Injury blog:Gluteal tendinopathy

Have you recently started to experience pain at the side of your hip? With the turn of the new year now behind us, maybe you’re embracing your new healthy lifestyle and have been going for a solid run several times a week to shift some of those festive kilos… Or it might just be that you’re getting a bit older, hitting the middle decades of life, and you’ve had a nagging hip for a while. There are a few structures in and around the hip that can lead to pain felt at the very outer aspect of it. Problems in the low back, the hip joint itself, and soft tissues that surround the joint can all be viable culprits.

Common culprits in the running and middle-aged populations are the tendons of the gluteal muscles. These muscles are responsible for movement at the hip (outwards, backwards and forwards) and stability of the pelvis and hip during movement. There are three gluteal muscles or ‘glutes’. The deepest muscle is the gluteus minimus, followed by gluteus medius, and finally gluteus maximus (which is the largest and most superficial of all three). Where the gluteus medius and minimus tendons wrap around the bony outer part of the hip and insert into the bone, are the areas most commonly associated with disease leading to pain in the outer hip.

Tendon disease

There are a few terms that can describe a diseased tendon. An acutely inflamed tendon is known as ‘tendinitis’, where ‘itis‘ means inflammation occurring at the tissue. A tendon which is chronically diseased (i.e. long-standing pain that may have been present for several weeks, months or years without the presence of inflammation), is known as ‘tendinopathy’. Historically the term ‘tendinosis’ was used to describe a chronic tendon problem, but tendinopathy is now the favoured term. The important thing is to think of a tendon problem sitting somewhere on a continuum between acutely inflamed and chronically degenerated and/or torn.

Let’s take our aforementioned population, a middle-aged female (females are more affected by this issue than males), who runs. What typically happens is they will start to run with the full intent of bettering themselves. Due to poor running technique, the tendon becomes overloaded and after a few weeks or months… Bang! Inflammation, pain, can barely walk! Once the initial pain settles and movement resumes, they start to run again. If they haven’t corrected the problem that underlies the initial acute episode (Tut tut… They didn’t go to see their osteo!), the problem compounds itself. The body will compensate, and further excessive load and compression are placed on the tendons and other surrounding structures. This might go on for a while with the hip grumbling from time to time. Eventually, the changes that have occurred to the tendon tissue result in widespread degeneration and derangement of the tendon fibres and you are left with a tendon incapable of dealing with the high loads required to do something like running. If left untreated, the tendon eventually tears and leaves you with a very unhappy and less mobile hip.

Signs and symptoms

The signs and symptoms of a gluteus medius and/or gluteus minimus tendinopathy include any or all of the following:

  • Pain felt on the outside of your hip
  • Pain that radiates down the thigh to the knee
  • Pain that is worse before and after exercise
  • Pain that improves initially with exercise (depending where on the disease process you are)
  • Pain when lying on the affected side
  • Difficulty walking up stairs or hills
  • Difficulty standing on one leg (on the affected side)

Treatment

Your first port of call is to temporarily cease the activity that is aggravating your hip, and ring your osteo (9078 2455)  This will help to de-load the injured tendon, and give you relief knowing soon you will be in the hands of an expert who is going to guide you through your recovery journey. We will assess your movement from top to bottom and work out where the root cause of your problem is. This is what osteopaths are great at doing. We look beyond the pain, take a picture of your whole life (occupation, hobbies, family life, etc…) and work out all of the contributing factors, so we can put a comprehensive plan in place to rid you of your problem forever.

For a gluteal tendon problem to occur in the first place, there will likely be mechanical issues to correct in the spine and/or lower limb (from the foot up). We do this with a combination of:

  • Hands-on therapy to soothe your pain and improve muscle and joint health
  • Re-training of poor movements into more efficient movements
  • Strengthening exercises for the muscles / tendons
  • Alterations to your daily life which may be contributing to your issue (i.e. increasing particular activities, decreasing aggravating activities, changing a work posture)

Over time, treatment will aim to progressively strengthen the gluteal tendons, so they are capable of withstanding greater loads again. Combined with correction of poor, inefficient movements, this will also decrease the compressive forces acting on the tissues in and around the hip, leaving you with greater strength and more flexibility.

We will be with you every step of the way. A gluteal tendinopathy doesn’t mean you have to give up running. We might need to change focus for a short period during rehab, but our goal will be to get you back to your pre-injury state… with a little extra in the tank so you’re not back with us for the same issue within two months.

Hip pain, was it? No problem. We got this!

References
1. Brukner, P. et al. 2017. Clinical sports medicine. 5th ed. Australia: McGraw Hill Education.

Injury blog: Facet lock

Neck pain

Hello readers! We hope you’ve had an enjoyable Christmas and sent 2020 off with the bang it deserved. We’re kicking things off with a blog about neck pain relating to small joints in our neck known as facet joints. Are you waking up to 2021 with a pain in your neck? You might have had one too many sleeps in the armchair over the festive period. And maybe the exercise dropped off a bit as focus changed to family get-togethers and binging in front of the TV after an exhausting year. Never fear, we’ve got your back (oops… we mean neck!)

What are facet joints?

