Multiple Sclerosis

Multiple Sclerosis -

Written by Titus Selvaraj

Definition

Multiple sclerosis (MS), also known as disseminated sclerosis or encephalomyelitis disseminata, is an inflammatory disease of the central nervous system in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This damage disrupts the ability of parts of the nervous system to communicate, resulting in a wide range of signs and symptoms, including physical, mental, and sometimes psychiatric problems.

Incidence

Nine thousand people and their family members live with Multiple Sclerosis across Ireland and 2.5 million people worldwide suffer from MS.

It is most commonly diagnosed between the ages of 20-40, affecting women more than men in a ratio of 2.5:1.

Types of Multiple Sclerosis

  • Primary-Progressive MS– About 10% of patients are diagnosed with primary-progressive MS.
  • Relapsing-Remitting MS – the most common form of multiple sclerosis. About 85% of patients are first diagnosed with this type of MS.
  • Secondary-Progressive MS – Some patients with Relapsing-Remitting MS go on to develop secondary-progressive.
  • Progressive-Relapsing MS – a rare form of MS, occurring in less than 5% of patients.

 Symptoms 

 

  • tingling and numbness in the face, hand and feet
  • pain
  • impairment of speech
  • impaired balance and muscular coordination
  • blurred vision
  • severe fatigue
  • spasticity
  • Cognitive problems including thinking, concentration and memory
  • bowel and bladder control problems

 Physiotherapy Management

Some people with MS can develop complex patterns of disability affecting physical and social function.

Our chartered Physiotherapist provide a unique contribution to the management of people with MS to attain improvement and maintenance of functional abilities and management of the long term symptoms.

There is a strong evidence demonstrating that exercise used as part of a rehabilitation programme can increase activity and improve the health and well-being of people with MS.

Our physiotherapist will perform a comprehensive assessment that include a thorough history collection and physical assessment. From that potential problems are identified and management is precisely planned according to your needs and will differ from person to person. This includes:

  • Active intervention with hands on physiotherapy.
  • Tailored exercise prescription (eg) Muscle stretching and strengthening exercises. This can often be carried out at your home or clinic under our guidance.
  • Monitoring your condition to identify the outcome and need for exercise modification as required.
  • Guidance on management including fatigue management and pacing of activities.
  • Communication with multi-disciplinary team will be made with occupational therapist, speech therapist, orthotist, podiatrist, doctors, nurse specialists, family and carers for continuity of care.
  • Ordering and provision of orthotic needs.
  • Referral to the appropriate professional as required.
  • Training to family and carers concerning exercises.
  • Instruction on aerobic exercise and improving cardiovascular fitness.

Benefits of Physiotherapy

  • Improved mobility
  • Improved independence with ADLs
  • Improved emotional behavior
  • Improved social interaction
  • Recreational enjoyment
  • Improved home management independence

Cycling Injuries

Cycling Injuries -

Written by Daniel Quinn

With the weather getting nicer, and the longer stretch into the evenings, it’s time to get back out on the bikes and enjoy the beautiful scenery that Dublin and the surrounding areas has to offer. Cycling is a wonderful way to exercise and get away from all the noise and chaos of the city in a short space of time. The benefits of cycling are numerous from decreasing the risks of heart disease, diabetes and cancer to improving strength and increasing fitness levels. It also good for clearing the head, getting a break from our busy lives and enjoying some peace and quiet. Not forget the infectious positive mood that is spread by all the nods and smile from the other cyclist you come across.

However cycling has its risk, most of which are minor but it they do occur they can have serious consequences for the cyclist and there pastime! There are two major types of injuries when it comes to cycling; acute and overuse injuries. Acute injuries tend to happen most often on a bike when there is a crash and these consist of concussion, abrasions and fracture. These can be prevented by good cycling habits and having the right safety equipment, including helmets!

