Exercise After COVID Pt 2 (April 2022 update)

Exercise After COVID Pt 2 (April 2022 update)

By Aaron Woolley, Physiotherapist 

Australia is making its way through another COVID-19 wave. Thankfully it appears that our health system has sustained this wave extremely well so far. But with another wave means more people getting ill, isolating, recovering and trying to return to exercise.

For the majority of people this should hopefully be a relatively easy task. But we are still seeing people having ongoing health issues long after COVID has passed.

When I wrote my first part of this blog there wasn’t very much peer reviewed evidence to follow for guidelines. Now there is some more information available as we are able to see how other countries are progressing that were technically further along in the pandemic than Australia.

Below I will provide a new infographic from the British Journal of Sport Medicine which provides some further insight in how to return to exercise after COVID-19 infection. The overall premise and much of the guideline appears to remain unchanged but it has broken the progress down into a few extra steps. I feel this would extra helpful for those that may be recovering a bit slower or perhaps in a vulnerable or elderly population. But first here is a quick recap on the risk categories of patients with COVID.

Low risk – includes:

  • Mild or no symptoms resolved within 7 days
  • Upper respiratory infection only
  • Younger patients (aged <50 years)
  • Recreational exercise goals.

Intermediate risk – any or more than 1 of:

  • Patients who experienced prolonged symptoms or fatigue (>7 days)
  • Ongoing shortness of breath or chest pain, which did not require hospitalisation.
  • Dyspnoea (breathlessness)/chest pain with illness
  • Elite and/or endurance athletes
  • Older patients (aged >50 years)
  • Those with pre-existing co-morbidities that may affect recovery eg asthma, chronic fatigue.

High risk:

  • Individuals who required hospitalisation / ICU
  • Patients with any evidence of system involvement outside the respiratory tract
  • Prolonged shortness of breath or chest pain at rest or with activities of daily living
  • Significant cardiac co-morbidities, history of cardiac disease, or abnormal electrocardiogram (ECG) or blood test findings during the illness.

Low risk patients should be able to return to exercise after COVID without requiring any further investigations. Although intermediate and high risk patients may need further investigations (e.g ECG) and monitoring. Therefore it is always recommended you consult your local medical professional before starting your return to exercise after COVID.

Exercise After COVIDFigure 2 Adapted from Elliot et al 2020

IMPORTANT NOTE: If any symptoms occur (including excessive fatigue) while going through the return to play protocol, the athlete must return to the previous stage and progress again after a minimum of 24 hours’ period of rest without symptoms.

I hope you found this update helpful and get back into exercise after COVID. If you need further assistance the Physio’s at Robina Physiotherapy on the Gold Coast are here to help. Contact us on (07) 5578 7233 or BOOK ONLINE.

Resoures

  1. Elliott N, Martin R, Heron N, et al. Infographic. Graduated return to play guidance following COVID-19 infection. BJSM 2020; 54:1174-1175. [Accessed 19 January 2022]  https://bjsm.bmj.com/content/54/19/1174

Office Ergonomics

Office Ergonomics

By Corinne O’Connor, Physiotherapist.

Over the past few years so many of us have shifted our work space from an office building to working from home, at least part of the time.  And that usually involves finding a workspace that works.  The problem is that without a good set-up, we are more prone to pain and injury.Desk Pain

Office Ergonomics – what exactly is that?

Ergonomics derives from two Greek words: ergon, meaning work, and nomoi, meaning natural laws. Combined they create a word that means the science of work and a person’s relationship to that work.  In practice, ergonomics is about designing and arranging things in a workspace so  that the people and things interact most efficiently and safely.

Our bodies are designed to work most efficiently in certain postures.  Our spines are designed in an S curve, and when this curve is maintained, all the muscles work most optimally.  When we overextend or flatten this natural curve for prolonged periods of time, we put more strain on our muscles, nerves, ligaments and skeleton.Human Spine

Chair selection 

Investing in a high-quality office chair is undoubtedly a wise decision, particularly one that offers adjustable features like height, backrest, and seat tilt. Some chairs come with arms, while others don’t, and the choice depends on personal preference. However, it’s essential to consider that chairs with arms may not always allow for close proximity to the desk. Thankfully, certain office chairs come with adjustable height arms, enabling customization to suit individual body types and requirements.