Facet joints are small joints in the neck, formed between bony parts of two adjacent vertebrae. With a few exceptions, you can find a pair of facet joints at each level of the spine: one on the left, one on the right. These joints, along with the disc connection between vertebrae, are responsible for allowing and restricting movements of the spine, depending on what region of the spine you are looking at. For example, the facet joints in the neck are orientated to allow a relatively wide range of motion in all planes of movement… Flexion and extension, rotation, and side-bending (lateral flexion). When we look over our shoulder to check our blind spot in the car, we are mainly using movement in our neck to get there.

If you move to the low back region of the spinal column, the facet joints are orientated in a slightly different way, allowing plenty of flexion and extension, but minimal rotation. This allows us to bend our bodies forwards and backwards easily.

What is a facet lock?

This condition is pretty self-explanatory from its name. A facet lock is a facet joint that is ‘locked’ or severely restricted in movement. This type of joint is what we call a synovial joint. This means it’s a joint that is held together by a joint capsule and is filled with a lubricating fluid, known as synovial fluid. A facet joint tends to lock when it has been overloaded with excessive forces acting upon it. This tends to occur over time and results in a ‘straw that breaks the camel’s back’ moment. It can also happen following a quick jerking movement of the neck, where a sudden large force is placed upon the joints and it is too much for them to bear. The tissue around the joints, including the overlying muscles which drive the movement stiffen and may go into spasm, and you are left with a neck that is extremely painful to move.

More often than not, we are moving poorly above and/or below the joint, leaving it struggling to hold everything together and keep movement going. The body is good at compensating for poor movement up to a point, and then failure is inevitable, unless we intervene.

Signs and symptoms

The signs and symptoms of a facet lock in the neck include:

  • Neck pain
  • Restricted neck movement
  • Restricted mid-back and shoulder movement
  • Headache (this is more likely if neck movement is not restored following injury)
  • Inability to perform daily tasks such as checking your blind spot whilst driving (we strongly suggest if you cannot turn your neck, to NOT get behind the wheel of a vehicle) and looking/reaching up to a kitchen cupboard

After the initial onset of pain, you will progressively lose movement in your neck over the next few hours. The following few days will be painful while your body deals with the acute inflammation occurring in and around the joint. Slowly but surely, you will begin to notice movement becoming easier and pain reducing.

We recommend coming to see us sooner rather than later. When inflammation is fresh and everything is really restricted, it is sometimes difficult to reach a 100% accurate diagnosis on the first session. But after careful questioning and consideration of your medical history, the majority of the time we can come to a solid working diagnosis. If we cannot, and we feel something else is going on, we may refer you on for a second opinion, or for imaging. Nine times out of ten, with a simple facet lock there aren’t any serious signs and symptoms which will make us question our course of action… it usually just bloomin’ hurts and is difficult to move your head. In those cases, we can get to work immediately.

Treatment

A locked, compressed and inflamed facet joint usually responds pretty well to some gentle traction of the neck. Traction techniques gently separate the joint surfaces, allowing for movement of fluid and for everything to calm down nicely. If you are super locked up and restricted, traction and very gentle neck mobilisations may be all we’re able to do in the early stages. We’ll cast an eye over the areas above and below the injury site to see what’s going on there, and treat those accordingly. Restoring movement in a non-painful area away from the injury site is commonly what’s needed to help calm everything down quick-smart. All being well, when you get up off the table after your first treatment, your pain will have reduced and your movement will have improved. Over the next few sessions, we will capitalise on this and aim to restore full function to your neck within 8-10 sessions, across a period of 8-12 weeks. These time periods are rough estimates and always depend on whether you do your homework with exercise, living well and avoiding potentially aggravating activities for a short time.

Injuries like these are usually the result of many years of poor movement. We encourage you to look long-term with your treatment goals. Injuries that take years to build up will not be undone in a few weeks. Yes, we will get your pain down and your movement up, but to get truly strong and mobile takes months to fully achieve. Our aim will be to get you to that point where the injury is not likely to return once treatment stops and you return to normal daily living.

Neck pain? Call us today 9078 2455 book an appointment.

References
1. Chila, A. et al. 2011. Foundations of osteopathic medicine. 3rd ed. Philadelphia: Lippincott Williams & Wilkins.
2. Snell, R. 2012. Clinical anatomy by regions. 9th ed. Philadelphia: Lippincott Williams & Wilkins.

Injury blog: De Quervain’s tenosynovitis

Hello readers! This month we switch focus to the wrist and hand, and to a condition known as De Quervain’s tenosynovitis (pronounced ‘tee-no-si-no-vi-tis’). This condition affects some of the tendons of muscles that help control thumb movement. It can cause considerable pain and disability.

Anatomy

If you lie your hand flat on a table and spread your fingers (and thumb) as wide as you can, you will notice a small hollowed-out section on the thumb side of the wrist. This region is known as the ‘anatomical snuffbox’. The walls of the snuffbox are made up of two tendons that pass from the forearm to the thumb. These tendons belong to two muscles: the abductor pollicis longus (APL) and the extensor pollicis brevis (EPB). The words abductor and extensor refer to the movements they help the thumb to perform… abduction (taking the thumb away from the palm) and extension (taking the thumb out to the side of the hand). Pollicis refers to thumb, and longus and brevis refer to long and short respectively.

Tendons are cord-like structures that attach muscle to bone. At the point where these tendons pass over the wrist joint, they pass through a thin, tunnel-like structure called a sheath in a smooth and frictionless manner. ‘Tenosynovitis’ refers to inflammation of the tendons and sheaths.

