Archview Physiotherapy Blogs

Pelvic Malalignment

Written by Amanda Olsen

Did you know that your pelvis can go out of alignment? It occurs more often than you’d think, and can be a cause of certain ailments/pain OR can be the result of other issues occurring in your body.

A general overview of the anatomy of the pelvis…
– The pelvis, or “the pelvic girdle” is made up of three components: the two hip bones (the ilia), the sacrum, and the coccyx (your tail bone).
– The area where the sacrum meets the hip bone (ilia) is called the sacroiliac joint (dimples at low back).
o This is the most common place for dysfunction to occur in the pelvis – this joint can also refer pain into the low back
– These three components are held together by many ligaments and muscles

What happens?
– Whether due to a sudden traumatic experience (i.e. car crash, landing forcefully on one leg) or a prolonged onset from muscle imbalances, the pelvis can become mal-aligned
– The different types of mal-alignment are:
o Upslip: one hip is higher than the other
o Forward/backward rotation: one side of pelvis is either more forwards or more backwards than the other side
o Inflare/Outflare: one side of pelvis either flares out from mid-line more or more towards mid-line more than the other side
o Leg Length Discrepancy: one leg may be longer than the other because of a forward rotation of the pelvis on the side of the longer leg
o Sacral torsion: the sacrum is tilted or rotated more to one side

Signs & Symptoms:
– Pain at site of sacroiliac joint (dimples of low back)
– Low back pain
– Buttock pain
– Feeling “off kilter” or “out of balance”

How physiotherapy can help:
– Your physiotherapist will carry out several tests and measures to determine if you have a pelvic mal-alignment that could be causing your current symptoms
– If a mal-alignment is confirmed, the following things can be done for it:
o Muscle Energy Techniques: there are a few, but the one specific to your findings is the one that will be used – this helps get the pelvis back into alignment
o Dry Needling: if muscle tightness is causing the mal-alignment then dry needling will help loosen it out and its hold on the pelvis will be released
o Trigger point/myofascial release: alternative to dry needling where the therapist’s hands are loosening out the muscle and connective tissue around it
o Exercises: specific exercises will be given to you based on what the findings are, and are tailored to keep the pelvis in its corrected alignment

Having a pelvic mal-alignment can create a knock-on effect to the back, hips, knees, and feet. So if you are experiencing any of these, it’s possible that your pelvis needs to be corrected!

Pelvic bones
Pelvic mal-alignment
Skeleton mal-aligned

Importance of warm up and cool down

Written by Alison Yeung

Importance of Warm Up and Cool Down

As winter draws near and temperatures drop, the importance of a warm up before exercise and a cool down after exercise cannot be understated.  Although most people know that warming up is a normal practice before beginning a workout, it is tempting to skip a warmup or cooldown if time is limited.   However, this article explains why warming up and cooling down the body is essential for preventing injuries and optimizing performance.

Why Do We Need to Warm Up?

The purpose of a warm up is to literally warm the muscles of the body so that they are prepared to stretch during exercise movements.  If the muscles are not warm, then rigorous exercise can cause muscle strains or ligament/ tendon tears.  In addition, performance in your workout or sport can be hindered without a proper warmup, since the muscles would be less able to move through certain ranges of motion.

How Do I Warm Up?

Although your warmup will depend on what kind of workout or sport you are doing, there should always be a cardio aspect to gradually increase the heart rate and increase the core temperature.  5-10 minutes of light cardio is sufficient.  Some examples of cardio warmups include:

  • Skipping rope
  • Jumping jacks
  • Jogging (can be in place)
  • Speed walking
  • Light elliptical
  • Cycling

In addition to increasing your heart rate, it is beneficial to warm up any specific movements you may be doing in your workout or sport.  This will help prevent injury because the ranges of motion you go through during exercise might be different than the ranges of motion you use for activities of daily living.  For example, if you are about to squat heavy weights, doing squats with no weights first will help your body attune to the movement and focus on form before you lift a heavier load.  If you are about to play football, warming up with agility and speed drills will help your fast twitch muscles “wake up” and be ready for quick movements during the game.

