. If you have an excessive curved upper back, your shoulders cannot reach up as high , but if your sport requires it, such as in swimming and tennis, then your rotator cuff tendons will be at a disadvantage, which increases the risk of tendon issues down the track. If you have a poked neck posture and especially with a head down posture, it can shorten the neck muscles and put more stress in the neck joints and increase the likelihood of headaches and other neck issues.

So the moral of the story is… straighten up, look up at the beautiful sky and the birds and the stars. Get off those screens a little more and you may save yourself pains and aches into the future!

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