Cause

The cause of De Quervain’s is not completely understood, but it is strongly associated with overuse of the previously mentioned structures. Overuse leads to degeneration of the tissues, and one of the ways the body adapts to these changes is thickening of those affected tissues. This leads to the tendon being trapped within the sheath, which ultimately leads to poor movement and pain. Any activity that leads to chronic overuse of the thumb can lead to the development of this problem. Common activities include playing the piano, fishing and typing. New mothers are regularly affected due to the repetitive action of picking up their baby with thumbs held out from the hand. With the explosion of smart phones and other technologies over the past decade comes a new population of sufferers also… texters! Those people who spend long periods of the day sending text messages and typing on mobile phones are more likely to experience this disorder.

Signs and symptoms

The main symptom of De Quervain’s is painful thumb and wrist movement. Any movement where the thumb moves away from the hand may be painful. The pain is mainly felt around the snuffbox area of the wrist.

Other signs and symptoms include:

  • Restricted thumb and wrist movement
  • Difficulty and pain with gripping objects
  • Pain that radiates up the forearm
  • Swelling over the snuffbox region
  • Popping and clicking of the tendons as they move through their sheaths
  • Weakness of the thumb
  • Tingling and/or pins and needles in the hand

Treatment

In order to get the right treatment for this condition, you must first be diagnosed correctly. Your first port of call should therefore be a consultation with us (your friendly osteopaths!). We are armed to the teeth with ways to treat this sometimes-menacing condition. We may use any or all of the following techniques to help you in the process:

  • Soft tissue release of the tight and/or shortened muscles that help to control thumb and wrist movements. We may massage you all the way from the neck down to the hand during treatment.
  • Mobilisation of the joints. Again, we might focus on joints in the neck, all the way down to the smaller thumb and wrist joints.
  • Stretching of tight muscles during treatment and also as part of a home exercise program.
  • Taping of the forearm, wrist and thumb to decrease pain and improve function of the hand.

Some of the things you can do at home to improve this condition include:

  • Ice or heat pack therapy to increase flow of blood through the region to aid with recovery and decrease pain.
  • Exercise to help strengthen and stretch weak and tight muscles.
  • If in doubt, check all homework by us first – it’s always better to get tailor-made care when injured.

Other forms of treatment include splinting, steroid injection and surgery. These forms are either more disabling to begin with, or more invasive. We always try to take a gentler approach to start and leave these treatments for those instances that do not respond to gentler techniques.

To close…

Do you need help with thumb or wrist pain? Does your job or hobby mean you perform repetitive tasks with your thumbs each day? If this is the case, call us today on 9078 2455 to begin your journey to pain-free movement… and happiness! Now that’s something we’ll give a thumbs up to! 👍🏼

References
1. Physiopedia. 2020. De Quervain’s Tenosynovitis. [Online]. Available from: https://www.physio-pedia.com/De_Quervain%27s_Tenosynovitis. [Accessed 06 Oct 2020].
2. American Academy of Orthopaedic Surgeons. 2013. De Quervain’s Tendinosis. [Online]. Available from: https://orthoinfo.aaos.org/en/diseases–conditions/de-quervains-tendinosis/. [Accessed 06 Oct 2020].
3. Ali, M. et al. 2014. Frequency of De Quervain’s tenosynovitis and its association with SMS texting. Muscles, Ligaments and Tendons Journal. 4 (1). 74-78. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4049654/
4. Oh, JK. et al. 2017. Effectiveness of Corticosteroid Injections for Treatment of de Quervain’s Tenosynovitis. Hand. 12 (4). 357-361. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5484456/

January clean-up

Healthy vegetable smoothie and juice. Selective focus

Looking to start 2021 with a clean slate? This blog isn’t about setting resolutions (although we can always help you do that if you desire), but rather giving you some tips on how to start the new year with a fresh body. The old saying “you get out what you put in” is very accurate. The Christmas break is notoriously full of rich, indulgent food, too much alcohol and not enough moving! Our bodies can cope with this for a short period, but long-term it begins to dislike us. Here’s how to clean-up and give your body the chance it deserves to be its best, for you.

Tips for cleaning-up your act

The following tips are just some of many pieces of advice we could give you to clean-up your act and start feeling alive again:

  1. Eat foods rich in antioxidants

This is a great way to start helping your insides detox. All of those sugary, fatty foods, soft drinks, alcohol and sleepless nights over the festive period will have left your body with a build-up of toxins. Now you need to rid your body of those toxins to begin feeling normal again. Eating foods rich in vitamins and minerals are a great way to increase your antioxidant intake. In particular, try to eat foods rich in the following vitamins and minerals to clean out the system:

  • Vitamin A: Liver, kidney, oily fish (e.g. mackerel), carrots, red capsicum, tomatoes, spinach
  • Vitamin C: Chilies, kiwi fruit, citrus fruits, guava, mangoes, papaya
  • Vitamin E: Almonds, hazelnuts and peanuts, sunflower seeds, corn and wheatgerm oil
  • Copper: Nuts, cereals, meat and organ meats (i.e. liver and kidney)
  • Zinc: Lamb, shellfish, leafy green and root vegetables, milk, eggs, whole grains
  • Selenium: Brazil nuts, poultry, fish, eggs, meat and organ meats (examples above)
  • Drink water, water, and more water!