Lastly, you can do warmup exercises for specific muscles that you want to activate during your workout.  For instance, if you are doing squats, you might want to do some glute-firing exercises beforehand, so that those muscles are more likely to be activated as you squat during your workout.

Why Do We Need to Cool Down?

After an intense workout, your heart rate is elevated and your core temperature is high.  Even after a low-intensity workout or sport, certain muscles that are used repetitively during the activity are tight by the end.  Thus, it is important to cool down to bring the body temperature back to normal and counteract any tension on the muscles.

How Do I Cool Down?

Immediately after an intense cardio workout, a cool down should start with some light movements such as walking or side stepping back and forth.  This gradually decreases the heart rate, prevents dizziness, and prevents blood from pooling in the veins.[1]

Stretching is also imperative after exercising. Static stretches (stretches that are held in one position) are good for counteracting the shortening of muscles after repetitive use in a workout.  For example, runners should take care to stretch their quadriceps, calves, hamstrings, hip flexors, IT bands, and glutes after running.  Lying spine twists are also helpful in stretching the lower back.  Golfers may want to stretch their lower backs because of the constant rotational motion of the sport, as well as their hip flexors and calves from all the bent over stances and walking.  Ultimately, you want to be doing stretches for the muscles that you used the most in your exercise.  This will assure that those muscles do not shorten or build up tension that could limit your range of motion or cause injury.  Make sure to hold each stretch for at least thirty seconds, and be careful to not overstretch; you should feel a gentle pull on the muscle but never pain.

Moreover, although it can seem time-consuming and boring to warm up and cool down, both practices significantly improve your body’s movement and protect your body from injury.  It is worth it to take those extra 5-10 minutes before and after your workout.  Your body will thank you in the long run!

group doing stretches to warm up and cool down

Fibromyalgia and Reflexology

HOW DO YOU SURVIVE WITH FIBROMYALGIA IN WINTER?

REFLEXOLOGY CAN HELP YOU!

Written by Susana Palazzotti

Fibromyalgia refers to a group of non-articular rheumatic common disorders characterised by pain and stiffness of varying intensity of the muscles, tendons and surrounding soft tissue. Although the outcome of the general physical examination is usually normal people look healthy, a careful examination of the muscles of people with fibromyalgia, reveals the touch sensitive areas in specific places called tender points.
Winter is probably the most feared season by people with painful chronic conditions like fibromyalgia, since climate change can increase the pain and, in turn, impact the mood.
There are several theories about why  winter increases the pain, for example:
–  Change in the sleep cycle and internal clock (circadian rhythm)
-The body creates more pro-inflammatory cytokines (proteins consider the bosses of immune system)
-During the winter many people experience seasonal affective disorder, a type of depression that could also increase the pain.
-The muscles are tightened more in the cold.
– People avoid going outside, so that you have less physical activity and worsens the condition.

In a small study of 10 fibromyalgia patients who were treated with reflexology twice a week for five weeks , the researchers found definite improvement in the symptoms of the ten patients , no side effects. Patients undergoing regular treatments reflexology report an improvement in : -Myofascial pain, headaches, tenderness and tightness in my muscles.-Mental Clarity-Irritable bowel syndrome-Fatigue-Sleep disorders-Depression

If you have fibromyalgia and suffer a lot of pain in this time, Here are some  practical tips to help you survive the winter:
1. Keep yourself warm. There are some items that you can use in your daily life and allow you to control the pain by cold winter. e.g electric blanket.
2. Keep moving. Exercise is one of the best ways to keep controlled the symptoms of fibromyalgia, and quitting can make them worse. Look for a plan of exercises you can do, such as yoga or Pilates .
3. Use wool. Wearing woolen clothes, woolen bedding can significantly reduce the pain of fibromyalgia. Make sure you are dressed warmly in winter.
4. Try to have a shower at night.  Just before you get to bed so that you stay warm.
5. Keep your home well lit. If you are a person who suffers from seasonal affective disorder, this can help you a lot.

Reflexology can be done as part of a full body massage, or as an independent treatment. Treatments usually last about 60 minutes. Make an appointment with our expert reflexologists.

reflexology for fibromyalgia
fibromyalgia

Physiotherapy for headaches

Written by Carol Hopkins

There are a couple of different classifications of headaches. This blog hopes outline each type and how physiotherapy may be able to help you. It is very important to see your GP if you regularly suffer from headaches, if this is your first headache, or if this is your worst headache yet.