When it comes to chairs, a one-size-fits-all approach doesn’t apply. Each person has unique dimensions, and the length of our thighs plays a significant role, as it can make certain seats feel either too deep or too short for proper support. Much like testing a mattress before committing to it for eight hours a day, the same consideration should be given to office chairs. Ensuring the chair fits well and provides adequate support is crucial for maintaining comfort and productivity during long work hours.

Ergonomic Office 

Find an office supply store where you can be like Goldilocks and try a few chairs until you can say “this chair is just right!”  Make sure you test it under a desk to make sure any arm supports don’t restrict you from moving in close.

Desk Selection/Set-up

In reality, many of us find ourselves working with whatever desk we have available when setting up a home office, and this article will take that into account. However, it remains essential that the desk space allows for the screen to be positioned at an appropriate distance directly in front of you as you pull your chair under the table. Prolonged neck rotation while looking at a screen can lead to discomfort around the neck and shoulders and possibly even nerve symptoms in the arms. If you use multiple screens, it’s best to arrange them towards the back of the desk to minimize neck rotation.

Moreover, ensuring adequate legroom is crucial, so it’s a good idea to declutter under the desk. Having enough space to move your legs while sitting can improve circulation and overall comfort.

For those who spend extended hours at their desks, considering a stand-up desk might be a beneficial option. This allows for regular changes in posture throughout the day, which promotes the health of muscles, joints, and ligaments. Varying your position between sitting and standing can be advantageous for overall physical well-being.

Finding the right chair vs desk height combo

Strive for a setup that incorporates 90-degree angles. Your posture should ideally maintain right angles at your hips, knees, ankles, and elbows. In practical terms, begin by adjusting the chair height so that your shoulders feel relaxed, neither raised nor drooping, while your arms rest on the desk to reach the keyboard comfortably. Once you’ve found the right chair height, ensure that your lower limbs are also at approximately 90-degree angles. If they aren’t, you might consider using a footrest to achieve the optimal posture.
Ergonomic Desk Set Up

Computers

Computer placement is of utmost importance for maintaining proper ergonomics. Surprisingly, many people position their screens too low in relation to their eyes. For optimal posture, the top of the screen should align with your eye level when sitting upright. If needed, you can use books or suitable risers to achieve the correct height (and maybe even impress your colleagues with your resourcefulness!). For laptop users, investing in a laptop stand and using a wireless keyboard and mouse can provide the same benefits.

Moreover, most keyboards come with adjustable feet underneath them. Utilising these feet to elevate the keyboard slightly puts your wrists in a more efficient position for typing. Ensure that the keyboard is placed far enough back on the desk to allow support for your forearms. Neglecting forearm support can lead to overused neck and shoulder muscles, resulting in discomfort and pain.

To prevent injury from sustained or repetitive movements, consider using a good ergonomic mouse and/or a mousepad. These accessories can help protect your operating arm and improve overall comfort during prolonged computer usage. Prioritising proper computer placement and using ergonomic tools can significantly contribute to your well-being and productivity at work.

Documents and Phones

If you work from documents when using your computer, putting them on a document stand not only improves your posture, but also means you are less likely to spill your coffee on them!

If you spend a lot of time on the phone, a headset or at least using a handsfree speaker will reduce the temptation of poor posture.   

Microphone Icon

Have you ever thought about using voice to text to save on typing effort?  Incidentally, did you know your mobile probably has a little microphone at the bottom of the text message screen where you can speak and it converts it to text?  It’s faster, and so much better for your arms and hands. 

Lighting

We often forget about light!  Make sure your work space has adequate light but no glare so that your eyes don’t have to work hard at reading.  This will reduce your risk of headaches and dry eyes. 