Overuse injuries are due to the constant repetitive movements that occurs when cycling for any long distances, or having to maintain static prolonged postures through the spine and upper limbs. These include:

Knee pain

Knee pain from cycling generally occurs due to patella femoral joint pain. This is when the knee is moving in the wrong pattern caused by tight and weak muscles. The pain is geneally at the front of the knee caps and is painful when you cycle. An associated pain with this is iliotibial band (ITB) dysfunction, this is due to a tight ITB that then rubs off the bones in the upper legs when you straighten your knee.

Back pain

Back pain when cycling is generally due to weak core muscle, or tight hamstrings, and a prolonger static posture when bent over a road bike or worse a tri/TT bike. The prolonger poor posture causes excessive pressures on the disc resulting in a bulge. If you are very unlucky this can pinch the nerve and cause sciatica.

Neck pain.

Neck pain is similar to back pain, but it is cause by weakness yin the trapezius muscles which help to stabilise you on a bike. Again a bulge in the disc occurs and can place extra pressure on the nerve resulting in numbness and pain in the upper limbs.

Numbness

Numbness in the upper limbs can also result from pressures on the ulnar nerve in the hand when gripping the handlebars. This can lead to permanent weakness and poor sensation in the hands if not treated.

Hip pain

Hip pain during cycling can come from a multitude of causes. Depending on where in the hip the pain occurs, it can be caused by ITB, glutes and hip flexor muscles as well as an impingement within the hip joint itself. Repetitive movements can all cause a slight irritation in these areas that increases over time.

Tendonitis

Tendonitis is an overuse injury that occurs due to too much stress being placed through a tendon for long periods. It can be caused by a tight muscle than strains the tendon until is degrades. This results in pain that progressively gets worse and beings to interfere with daily activities and cycling. Tendonitis most commonly occurs in cyclists in the patella, Achilles gluteal and elbow tendons.

In further blogs we will discuss how to prevent cycling related injuries. If you have any questions on cycling related injuries, contact Daniel Quinn on 01-491 3228.

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The Trapezius

Trapezius -

Written by Ethan Baxter

The trapezius other known as the traps consist of three parts:

  • The superior region which is the descending part or Upper fibers which function is to support the weight of the arm.
  • The intermediate region which is the transverse part or middle fibers, which functions are to draw or pull the scapula inwards or closer to the spine.
  • The inferior region which is the ascending part or Lower Fibers, which functions are to rotate and or lower the scapula.

The trapezius has a few functions such as:

  • Movement of the scapula in toward the spine
  • Movement of the rotation of the scapula to support the topmost part of the upper arm.
  • Movement of the Scapula in an up or down direction.
  • Movement of the head and neck in a backwards direction
  • Movement to the side of the head and neck
  • Assisting in breathing- The Trapezius muscle is also considered an accessory breathing muscle meaning it assists the breathing function by slightly enlarging the upper chest region to increase the breathing capacity of the lungs.

In the three sections of the trapezius there are 6 trigger points which can cause distinctive pain in your body.

In the upper trapezius the referred pain from this trigger point can be a cause of pain in the back of your neck and also down your back it could also be a cause of some of your headaches.

In the middle trapezius the referred pain from this trigger point doesn’t travel far and the pain would stay in the local region.

In the lower trapezius the referred pain from this trigger point would be felt on the tip of your shoulder joint. This trigger point is extremely common and is responsible for the feeling of the “weight of the world on my shoulders” that we are all very familiar too.

There are many ways to help alleviate the pain from the trapezius and if it is to do with trigger points there Is no better way than dry needling as it targets the trigger points and relieves the pain.

Trapezius

Rotator Cuff Pain

Rotator Cuff Pain -

Written by Ethan Baxter

The rotator cuff is made up of four muscles that help move and stabilize the shoulder joint. Damage to any or all of the four muscles and the ligaments that attach these muscles to bone can occur because of small injury, chronic overuse, or gradual aging. This damage can cause noticeable pain and disability with range of motion and use of the shoulder joint.