Tension Type Headaches (TTH)

This type of headache can be either episodic which means you have less than 15 days a month or they can be chronic meaning you experience more than 15 days a month. These headaches can last anywhere from 30 minutes to 7 days. People often describe them as a bilateral pressing or tightening head pain with no significant associated symptoms. Along with this people often have tenderness in their neck and shoulders.

Cervicogenic Headaches

This type of headache is often secondary pain felt in the head from a source in the neck. This pain is often felt on one side of the head. There is often no pattern of frequency, severity, duration or any associated features. There may also be a history of neck trauma or poor posture.

Migraine

This type of head pain is different as it is a disorder of the central nervous system resulting in pain & neurological symptoms. There can be a genetic predisposition to migraine. Attacks normally last 4-72 hours. This pain is also often felt on one side of the head and described as a pulsating, moderate to severe pain. Sufferers can also experience associated symptoms such as, nausea or photophobia.

Physiotherapists commonly see TTH and cervicogenic headaches. There are 20 muscles that refer pain to the head. Your physiotherapist will use techniques such as soft tissue and trigger point release, dry needling, exercise rehabilitation and massage along with others to treat the headaches.

If you are experiencing any of the above please contact us on 01-4913228 for an appointment with one of our Chartered Physiotherapists. If you would like more information on types of headaches and the treatments available you can also contact Migraine Association of Ireland.

lady with neck pain
woman with headache

Parkinson’s Disease

Written by Titus Selvaraj

Role of physiotherapy in Parkinson’s disease

 Parkinson’s disease (paralysis agitans / shaking palsy) is a slowly progressive neurologic disease that is characterized by a fixed inexpressive face, tremor at rest, slowing of voluntary movements, gait with short accelerating steps, peculiar posture and muscle weakness (caused by degeneration of an area of the brain called the basal ganglia), and low production of the neurotransmitter dopamine.

Approximately 9,000 people are with Parkinson’s in the Republic of Ireland. The WHO estimate that in the next thirty years the incidence of Parkinson’s will double. It is commonly seen in population over 50, but at least 10 percent are under 40.

Main symptoms of Parkinson’s disease are:

  • tremor, shaking, or trembling
  • slowed movement
  • stiff or rigid arms, legs, and trunk
  • balance trouble that can lead to falls

Other symptoms that are common in Parkinson’s (not everybody will have all of them) include:

  • abnormal walking
  • decreased arm swing
  • excessive salivation
  • feelings of depression or anxiety
  • increase in dandruff or oily skin
  • lack of facial expression (hypomimia)
  • less frequent blinking and swallowing
  • lowered voice volume (hypophonia)
  • slight foot drag
  • small cramped handwriting (micrographia)
  • stooped posture
  • trouble sleeping
  • constipation
  • generalised body pain
  • decreased sense of smell
  • tiredness

Depression is common in people with Parkinson’s. Psychotic symptoms, such as visual or auditory hallucinations, may occur in up to 50% of cases.

 

Physiotherapy Goals

  • Maintain and improve levels of function and independence, that helps to improve a person’s quality of life
  • Use exercise and movement strategies to improve mobility
  • Correct and improve abnormal movement patterns where possible
  • Maximise muscle strength and joint flexibility
  • Correct and improve posture and balance to minimise risk of falls
  • Maintain good breathing pattern and effective cough
  • Educate the person with Parkinson’s and their carer or family members
  • Enhance the effects of drug therapy

Our physiotherapists play a vital role in supporting people with Parkinson’s to choose management strategies, prioritise and address the challenges they face over the course of the condition.

During the earlier stages of diagnosis, greater emphasis is placed on education and self-management. The individual should be encouraged to continue being active and participate in physical exercise for as long as possible. Significant respiratory complications develop in many people as Parkinson’s progresses, so attention is paid to monitor and manage encroaching weakness of respiratory muscles and rigidity of the thoracic cage.