Good workday practice

We are all aware of this, but it’s essential to be reminded: MOVE REGULARLY! This is the best thing you can do for your body. Prolonged postures can tire active muscles, strain ligaments, and cause inactive muscles to shorten. The key is to take short breaks regularly. It doesn’t have to be a long interruption; a quick break for a cuppa and some shoulder circles, head movements (up, down, and side to side), as well as stretching your arms and legs can do wonders. Don’t forget to take a few deep breaths too. Not only will this benefit your body, but it will also boost your mental clarity and productivity.

Consider setting an alarm on your phone as a gentle reminder, and most importantly, don’t ignore it!

Oh, and let’s not overlook the importance of staying hydrated. Remember to drink water throughout the day. While coffee may be a go-to for many, it can dehydrate your tissues, making you more susceptible to injury and discomfort. It’s essential to balance your caffeine intake with adequate rehydration to maintain your well-being while staying focused and alert.

Office Ergonomics Joke

But I have pain already … what should I do?

At Robina Physio on the Gold Coast we can provide a thorough assessment and treatment with regards to your particular problem. Whether it is a chronic condition or an acute pain, we can provide individualised treatment and advice on exercises, postures and work set-up to help you on the road to recovery. Contact us on (07) 5578 7233 or BOOK ONLINE.

Exercise After COVID

Exercise After COVID

By Aaron Woolley, Physiotherapist.

COVID-19 has officially hit Queensland and it appears it will only be a matter of time before coronavirus becomes an endemic disease within Australia. With the recent influx of the virus I have treated many patients who contracted COVID, thankfully recovered well and now looking to get back into the normal activities/exercises they performed pre-COVID. The majority of these people have been surprised by how hard it has been for them to get back into exercise after COVID. Interestingly, this complaint is occurring consistently despite illness severity and is affecting people who suffered both mild and moderate to severe symptoms.

Typical with the Coronavirus pandemic is a lack of clear evidence to guide medical decision making, returning to exercise is no different at this stage. But based on what little evidence is available and using some principles used for other respiratory illnesses I have written you all some advice to help guide you slowly and carefully back into exercising.

How do I know if I am ready to return to exercise?

It is very important that a one size fits all approach is not taken here. Everyone experiences coronavirus differently, meaning that the risks of returning to physical activity have to be managed for each individual. Due to the fact that the deterioration of symptoms that signify a severe infection occurs roughly a week from symptom onset, a consensus is that exercise or sporting activity should only be resumed after an asymptomatic period of 7 days.

The second factor that needs to be considered is the possibly of the person having “Long COVID”. If an individual is experiencing ongoing symptoms (regardless of body system) following the acute phase they should seek medical attention before starting exercise again. This is important because there is a risk of cardiac complication and thromboembolic events related to COVID-19, especially in those who required hospital treatment. If you had mild symptoms but they included signs of a myocardial injury such as chest pain, severe breathlessness, palpitations and fainting then you should have a medical assessment before starting physical activity.

The third factor to consider when deciding to exercise after COVID is ongoing respiratory symptoms. It is expected that these symptoms including breathlessness and coughing will subside after several weeks. But if these symptoms are not resolving as expected or even worsening, that could be a sign of pulmonary-vascular complications such as a pulmonary embolism or pneumonia. If this sounds like you then please seek medical attention before trying to exercise.

The final thing to consider is the psychological aspect of recovering from COVID-19. Physical activity has been shown to be incredibly affective at managing mental health conditions, but if you are struggling with your mental health post coronavirus your medical professional can help you access other support systems as well. And keep in mind if you don’t have the motivation to start physical activity just yet it’s probably not worth the stress of trying to force it, you can start when you’re feeling ready cause exercise isn’t going anywhere.

Exercise after COVID chart

https://www.bmj.com/content/372/bmj.m4721

When trying to decide if you’re ready to start exercise after COVID, you can guide your decision with the information above. But most importantly if you’re unsure or concerned speak to your doctor first or check in with us at Robina Physio on the Gold Coast. A quick check up can make all the difference.

How Do I Get Back into Exercise?