The four main muscles in the rotator cuff are:

  • Supraspinatus
  • Infraspinatus
  • Subscapularis
  • Teres minor.

These four muscles help move the rotator cuff whereas the tendons are what keep the ball in the socket for the most part.

The shoulder is a ball-socket joint that allows the arm to move in many directions. It is made up of the humeral head (the upper end of the bone of the upper arm) fitting into the glenoid fossa of the scapula (shoulder blade). The humeral head is kept in place by the joint capsule and labrum, thick bands of cartilage that form an elongated cone where the humeral head fits. The rotator cuff muscles are the dynamic stabilizers and movers of the shoulder joint and adjust the position of the humeral head and scapula during shoulder movement.

When the rotator cuff is damaged many issues can appear:

  • Pain and spasm reduce the range of movement in the shoulder
  • Swelling can occur due to build-up of fluid
  • The muscles can’t make the small movements within the joints to move the shoulder in a fluid motion

The severity of the injury can range between a minor strain and inflammation to the muscle or tendon that won’t led to any long term effects, to a partial or complete tear and need surgery for repair. An inflamed rotator cuff could take 2-4 weeks to heal with the aid of ice and rest. Unfortunately, if you have torn your rotator cuff it will most likely need some sort of surgery to repair it.

Whether your rotator cuff was a minor strain or a complete rupture, physiotherapy can help to alleviate painful symptoms and help to rehabilitate the shoulder allowing you a swift return to function.

Rotator cuff
A man having his rotator cuff muscles treated

Workplace Wellbeing

Workplace Wellbeing -

Workplace Wellbeing

How active are you during your working day? Research carried out by the Nutrition and Health Foundation (NHF) found that only one in three workers takes the recommended level of exercise for a healthy lifestyle each week. The NHF are the organisers the National Workplace Wellbeing Day which takes place on 8th April 2016. This is second year of the event which encourages employee health through promoting better nutrition and physical activity.

Many of us work in very sedentary environments, a lack a physical activity combined with unhealthy eating habits can lead to a variety of health concerns. When you consider how much of your day is spent at work, a greater focus on wellbeing in the workplace can only be a good thing. There are many simple ways to encourage greater wellbeing at work:

  • Healthy eating initiatives
  • Lunch time mile
  • Link in with local gyms / fitness classes

Here at Archview Clinic we are working with local offices to promote wellbeing at work. We offer on-site workplace wellbeing days which include postural classes, educational talks, on site physiotherapy and massage sessions. If your business is looking for new ways to help promote wellbeing at work then let us help. We have a number of options that can be customised to suit all businesses.

workplace wellbeing

Low back pain in pregnancy

Low back pain in pregnancy -

Many women experience back pain during pregnancy, it is a good sign as it shows your baby is growing. Many studies have been done on the percentage of women who suffer with back pain. The results vary greatly; one systematic review found that on average 45% of woman suffer with back pain at some point in pregnancy. This pain can greatly affect your daily life and limit many simple tasks i.e. sitting, walking and standing. Historically the main reasons found to cause this are either mechanical or hormonal.

Our physiotherapist Carol Hopkins hopes to break these down for you to gain a better understanding of your pain and how she may be able to help.

Mechanical factors:

Many of the studies suggest that due to the increase in weight of carrying the added load in the abdomen there is a shift in centre of gravity; causing a change in posture. This change can increase the natural curvature of the spine and therefore put increased stresses on the joints and discs of the lumbar spine. Also the abdominal muscles will be required to stretch to all for the growth of the uterus. This may cause muscle fatigue leading to increased load on the spine.

Hormonal factors:

During pregnancy the hormone levels being produced by the body are increasing to accommodate birth, however this change causes laxity in the ligaments and joints; causing decreased support and promoting pain.