Physiotherapy Management includes:

 Visual cueing

  • Auditory cueing
  • Proprioceptive cueing
  • Dual task training
  • Intensive sports training
  • Treadmill training with body weight support
  • Resistance training
  • Aerobic exercise

Benefits of exercise in PD?

Exercise can benefit in two ways:

Symptom management.  Research has shown that exercise can improve gait, balance, tremor, flexibility, grip strength and motor coordination.  Exercise such as treadmill training and biking have all been shown to be beneficial.

Possibly slowing disease progression.  Improved mobility decreases the risk of falls and other motor complications of Parkinson’s.

How can you benefit from exercise?

The best way to achieve these benefits is to exercise on a consistent basis. People with Parkinson’s enrolled in exercise programs with durations longer than six months, regardless of exercise intensity, have shown significant gains in functional balance and mobility as compared to programs of only two-week or ten-week durations. Furthermore, when it comes to exercise and PD, greater intensity equals greater benefits. Intense exercise is exercise that raises your heart rate and makes you breathe heavily.

 Should exercise be done well before major motor symptoms of PD occur?

In PD, a special kind of neuron—brain cells—that produces the chemical transmitter dopamine gets damaged and lost. There is a lag between the time when the loss of neurons begins and the time when Parkinson’s motor symptoms start to show. By the time most people are diagnosed, as much as 40-60 percent of their dopamine neurons are already gone.

The reason that people with Parkinson’s don’t experience symptoms until they reach this point is that the brain can compensate for the loss of dopamine neurons by gradually changing to adapt to the situation.

In fact, the brain reshapes itself throughout life in response to experience. Scientists call this ability to change and compensate experience-dependent neuroplasticity.

 How does exercise change the brain?

Researcher found that the ones that had exercised, the brain cells were using dopamine more efficiently. They also found that exercise improves that efficiency by modifying the areas of the brain where dopamine signals are received — the substantia nigra and basal ganglia.

group doing stretches to warm up and cool down

Calf Pain

Written by Alison Stickel

In the midst of the summer, many become more involved in the outdoors with cycling, hiking and more. Patients often present us with really sore and tight calf pain as a result. The calf can easily be injured due to overexertion and improper stretching before exercise.

The calf anatomy is made up of two muscles. The gastrocnemius is the largest muscle and bulge you see as your calf. The smaller and more intrinsic muscle deep below the gastrocnemius is the soleus muscle.  Acute muscle strains can occur in both muscles. The larger gastrocnemius muscle is more commonly affected or injured.

Symptoms of calf muscle strains can include:

  • Pain with calf stretching
  • Tenderness at the muscle
  • Tightness of the muscle
  • Pain with exertion of the calf
  • Pain with the raising the heel (especially on steps)

Treatment is necessary because overuse of the calf muscle can lead to thickening of the tissue and predisposing the calf to further injury. Overuse can also cause muscle imbalances and compensatory movement and walking patterns that can lead to other biomechanical issues.

Treatment from a physiotherapist will help reduce pain, tightness and prevent re-injury. Treatment techniques include:

  • Deep and soft tissue work to release tension In the muscle
  • Dry needling
  • Hot and Cold Therapy
  • Massage Therapy
  • Tailored stretches and exercises for muscle re-strengthening
calf pain

Stay Healthy During Travelling

Written by Alison Stickel

Travelling and vacationing is obviously meant to be a relaxing, fun and break away from home and work. However, it is easy to forget about your health while travelling and accidents can unfortunately occur. It’s important to stay healthy during travelling.  Travelling causes you to put yourself in unnatural physical positions. This includes sitting in cramped spaces, sitting for prolonged periods of time, or walking for extended amounts. Here are a couple of tips to prevent common injuries while travelling.

Drink Lots of Water!