 So, you have accessed your risk factors, been cleared by your doctor and ready to start but not quite sure how? This next part is for you. Please keep in mind that there still isn’t clear evidence to guide us yet so this information may change in the future.

The plan is broken into 4 phases, each lasting 7 days but only go to the next phase when you feel ready. But firstly, its important you assess your baseline activity/fitness pre-COVID. For example, if you struggled to walk 5km before, aiming to walk 5km immediately post is probably not going to end well. Next its important you set goals and consider how you will monitor your progress. If you feel stuck writing SMART goals check out my previous blog HERE.

Phase 1.

  • Spend at least 7 days here
  • Very Light Intensity. You should be able to hold a full conversation without difficulty.
  • Aim to keep your heart rate below 100-110bpm
  • Aim for 10-20 minutes per day
  • Good activities for this stage include:
    • Light housework and gardening
    • Gentle walking
    • Stretching inc gentle Yoga and Pilates
    • Very light body weight strengthening type exercises

Phase 2.

  • Spend another 7 days here. (Phase 1 and 2 combined = 14 days)
  • Light intensity activity. Can still hold a conversation but only have slightly laboured breathing
  • Can work heart rate up to a maximum of 120bpm
  • Increase to 20-30 minutes per day
  • Keep the same activities as in Phase 1
  • You should feel like you can perform this type of activity on back to back days
  • You should NOT feel tired after exercising. If you do then you’re likely pushing too hard

Phase 3.

  • The next 2 stages are highly dependent on your pre-illness fitness levels
  • 7 days in this Phase. But some may require up to 14 days here
  • Build the intensity slightly. You should be slightly out of breath but able to hold a conversation. E.g. need a breath after 5-6 words
  • Heart rate up to 120-130bpm
  • Aim for up to 45 minutes per day
  • Exercise should not feel hard. This is moderate level exercise
  • If it takes longer than 1 hour to feel recovered then you went too hard
  • Activities you could do include:
    • Brisk walking, including hills/stairs
    • Jogging
    • Swimming
    • Cycling
    • Light-weight compound exercises (ensure adequate rest between sets)
    • Moderate intensity household work and gardening (e.g. digging)
    • Golf

Phase 4.

  • This phase builds intensity once again and adds more complex sessions including circuits and/or intervals
  • 7 days in duration
  • High end moderate intensity but not considered hard yet
  • Noticeably puffing but still able to talk (3-4 words at a time)
  • Heart rate up to 140bpm and beyond depending on previous fitness level
  • Should be able to recover quickly. Exercising should not have an impact on your normal daily activities
  • By the end of this stage you may still not have returned to your pre-COVID fitness
  • Add activities such as:
    • Running including speed and change of direction work
    • Body weight circuits
    • Super-setting gym programs
    • Intervals (e.g. 30 sec on / 30 sec off)
    • Moderate resistance exercises including free weights
    • TennisRun After COVID

If at any stage you feel a phase is too hard or have a set-back including worsening fatigue and/or a return of symptoms revert to the previous stage until fully recovered and I would recommend seeking medical attention.

I hope you found this guide helpful and get back into exercise after COVID. If you need further assistance the Physio’s at Robina Physiotherapy on the Gold Coast are here to help. Contact us on (07) 5578 7233 or BOOK ONLINE.

Resources 

https://www.bmj.com/content/372/bmj.m4721

Injury Prevention

Injury Prevention – Load Management  

By Aaron Woolley, Physiotherapist

The next part of the Robina Physio blog series continues from my previous post about goal setting and injury prevention. Once your goals are set the next part of the puzzle is trying to achieve them without breaking too many times. A well thought out and structured plan won’t stop every injury but it can certainly help prevent injury occurrence and hopefully severity.Running Injury Prevention

Defining Training Load

Before delving into how we go about managing load we need to define it. Load is a term used to describe the training related stress that is placed on the body. Other terms you may hear is “acute load” which is what you did in the last 7 days and “chronic load” which is what you did in the 4 weeks. Proper planning needs to consider more than just which body structures are being stressed for each specific sport because the nature of training load on the human body is highly multifactorial. Training load places physical, psychological, physiological, cognitive, emotional and technical stress on the human body.