Water is life-giving. Without it, we die within 3 days (depending on the person). That’s a pretty scary thought. Our bodies are also somewhere between 60-70% water, and they rely on us to replenish our water stores regularly and daily. All of the internal chemical processes that occur in our bodies (without us even knowing they are happening) require water for them to occur. When the body is low on water, these internal processes begin to struggle, and we begin to feel pretty terrible. Water is purifying for the body and it’s a pivotal part of any clean-up or detox (whatever you want to call it). We don’t think we need to give you any more reasons for drinking lots of water every day, so get to it. To help the system a bit more, reduce the amount of caffeinated, alcoholic and sugary soft drinks you are consuming and try to concentrate on just water. Your body will love you for it.

  • Exercise daily

What better way to purify the body than literally sweating it all out!? Get into an exercise routine for the new year, or just pick up where you left off if you slumped a bit over Christmas. If you’re not a fan of jogging, running or gym-going, then consider swimming. Swimming is great for the whole body and gives the joints a rest from high impact experienced in running or lifting weights in the gym. And if you can find yourself a lovely warm salt pool or natural ocean or rock pool, then your skin will also benefit from the cleansing action of the saltwater. If you’re not up for swimming, then try a walk a day. A stroll in the park surrounded by lots of green trees is great for the mind, body and soul.

We don’t want to overload you with stuff to try, so we’ll leave it there for now. Give some or all of these a go and come and let us know how you feel after a few weeks. We think you’ll love the results!

Happy New Year! Oh… and now would be a great time to come see us for a new year full body check! You know what to do…

References

1. Webster-Gandy, J. et al. 2012. Oxford handbook of nutrition and dietetics. 2nd ed. Oxford: Oxford University Press

Quick workouts for Christmas

Christmas time is just around the corner, and that can mean only one thing… Life is about to reach a whole new level of hectic! Between work Christmas parties, food and present shopping, catching up with relatives and friends (COVID permitting of course!), wrapping, cooking, eating, drinking… all whilst trying to maintain some level of sanity, there isn’t much room for anything else!

We all tend to indulge and consume probably a few too many calories over the Christmas period. It seems to be ingrained in society that it’s the done thing. Now, as health professionals we are all about promoting just that… Health. We are all for a little indulging every now and then, but over Christmas it can be easy to overdo it and then lie around like sloths all day watching re-runs on TV. One of the beautiful things about being an osteopath is being able to make a difference to our patient’s lives in many different ways. As well as all of the hands-on stuff we do with you, we also give advice on lifestyle, diet and nutrition, relaxation and exercise. So, if you don’t want to see the waistband expand too much over the festive period, we suggest countering the odd indulgent episode with an awesome workout to ensure you stay flexible, strong and that little bit healthier this December and January.

What follows are some quick-fire workouts to fit in around your busy Christmas schedule, to really get the heart rate up and the waistline down. We strongly suggest making an appointment before carrying out any exercise program to ensure they’re the right fit for you. Whilst these exercise regimes are quite straight forward and achievable by many, they may need tweaking for you depending on your fitness level and injury state. So please ‘exercise’ caution.

Workout 1

Your exercises are as follows:

  1. Step ups: Find a sturdy bench, chair or step and put one foot onto it. Step up and drive your opposite knee up towards your chest into the air. Return down to the starting position and repeat. Stay on the same leg until all repetitions have been completed, and then switch sides.
  2. Sumo squats: Stand with your feet and knees wide with toes pointing out on a slight diagonal.. Squat down until your knees reach a bend of 90 degrees, tracking in the direction of your toes. Return to the start position and repeat.
  3. One leg L-sits: Sit upright with your legs out straight in front of you. Put your hands on the ground next to your hips and raise your body off the ground. Holding that position, raise one leg off the ground about the height of your shoe or foot. Slowly lower and repeat. Stay on the same leg until all repetitions have been completed and then switch sides.

Cycle these exercises completing each for 10 reps, 8 reps, 6 reps, 4 reps and 2 reps. Rest for one minute between each set.

Workout 2

Your exercises are as follows:

  1. Mountain climbers: Assume a plank position on your hands (like you’re about to do a push-up). Keeping your arms straight and upper body as still as possible, bring one knee in towards your chest without raising your hips into the air. Return to the start position and repeat, alternating between legs for each rep. Try to keep your form while speeding this movement up, and keep a solid rhythm going to really get the cardio aspect of this exercise going. Perform for 30 seconds.
  2. Skipping: Using a skipping rope, continuously skip for 45 seconds. If the rope hits your legs or you have to stop and restart, this is fine. Keep going until the 45 seconds are up. Knee issues? Choose a low-impact version by doing knee lifts or side steps.
  3. Get-ups: Lie on your back and get yourself to standing position any way you can. Lie back down and repeat. Complete 60 seconds of these.

Rest between exercises for 15 seconds, but ensure you move straight on to the next exercise as soon as the 15 seconds are up. Try to complete three sets.

Workout 3

  1. Run or jog around the block or a small local park at least twice
  2. Run up and down a set of stairs five times
  3. Go for a long walk to cool off

If you cannot run or jog, try cycling instead. Cycle around the block five times though! You can also walk up and down the stairs ten times if running is an issue.