    • On Vacation it is often times easy to forget to drink enough water when new cafes, bars, and more surround you. Make sure to drink appropriate amounts of water, especially when in hotter and humid climates to prevent dehydration. Also you may be exercising and walking more on your trips, making it more important to drink enough water.
  • Take Breaks
    • Take breaks while sitting for long periods on airplanes, trains, buses and more. Often times these spaces can be very cramped and can cause discomfort and tightening of your muscles. While driving make sure to take breaks to stretch your legs and refresh your mind. If you are traveling by an airplane or train make sure to walk up and down the airless and pump your ankles up and down to promote blood flow.
  • Mind Your Posture
    • While sitting for long periods of time, such as airplanes, buses, cars etc., make sure to sit up properly. Avoid shrugging your shoulders forward and slumping in your chair. Think about relaxing your shoulders, lifting your chest, and maintaining a level chin. You should feel comfortable in your back and in your legs. Adjustment of your seat may be necessary to reach this position.
  • Lift Luggage Properly
    • It is easy to pull and strain muscles while lifting heavier objects such as suitcases while traveling. The first key to success it to try to pack light so that you do no to lift as much over your holiday. While lifting luggage use proper technique, which includes using your legs and holding the luggage close to your body. Avoid using your back and creating twisting movements while lifting luggage.
  • Prevent Deep Vein Thrombosis (DVT)
    • Deep Vein Thrombosis, also known as a blood clot is a common and serious medical condition while traveling. It can be a real threat while on long flights that require sitting in a cramped space for a long time. To prevent this injury it is necessary for you to follow all of the above following tips, especially taking breaks and moving around.
    • Knowing the warning signs is also essential in order to ensure proper medical assistance. The most common signs are swelling, cramping, warmth redness, or pain in the calf region. Pain and swelling can also be present in other extremities.
    • DVT can develop into Pulmonary Embolism, (PE), which is the blocking of the lungs from a blood clot. The most common signs of PE include irregular breathing, irregular heartbeat and chest discomfort. This is a serious medical condition that can be prevented if the signs of DVT are noticed and treated early on.

Don’t let a current or pre-existing injury, muscle tightness or immobility prevent your from taking a relaxing and fun holiday. If you feel as if you are physically limited to take a holiday, you can benefit from physiotherapy in order to get well for travel. Physiotherapists can provide therapeutic massages, manual therapy, dry needling, muscle stimulation techniques and more in order to get you well for your holiday!

Maisonneuve Fracture

Written by Alison Stickel

The Maisonneuve fracture is an injury that involves both a sprain and fracture to the ankle. This sport related injury disrupts the ankles’ integrity and ankle mortise, resulting in the need for surgery and physiotherapy.

Anatomy

 Maisonneuve fracture involves the complete rupture of deltoid ligament, which is a term for the medial or inner ligaments of the foot that connect the inner portion of the tibia (medial malleolus) to the talus bone of the foot.

Other ligamentous injury occurs the rupturing of the anteriorinferior tibiofibular ligament and interosseous membrane or syndesmosis of the tibia and fibula. The rupture of these ligaments causes an unnatural separation between the tibia and fibula. This separation therefore disrupts the ankle mortise or bony arch of the foot.

The third component of the maisonneuve fracture is the fracture of the fibula.  This fracture normally occurs proximally on the bone or closer to the foot. However, in some cases the fibula can break distally and still produce a maisonneuve fracture.

Causes

Generally this injury occurs in sports related falls. The maisonneuve fracture occurs when the foot hits the ground from a far distance and the fibula externally rotates unnaturally around the foot. This large impact and rotation causes the ankle to strain, unable to support the leg and causes the fibula to crack. Generally this injury is caused by sports incident that involves major leg elements or risk of falling such as gymnastics, cheerleading, diving, cycling, dance, and skiing.

Signs and Symptoms

  •  Pain in the medial side (inner portion) of the ankle
  • Laxity/instability of the ankle
  • Inability to move ankle
  • Bruising and inflammation/swelling of the ankle
  • Cracking noise
  • Tenderness and pain of the fibula (extending on the outer side of the leg from the knee to the ankle)
  • Bruising and swelling of the fibula
  • Pain or inability with walking, standing or weight bearing

Medical Treatment

Because of the disruption of the ankle joint, it is vital to seek medical treatment immediately after injury. A trip to the emergency room and referral to an orthopedic surgeon is necessary. Generally surgery is required to insert screws or tight-loops into the ankle in order to reconstruct the unstable ankle and allow for torn ligaments to heal. Sometimes based on the severity, the fracture of the fibula will require the insertion of a metal plate to allow for correct healing.