Research describes two types of back pain in pregnancy. The first being lumbar spine pain which occurs at the lower back and this will be felt around the spine itself and the other being pelvic girdle pain which occurs in back of the pelvis and will generally present lower than the lumbar spine into the buttocks. Most will experience one or the other, however sometimes they can occur together.

Physiotherapists will be able differentiate between pelvic pain and low back pain. Once a diagnosis is made appropriate advice and treatment will be applied. Physiotherapy can help to alleviate and manage the pain throughout your pregnancy and even after your baby is born.

The type of treatment techniques commonly used are manual therapy including soft tissue massage, education on self-management strategies, advising on appropriate physical activity i.e. Pilates, swimming, walking; and an exercise based rehab programme. All the above will help to decrease pain, increase range of movement/flexibility and muscle strength and improve posture/joint alignment.

low back pain pregnancy
pregnancy low back pain

Should you stretch after a run

Should you stretch after a run -

Written by Toni Teggin

Stretching is a topic that can cause a lot of disagreement. There are so many differing opinions out there on whether to stretch or not, when to stretch, how long to stretch for, should stretching form a training session on its own, should you stretch after a run or before. To try to understand why we stretch we need to understand what happens to a muscle during exercise.

 

In order for us to move, our muscles must contract and relax. When we exercise we put greater demands on the body. Many of us will exercise by doing repeated movements using only partial ranges of motion. Runners for example perform the same movements over and over again, but these movements do not bring the body through its full range of motion. Doing repeated movements through a partial range of motion can cause muscle imbalances. Some muscles are shortened and after exercise will stay in this shortened position. A number of things would result from our muscles were staying in this shortened position:

  • Increased muscle tension
  • Decreased range of movements in the joints
  • Change in posture

 

It is worth mentioning that there are some athletes and sports in which the body’s full range of motion is utilised. For these groups a post-stretch is less important. However, many runners will suffer from muscle shortening and muscle imbalances. If you are one of these runners, then stretching is an essential part of your post-training routine. There are any number of reasons that we use to justify not stretching at the end of a run and head straight for the showers such as I don’t have enough time, I find stretches boring, I don’t know if I’m doing them right, I’ll stretch later on. But the benefits of stretching after a run are too important to ignore, especially for a runner with muscle imbalances:

  • Reduced muscle tension
  • Increased range of motion in the joints
  • Enhanced muscular coordination
  • Improved posture

 

If you are suffering from stiffness or pain after running, you should get an assessment to see if there is a more serious injury developing, or if there a particular muscles that need to treated or stretched.

shutterstock_153641837
Athletes lower leg in runners standing on a running track

0-10km Training Programme

0-10 Training Week 1-4 -

Written by Toni Teggin

If you have decided to complete the VHI Women’s Mini-Marathon this year, or indeed any 10km, we will be updating our blog page every week with training programmes, tips and useful information for any novice runner or walker.

Below is the first 4 weeks of your beginners 0-10km training programme. Before beginning this or any training programme it is important to consult with your doctor. Make sure you are wearing comfortable clothes, runners with good support, and take breaks when you need to.

The programme is designed to gradually build you from no running experience up to running 10km. If you would prefer to walk the mini-marathon, then the programme below can still be followed by changing the run sections to a fast walk.

0-10km Training Programme

Week 1

  • Day 1: Run 1min / Walk 1min } repeat X 5
  • Run 2mins / Walk 2mins } repeat X 2
  • Day 2: Run 2mins / Walk 2mins } repeat X 6
  • Day 3: Run 2mins / Walk 2mins } repeat X 8

Week 2

  • Day 1: Run 3mins / Walk 2mins } repeat X 6
  • Day 2: Run 3mins / Walk 2mins } repeat X 8
  • Day 3: Run 4mins / Walk 2mins } repeat X 6

Week  3

  • Day 1: Run 5mins / Walk 2mins } repeat X 5
  • Day 2: Run 5mins / Walk 2mins } repeat X 5
  • Day 3: Run 6mins / Walk 1min } repeat X 5