Workout 4

Hold a plank for 5 minutes. You may rest whenever you need to, but ensure you complete 5 whole minutes. Set a timer on your phone!

To adopt the plank position, get on the floor face down. Grasp your hands together and push up, elbows shoulder-width apart, so you are resting on your forearms. Raise up onto your toes and lift your whole body up into the air. Keep your legs and body in a straight line from head to heels and avoid pushing your bottom up into the air (see photo).

That’s a total of four workouts for you to try. A good way to start is to perform a workout on one day, then aim to perform your next workout after one or two rest days. Eventually you will be able to perform them closer together, but rest days allow time for the body to repair and recuperate.

If you are unsure about any of the exercises above, please do not hesitate to get in touch. Enjoy your healthy Christmas everyone! And remember, call us on 90782455 today to arrange your pre-Christmas appointment, and we can tailor a program just for you!

Healthy foods to sneak onto the table this Christmas

It’s approaching the end of the year, and we’ve been filling your inboxes with lots of tips on how to stay healthy every month throughout 2020. Well, why stop there?! December is a notoriously tough month for foodies with a vast array of unhealthy foods including cakes, chocolate and sweets filling the shopping aisles and restaurant menus. But Christmas doesn’t have to be so unhealthy. We wouldn’t’t be doing our job as osteos if we didn’t give you a bit of dietary advice to ensure your festive season doesn’t leave you feeling rock bottom come January.

We’ve compiled a list of super healthy foods that you can try and sneak on to the dining table this Christmas to ensure the whole family get a nutritious boost, to counter some of those naughty calories that are likely to make it in their bellies this season.

Turkey

We’ll start with one for the meat eaters. If you’re looking for a healthy option for the table on Christmas Day, then turkey is a great choice. Many people opt for chicken when it comes to a roast dinner, but both birds hold similar nutritional values when it comes to protein, fats, vitamins and minerals. Turkey meat, especially white turkey meat, is slightly leaner than white chicken meat, and is overall less calorific. Every little bit helps!

Cranberries

What goes better with turkey than cranberry sauce? Nothing, right?! It’s good to know that cranberries are super healthy, like all berries. We’re going to give you a tip though… Make your own sauce! Yes, it will take longer than going to the supermarket to buy it off the shelf, but the end result will be so much more satisfying, and healthy! Sauce from the supermarket is loaded with sugar and preservatives. Buy them fresh, search out a recipe online and get cooking up a storm. You can choose to put in less sugar and end up with a tasty sauce to accompany your meat that is full of vitamins and minerals. Boom!

Sweet Potato

If you’re anything like our households, there will probably be various types of potato hitting the tablecloth… Mashed, roasted, dauphinoise (ooh, fancy!). How about substituting your normal potatoes with sweet potatoes? The sweetness of sweet potatoes brings any plate of food alive without the need for lots of butter, which we know is not great for the arteries. Mash or roast like you would a normal potato. These potatoes are excellent sources of fibre and antioxidants, including beta-carotene which is vital for good brain, skin, hair and eye health. No brainer! Or should we say, big brainer!

Chestnuts

These roasting on an open fire with Jack Frost nipping at your nose… Nat King Cole hits the nail on the head with this one. Chestnuts are Christmas in a food (see photo), and if you haven’t tried them before, this year is the year! Chestnuts are low in saturated fats and high in fibre and taste amazing! Crumble them over your stuffing or add them to your carrots or brussels sprouts to give them a lovely crunch. These will help keep the bowels moving on those lazy days.

Give these a try and you’ll ensure Christmas stays healthy this year. There are so many foods to bring to the table. Keep the table full of healthy fruits and vegetables all season and you can’t go wrong. And remember to drink water! Lots of water. Pretty please!

Stay safe everyone and have a wonderful time!

References

  1. Healthline. 2018. Turkey vs Chicken: Which Has More Protein? [Online]. Available from: https://www.healthline.com/nutrition/turkey-vs-chicken. [Accessed 04 Nov 2020]
  2. Better Homes and Gardens. 2015. 6 Holiday Superfoods. [Online]. Available from: https://www.bhg.com/recipes/healthy/eating/holiday-superfoods/. [Accessed 04 Nov 2020]
  3. Jamie Oliver. 2015. 12 days of Christmas super food. [Online]. Available from: https://www.jamieoliver.com/features/christmas-super-foods/. [Accessed 04 Nov 2020]

The thyroid gland

Thyroid issues? Have you been told by your doctor that you have a dysfunctional thyroid gland? This tiny little organ packs a massive punch when it goes wrong. It’s a very complex gland that carries a lot of responsibility on its shoulders. We’ve created a brief ‘get to know your thyroid’ blog to help you understand the role of the thyroid gland in everyday life.

What is the thyroid gland?

The thyroid gland is a small (approximately 5 cm long) organ that produces, stores and releases thyroid hormones into the bloodstream to be sent around the body. It is made up of two lobes (left and right) and a central core (known as the ‘isthmus’) that connects the two lobes. When looked at from the front, the organ takes on a distinctive butterfly shape. The organ tissue is made up of many glands where the hormones are made and secreted.

Where is it located?