From an injury prevention point of view, stressors on connective tissues such as muscle, tendon, ligament and bones are what we predominantly focus on managing. This is even more important when returning from injury because people that have had a recent injury have a noticeably increased risk of injury the same or a different body part again.

Managing Training Load

I truly believe the most important thing to consider here is the individual/athlete. A deep understanding of the person you’re dealing with holds the utmost importance. This includes their physiology (age, sex, medical history/injury history), their training history, mental and nutritional health and not to be understated their non-sports demands (family, work, study).

Injury Prevention

https://www.ais.gov.au/position_statements/content/training-load-in-relation-to-loading-and-unloading-phases-of-training

From here we can follow a few simple principles to help prevent injury. Keep in mind this is a very simplistic overview of what research tells us.

  1. Try to keep your load consistent. This links back to acute vs chronic load. Sharp increases or decreases of load will put you in the danger zone for an injury. Aim for weekly increases that do not exceed 30% and decreases that are within 20%. The data has shown that increases above 50% increase your injury risk by up to 8 times.
  2. Keep it simple. Many of the new fitness/training trends prioritise excitement and flashiness over results. Plus, they also tend to have high injury rates. Sometimes sticking to a tried and tested plan is the best option, especially when you’re just starting out.
  3. Listen to your body. A simple idea but often neglected. This mainly relates to giving your body enough recovery between sessions. If you’re feeling flat and/or sore maybe consider dropping the intensity or volume for that session. If you’re mentally spent maybe you need a well-timed rest day or some active feel good type of activity.
  4. Don’t neglect your body. To help prevent injury it’s a good idea to add in some extra recovery aids. You could consider some stretching, foam roller and recovery baths. At Robina Physio on the Gold Coast we can also help with some preventative treatments including massage and dry needling. Got a niggle? Then BOOK NOW before it gets too bad.
  5. Consider some technique correction and/or cross training. Technical correction help improves your bodies efficiency leading to improved connective tissue loading. Cross training is a simple way to keep you moving whilst minimising overload to the specific body parts you train most.

I hope these posts have been helpful and informative. If you need some assistance managing an injury or if you need some expert advice developing a training load plan and prevent injury Contact Us on (07) 5578 7233 or BOOK ONLINE. The Physiotherapists at Robina Physio on the Gold Coast would love to help.

 

References

Blanch P, Gabbett TJ. (2016). Has the athlete trained enough to return to play safely? The acute:chronic workload ratio permits clinicians to quantify a player’s risk of subsequent injury. Br J Sports Med; 50: 471–475.

SMART Goal Setting

Goal Setting and Injury Prevention 

By Aaron Woolley, Physiotherapist.

The new year is upon us and with that tends to come some hefty new year’s resolutions. Most of the time these resolutions involve something to do with starting exercise, living a healthier life, losing weight and/or taking up a new skill. SMART goal setting is important to get the best out of your new year’s resolutions and preventing injuries.

At Robina Physio on the Gold Coast we tend to see some new injuries appearing that are related to people’s new goals and taking up activities their body is not yet accustomed to e.g. going the gym or starting running. So, the purpose of this blog is to help give you some tips for setting effective SMART goals helping you stick it out and achieve your goals and finally some important ways to minimise the risk of injury.

The information below should help minimise your injury risk, although if you happen to sustain an injury or would like to discuss goal setting in depth with us at Robina Physio on the Gold Coast BOOK ONLINE.SMART Goal Setting

SMART Goal Setting

Getting your goals set out properly from the beginning is an incredibly crucial and underrated step. Getting this right will not only help with minimising setbacks but also is great for improving motivation especially when things get tough. But most importantly getting your goals right drastically improves your chances of achieving them.

I’m sure many of you have heard of SMART goals before. This is a very well-established tool for making great goals. The SMART acronym stands for SPECIFIC, MEASURABLE, ATTAINABLE, REALISTIC and TIMELY. Below are some of my keys too effective and SMART goal setting.