Week 4

  • Day 1: Run 8mins / Walk 1min } repeat X 3
  • Day 2: Run 10mins / Walk 1min } repeat X 3
  • Day 3: Run 8mins / Walk 1min } repeat X 3

      

Woman running

Mini Marathon Training

Mini Marathon Training -

Written by Toni Teggin

Entries opened today for the 2016 VHI Women’s Mini-Marathon. The mini-marathon is a 10km road run around the city that takes place in June. Every year tens of thousands of women take to the streets and complete the 10km while raising money for charity. The charities really are the big winners in this event. In 2014 nearly €12m was raised for good causes. This event is a great excuse to dust off the runners and get fit while supporting your chosen charity. You can run, jog or walk the event.

Here at Archview Physiotherapy, we will help you along the way by updating regular blogs to keep you motivated. We will be including a mini marathon training program to help you along the way. So if you’re planning on completing the min-marathon or any 10km event this summer, make sure to check the blog page regularly.

Next week we will post up a beginners mini marathon training plan, this is designed for people with no previous running experience but would like to build up to 10km. Before you start your training there are a number of things you can do to make your training easier:

  • Invest in a good pair of running shoes – this is so important for every athlete out there, the right pair of shoes can give your proper support and help to prevent injuries.
  • Convince a friend to run with you – training with a friend or group is a great way to keep motivated.
  • Enjoy your rest days – your rest days are just as important as your training days, so make sure you enjoy them guilt free.
  • Keep a training diary – keep track of your progress along the way.

As with all exercise programs it is important to consult your doctor if it’s been a while since you were last active. You should stop exercising and consult your doctor if you experience any of the following:

  • Pain or discomfort in your chest, neck, jaw or arms during activity
  • Dizziness, lightheadedness or fainting
  • Shortness of breath with mild exertion, at rest, or when lying down
  • Ankle swelling, especially at night
  • A rapid or pronounced heartbeat or a heart murmur
  • Lower leg pain when you walk, which goes away at rest
Woman running

Chia seeds

Chia Seeds -

Written by Anna Masternak

Chia Seeds – Superfood, not only for Athletes.

As a Massage Therapist, I outline to my patients an importance of healthy eating because ”We Become What We Eat”.

There is a new wave of people looking after their health in natural ways. Mindful eating, which is eating with the intention of caring for yourself, as well as choosing food for both enjoyment and nourishment is one of the ways to do that.

I love to try different foods and recipes in my kitchen. About a month ago, I purchased a little 150g bag of Chia Seeds. I knew it’s one of the Superfoods high in Proteins, Omega-3, Antioxidants, but I did not have a clue how do I eat it… So I went to the Internet and found thousands articles with information and recipes there. I was amazed how those little seeds, the size poppy seeds can tremendously enhance your health. Most importantly, they can impact lives of people involved in high intensity activities as Athletes, Runners and any Sport person, as well as people with low energy levels.

Chia means ”strength” in the Mayan language.

Chia Seeds contains Essential fatty acids alpha-linoleic, linoleic acid, Omega-3 and Omega-6, proteins, minerals, vitamins A, B, D, E and antioxidants.

The Chia Seeds can prolong the hydration, helping retain moisture and regulate more efficiently the body’s absorption of nutrients and fluids, including electrolyte balance.

The seeds are also responsible for slowing the conversion of carbohydrates into sugar with endurance and metabolic rate, which is beneficial for Athletes and others.

For weight loss, Chia Seeds are an appetite suppressant.

It can be used in your porridge, yoghurt.  You can eat it dry or drink soaked in water or add to your salad or soup. And it has no flavour, which makes it so easy to consume.

It took me only 1 week to notice the difference in my energy levels and gut feeling after adding Chia Seeds only to my porridge in the morning.

Try it for yourself!!!

Chia seeds
Chia seeds
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