The thyroid gland is found at the front of the neck. It can be found below the Adam’s Apple – a prominent piece of cartilage that is easily felt in men, but not as easily in women. Sometimes with thyroid disease, the thyroid gland expands to create a lump at the front of the neck known as a ‘goitre’ (or goiter, pronounced ‘goy-tur’). This is a common sign of thyroid disease and highlights the location of the gland in the body.

What does it do?

As previously mentioned, the thyroid produces, stores and releases thyroid hormones into the body. There are two thyroid hormones:

  • T3 (or Triiodothyronine)
  • T4 (or Thyroxine)

It’s easier to just remember these as T3 and T4. The scientific names are a bit of a mouthful, aren’t they! These hormones are made using a substance called iodine, that the body obtains from foods that we eat. Between the brain and the thyroid gland itself, the levels of T3 and T4 are closely monitored and maintained in balance. If levels of these hormones in the blood become too low or high at any one-time, other glands in the brain send the thyroid a signal to produce more or less, respectively.

T3 and T4 have some very important roles in the body relating to metabolism (i.e. how the body uses energy). Among their many functions, some of the most important include the control of:

  • Breathing rate
  • Heart rate
  • Body weight and temperature
  • Muscle strength
  • Menstrual cycle (in females)
  • The body’s nervous systems

What can go wrong with it?

There are several conditions relating to thyroid disease. As a general overview, it is helpful to think about the organ as being either over-active or under-active:

Over-active thyroid disease or ‘hyperthyroidism’ refers to a state where the levels of thyroid hormones in the blood are too high. This can lead to a group of symptoms including:

  • Weight loss (despite a good appetite)
  • Fatigue
  • Increased sweating
  • Heat intolerance
  • Nervousness and anxiety
  • Tremors
  • Diarrhoea
  • Heart palpitations / increased heart rate
  • Hair loss

Under-active thyroid disease or ‘hypothyroidism’ refers to low levels of circulating thyroid hormones. This can lead to a group of symptoms including:

  • Weight gain
  • Fatigue
  • Cold intolerance
  • Muscular aches and pains
  • Constipation
  • Low heart rate
  • Dry hair and skin
  • A slow, deep voice

It is interesting to know that the presence of a goitre is possible in both over and under-active thyroid disease.

As an osteopath, we take a keen interest in your health as a whole, including an in-depth knowledge of your medical history. Many people see us for help with pain, but as we’ve just highlighted, pain is not always about muscle damage or joint sprain. Having unbalanced thyroid hormone levels can also lead to pain in certain cases. If we suspect a thyroid issue when we are questioning and assessing you, we will ensure you are seen by your doctor at the earliest convenience to help rule it in or out. If you have questions about any aspect of your body, feel free to ask us at any time. Give us a call on 9078 2455 to have all your questions answered!

References

  1. InformedHealth.org. 2018. How does the thyroid gland work? [Online]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279388/. [Accessed 06 Oct 2020].
  2. Brady, B. 2019. Thyroid gland: overview. [Online]. Available from: https://www.endocrineweb.com/conditions/thyroid-nodules/thyroid-gland-controls-bodys-metabolism-how-it-works-symptoms-hyperthyroi. [Accessed 06 Oct 2020].

Safety at work

The great thing about Osteopathy is that it’s not just about ridding people of their pain. It is a way of life. Yes, people come to see us to get rid of pain, but once they are in our caring hands, our work doesn’t stop there. We are huge advocates of ‘prevention is better than cure’. So, we will delve deep into your life – your diet, sleep patterns, hobbies, job and more. We look at you and your life as a complete package and will help you work out what areas need adjustments so you can live a long and healthy life (which is as pain-free as possible!).

Work is a big part of most people’s lives and is often a significant contributing factor to their pain. This month we’re giving advice on two key areas to ensure you are looking after yourself at work, so you can avoid injury and keep food on the table. All in the name of ‘National Safe Work Month’! Read on to ensure you are giving yourself the best possible chance of staying injury-free at work.

Lifting posture

We see lots of people coming in for treatment because they have hurt their back, neck or shoulders in a lifting-related incident. Our advice for you…

  1. Plan ahead to make sure you have a clear path from A to B for the object you are carrying. Make sure the object is stable and is not going to topple over whilst you are carrying it.
  2. Get close to the object and with your feet hip-width apart, and whilst keeping a straight back, bend at the hips and knees to get low to the ground (key words here – “STRAIGHT BACK”!).
  3. Ensure you have a firm grip of the object and whilst keeping your back straight (there it is again!), lift from your hips and knees until you reach an upright position.
  4. Always move using your feet rather than twisting or leaning through your back.
  5. Always keep the object close to your body. Never try to hold it out in front of you with your arms, as this places a great deal of stress on your shoulders, neck and back.
  6. Always get help from another person(s) if the object is too heavy for you alone. It is NEVER worth the risk of injury by tackling a task that may be slightly beyond your physical capabilities.

Desk set-up

Postural strain from a seated desk job is another common work-related injury we treat. To ensure you are sitting pretty, our advice to you is…

  1. Ensure the top of the screen is level with or just below the level of your eyes, and centred in front of you.
  2. Sit with relaxed shoulders, elbows bent at 90 degrees and avoid cocking the wrists back when typing (adjust your desk height to suit this if possible).
  3. Adjust the tilt of your chair to allow the hips to sit at an open angle of 100-110 degrees.
  4. Adjust the backrest of the chair to ensure you are supported in an upright position whilst seated.
  5. Avoid slouching back on to your tailbone. Instead, gently roll your pelvis forward to sit on your sitting bones and bring the curve of your low back into its natural position.
  6. Take regular breaks from sitting. Get up out of your chair every 30-45 minutes to allow your body to move and stretch.