 Physiotherapy

 Rest and rehabilitation will be vital in the healing process of this injury. Rest and non-weight bearing activity is advised for a period of 6 weeks.  During this period the ankle up to the knee will be splinted or casted for immobilization. After around 6 weeks physical therapy should begin as the patient transitions into a walking boot. Physiotherapy exercises will involve stretching and strengthening of the ankle to maintain mobility and improve ankle range of motion. Stretching and strengthening exercises will allow the patient to return to gradual weight bearing activity at around 8-12 weeks and full weight bearing around 16 weeks. Return to sport after a maisonneuve fracture with rehabilitation occurs generally within a time frame of about 20-24 weeks.

Specific Physiotherapy treatments:

  • Tailored exercise and stretching prescription to improve ankle range of motion at strength. Carried out with guidance of a physiotherapist.
  • Cold laser therapy to stimulate healing of damaged ligaments
  • Cold and ice modalities to improve swelling and stiffness
  • Heat modalities such as ultrasound to improve tenderness of other ligaments and tendons of foot and ankle
  • Guidance on management of weight bearing, activities including walking, running and usage of walking boot, and return to sport

 

Physiotherapy and rehabilitation is vital for correct healing, recovery, and prevention of re-injury!

Be well at work!

Poor posture is one of the most common complaints we treat at Archview Physiotherapy Clinic, Dublin. Poor posture is largely due to inadequate ergonomic work stations. Long working days spending up to eight hours sitting in a prolonged static position can lead to the development of back and neck pain, headaches and stress. This in turn may lead to absenteeism and reduced work performance. We offer work well being days to help educate employees on proper posture and self help methods to treat their own spine.

Employers have a statutory obligation to “evaluate health and safety at workstations with particular reference to eye sight, physical difficulties and mental stress” under the Safety, Health and Welfare at Work Act 2005 section 12, General Application of the Regulations 2007 and EC Council Directive 90/2270/EEC. In short, you are entitled to having your work station assessed. Even better ask your work place to hold a work well being day where you can have your desk assessed as well as physiotherapy and massage therapy.

At Archview Physiotherapy Clinic, Dublin we can provide you with an in-office ergonomic assessment of your work station or why not ask a colleague to take a photo of you at your work station today, bring it along with you to your physiotherapy consultation and we can provide you with immediate advice!

If you do work in an office environment, it is of the utmost importance that you take care of your back and give it some TLC. Here are top tips for you!

  1. Have an ergonomic assessment to correct your desk and computer alignments
  2. Take frequent breaks from your desk.
  3. Use a lumbar roll for your chair to protect your back further.
  4. Drink plenty of water throughout the day to prevent dehydration.
  5. Call our clinic about our offers on work well-being days, onsite classes, onsite physiotherapy & massage for employees.

CALL 014913228 for more detail or to book an appointment.

 

Woman sitting at desk feeling sore neck from looking down at laptop
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People exercising
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workplace wellbeing

AMMA Therapy

Alexandra Earl is qualified in AMMA Therapy. She offers AMMA as an individual treatment or in combination with a 60min massage. She explains the benefits below:

Written by Alexandra Earl

AMMA Therapy is a Korean form of massage. The word AMMA literally means ‘push-pull’. AMMA Therapy uses the same principles as Acupuncture and other forms of Eastern medicine. When our bodies experience ‘dis-ease’, an AMMA therapist will use different objective and subjective methods of assessing the patient to find where these imbalances are and work out a treatment plan. Through gentle circular thumb and finger manipulation and pressure, AMMA stimulates acupressure points and acupuncture meridians that are linked to different organ systems in the body. The massage itself is done dry with no lotion or oils needed, so the option for the patient to be fully clothed is available.

AMMA Therapy is an excellent form of complimentary treatment for a wide variety of ailments from muscular and neurological, to internal organ function and even emotional well being. Introduced in America by Tina Sohn, a Korean born practitioner who herself suffered from gangrene as a young aspiring Olympic swimmer. After being mended back to health by her wise grandmother, Tina brought the teachings of AMMA to America where she and her husband began a Wholistic Health Centre that eventually became the accredited college The New York College for Health Professionals in Long Island, New York.