So there you have it. Our skills are much more than just our hands. We’re full of good advice! No matter what job you do, we’ll help you break it down to make sure you are getting the most out of it and not putting yourself at risk of a workplace injury. Here’s to a happy workday, every day!

References

  1. Employsure. 2019. Reduce the risks associated with manual handling. [Online]. Available from: https://employsure.com.au/blog/reduce-risks-associated-manual-handling/. [Accessed 21 September 2019].
  2. The University of Western Australia. 2016. Computer workstation ergonomics. [Online]. Available from: http://www.safety.uwa.edu.au/topics/physical/ergonomics/workstation. [Accessed 21 September 2019].
  3. Safe Work Australia. 2019. National safe work month. [Online]. Available from: https://www.safeworkaustralia.gov.au/national-safe-work-month. [Accessed 21 September 2019].

Osteo Arthritis: aging and your body

Hello readers and welcome to October’s blog post! This month we are turning our focus to the elderly – an ever-growing population. Did you know that there are approximately 700 million people in the world aged 60 and over? And did you know that it is estimated that by 2050, there will be around 2 billion people on the planet that fall into this age bracket? That’s just over 30 years away! That’s quite difficult to comprehend, but with people beginning to work and live longer, it’s important that the elderly population get the attention and care they need to stay healthy and active; so they can enjoy the quality of life they deserve.

You might think that as people get older, they become less active and therefore are less likely to injure themselves. This may be true to a degree, especially once reaching retirement age, but the elderly population are generally an active population and are just as much at risk of injury as the next person. A 60-year-old person might not play footy or run around the basketball court as much as a teenager might, but they have other things to contend with – an ageing body with years of gradual degenerative change and weakening that we all experience at some point as we go through life. One of the most common causes of injury in the elderly is falling. Unfortunately, as the body ages, it becomes more prone to falls. This usually boils down to a combination of individual factors (i.e. having multiple diseases, poorer eyesight, or general weakening of the body) and environmental factors (e.g. trip hazards around the home setting). Some of the most commonly seen injuries sustained from falls include fractured hips, arms and forearms, cuts and lacerations, as well as head injuries.

In a clinical setting, us osteos see our fair share of older patients. It’s less likely we’ll see someone in the acute setting immediately following a trauma like a cut, laceration or in many instances where a fracture is suspected, but it does happen. It is much more likely however, that we will see patients experiencing pain related to postural strain (think about the retiree who sits around a lot), or from degenerative changes in the body. A common degenerative condition affecting the elderly population is osteoarthritis (OA). This most commonly affects the joints in the hips, knees and spine – particularly those of the neck and lower back. It’s no coincidence that these are the main weight-bearing joints of the body.

So what is OA?

OA is a condition affecting the synovial joints in the body (the joints between two bones in the body that have a lubricating fluid between them). It is characterised by changes to the cartilage and underlying bone, as well as inflammation and irritation to the soft tissues that help to hold the joints together – known as the synovium – it’s the tissue that forms the lubricating fluid that sits between the joints.

Primary OA refers to changes in the joints that relate to the ageing process. It will often run in the family, so if your granny or dad has it, you may be more at risk to develop it. Secondary OA is arthritic change from any other cause. For example, following on from trauma, repetitive stress, poor posture, or from diseases such as gout.

Signs & symptoms

The main symptoms (things the person experiences) of OA include pain, stiffness, poor joint function and muscle weakness. Signs (things we look for in the clinical setting) that a joint is degenerated include popping and clicking, poor range of motion, bone and joint swelling, deformity and instability.

What to do if you have or think you have OA

First things first, book an appointment to see your local osteo. After questions and assessment, we’ll get to work on your body and putting you on a pathway to moving better. There is a good chance your arthritic joint is paining you because you aren’t moving well, and the joint is being loaded incorrectly. The good news is, we know how you should be moving, and what needs to be done to get you there. We’ll aim to reduce your pain down by releasing tight and over-worked muscles and mobilising your stiff joints. Mobilising the joints helps to increase range of motion and will help promote production of the lubricating synovial fluid that sits between the joints to allow smooth fluid movement. You should get off the treatment table feeling less pain and moving better. There is a good chance you’ll need to do some form of strengthening to the surrounding weakened muscles, so the joint is more supported when you move it. More good news, we know which exercises will be beneficial to get you on the path to stronger muscles. Unfortunately, we cannot claim to cure your OA, but we can certainly get you moving with less pain or in an ideal situation, no pain at all.

What’s the outlook with OA?

More often than not, if caught early, significant changes can be made to stunt the progression of this degenerative condition. So, don’t ignore pain, it’s your body’s way of telling you something isn’t right. With early treatment, the best possible outcome will be achieved. If you pop into the clinic and we determine your issue is not OA-related, we can provide you with a sense of relief and get you on the right track for your situation (a positive outcome, either way!). In severe cases, you may require the opinion of a specialist orthopaedic surgeon. Sometimes people require joint replacements and can go on to live a very good quality of life with a new hip or knee for example. Always see your osteo first though. Using our skills, we can possibly keep you from having to go under the knife a bit longer, and maybe even at all. Worth a shot don’t you think?!

References:

  1. United Nations. 2019. International day of older persons – 1 October. [Online]. Available from: https://www.un.org/en/events/olderpersonsday/. [Accessed 04 Sept 2019].
  2. Medscape. 2017. Falls in the elderly: Causes, injuries, and management. [Online]. Available from: https://reference.medscape.com/features/slideshow/falls-in-the-elderly#page=1. [Accessed 04 Sept 2019].
  3. Arthritis Australia. 2019. Osteoarthritis. [Online]. Available from: https://arthritisaustralia.com.au/types-of-arthritis/osteoarthritis/. [Accessed 04 Sept 2019].

Injury blog: Plantar fasciopathy or fasciitis

Image x-ray of a feet with red pain

It’s morning, and the alarm clock has just told you it’s time to get out of bed. Another few minutes won’t hurt. You check your emails, social media sites, and you even ring your mum to see how the dog slept last night… basically anything to delay putting your feet on the ground and taking those first steps to get the day started. And it’s because of this pain you’ve been getting on the bottom of your heel every morning for the last few weeks. And it’s getting worse… Time to see your osteopath!

There are a few things that can cause pain on the bottom of the heel, but the most common cause is a condition named plantar fasciopathy (pronounced ‘fash-ee-op-a-thee’ — previously known as plantar fasciitis (pronounced ‘fash-ee-i-tis’)).

What is plantar fasciopathy?

Plantar fasciopathy is an overuse condition affecting the plantar fascia. The plantar fascia is a layer of soft tissue that stretches along the bottom of the foot, from the heel bone to the metatarsal bones in the front of the foot. It helps to provide stability to the arch of the foot and is similar in make-up to a tendon (the things that attach muscle to bone). If too much stress is placed on this structure, over time the tissue can degenerate, weaken, and start to give you pain. The pain is commonly felt where the plantar fascia attaches into the heel bone.

Risk factors

Scientific research suggests there are a few groups of people who are more prone to developing plantar fasciopathy. These include:

  • Runners
  • People who are over-weight and lead a sedentary lifestyle and/or spend long periods standing for work (e.g. a factory worker)

Important things to consider with these at-risk groups include:

  • Foot alignment and arch height: Having a very low or high arch or having excessive or not enough movement in the foot joints can lead to the development of this problem.
  • Amount of training: Increased levels of training can place greater stress on the plantar fascia more regularly.
  • Footwear: Wearing certain types of footwear when training can lead to an increased risk of plantar fasciopathy (i.e. wearing athletics spikes, or the wrong footwear for your foot type).
  • Muscle strength and flexibility: Decreased strength in the muscles that control toe movement, as well as weakened and tight calf, hamstring and gluteal muscles are all associated with higher rates of plantar fasciopathy.

Signs and symptoms

The signs and symptoms of plantar fasciopathy include:

  • Pain at the bottom of the heel
  • Pain that appears as a gradual onset
  • Pain felt first thing in the morning (i.e. taking those first steps out of bed in the morning is classic!)
  • Pain that decreases with activity, but increases again afterwards (early stages)
  • Pain that increases with activity and pain felt at night (latter stages)
  • Pain felt after periods of prolonged rest during the day (i.e. being sat at your desk for 2-3 hours and then getting up again)
  • Tight calf, hamstring and gluteal muscles
  • Weak muscles that help to support the arch of the foot
  • Stiff or over-flexible foot and ankle joints

Diagnosis and treatment

First things first, if you have heel pain that sounds similar to the picture we have painted above, make an appointment with us now (you know what to do… call us on 9078 2455 Once we have asked the relevant questions, performed the necessary tests, and are convinced that  the issue stems from the plantar fascia, we will formulate a plan with you with short and long-term goals to reach within a set time.

Initial hands-on treatment will include a combination of massage, joint mobilisation and manipulation, and dry needling of the lower limb muscleswith the aim of correcting any mechanical issues that are playing a role in this issue. Depending on the presentation, we may also use tape around the foot and ankle to provide support and reduce the stress being placed on the tissues. Other treatment will include advice on weight loss (if required), training regimen, footwear, and exercise prescription that helps to lengthen and strengthen tight and weak muscles. Some cases of plantar fasciopathy may require a foot orthotic or in-sole to provide extra support to the foot whilst wearing shoes. We can advise on footwear too!

Plantar fasciopathy is a tricky condition to treat which may require ongoing treatment for several months. We will endeavour to get you pain-free in the shortest time possible, so we recommend following all advice to a T, which may include a reduction in the amount of training you are doing at present. When you start to hit goals and we see improvements being made, we’ll have you back up to your full training program before you can say “plantar fasciopathy”.

Imaging?

People regularly ask if they need imaging for such an issue, but the majority of cases of plantar fasciopathy can be diagnosed with a thorough case history and physical assessment. This is where we excel! Imaging is there for cases that do not respond to treatment and for those instances where we need to rule out a more serious problem.

If you need help with heel pain, please call us today on 9078 2455 to book your appointment. Let’s have you putting your best foot forward, ASAP! 👌