  1. Be clear (specific and measurable) about what you want to achieve. For example, just saying I want to be fitter doesn’t quite cut it. Cause when you do you actually know if you have achieved this and on your bad days you will feel like this goal is impossible to achieve (attainable).
  2. Try not to get overexcited about your new-found enthusiasm and aim for something that just isn’t possible based on your life (realistic). For example, if you have a full-time job and a family is it really possible to go to the gym or running everyday day of the week? Unlikely. You’re better off starting small to be sure your goal is attainable cause you can also alter it and increase things later on once the new habit and routine is established.
  3. A common thing people get wrong with goal setting is plain and simply not giving themselves enough time to achieve it. I recommend everyone should have a couple of short-term (4-12 weeks), medium-term (12 weeks – 6 months) and long-term goals (up to 12 months and beyond). Having your goals broken down like this is helpful for motivation cause those larger goals won’t seem as daunting and can give you a little boost when you achieve that smaller milestone. When trying to determine how long a goal will take many factors need to be considered but in general if you can give yourself a bit longer than you think do it. It feels much better to hit a goal earlier than expected than miss it and many people will realise half way through they can’t make the deadline and simply chuck in the towel instead of adjusting the timeframe.

So, let’s put together an example of a short-term goal using these principles. Let’s say this person wants to start running and has a longer-term goal of running the half marathon mid-way through the year in approximately 6 months. A couple of short-term goals may include.

  1. I want to run/walk 2-3 days per week for the next 4 weeks.
  2. Be able to jog the 5km ParkRun in 4 weeks.

As you can see these goals have all the attributes of SMART goal. We made sure its specific (wants to run), easily measurable (jog 5km ParkRun), attainable and realistic (run/walk 2-3 days per week allows some flexibility and not be over dominating) and is timely (4 weeks).View from achieving goal

Minimising Injury Risk

This is a big topic in itself and one quick paragraph will not do it justice so I will write another in depth blog in the coming days to elaborate further. Below are a few small things you can implement right now that make a meaningful impact on your injury risk.

  1. Start small. If you haven’t been exercising lately then start really small. Going too hard too fast is the number one culprit for injury. Keep the sessions short and intensity low for the first week or 2. Your #1 aim at this stage should just be getting moving
  2. Build slowly. Steady and progressive overload is important here. Aim for an increase of between 10-20% per week. Anything above this is putting in danger zone for overload and injury. From time to time don’t be afraid to a have recovery week where the load slightly eases (but not stops).
  3. Consistency is key. Many if not most of tissues in the human body thrive on consistent physical load day to day and week to week. Try to avoid large peaks and troughs in weekly and monthly loads.

Happy new year from the team at Robina Physio on the Gold Coast. If you need some help getting on top of a new or existing injury or even some help with SMART goal setting Contact Us on (07) 5578 7233 or BOOK ONLINE today.

Mastitis

Mastitis

By Aaron Woolley, Physiotherapist.

Mastitis, a prevalent concern among breastfeeding women, affects at least 1 in 10 individuals. Despite its common occurrence, many people lack a comprehensive understanding of its causes, warning signs, and optimal treatment approaches. Mastitis entails inflammation of the breast tissue and presents in two forms:

  1. Non-infectious mastitis: This type is typically caused by blocked milk ducts, leading to the retention of milk within the breast.
  2. Infectious mastitis: In this variant, a bacterial infection affects the milk within the breast.

It is crucial to address non-infectious mastitis promptly, as untreated cases may progress into infectious mastitis. This progression occurs when the blockage provides a breeding ground for bacteria, leading to an infection of the retained milk within the breast tissue.

Baby Breastfeeding Mastitis

Symptoms

Mastitis can manifest with a combination of local and/or systemic symptoms. Generally, more severe infections tend to trigger a broader range of systemic symptoms. Here are the key signs to be vigilant about:

  1. A reddened area of the breast, which may feel tender, hard, and painful, with or without an apparent lump.
  2. Localised heat surrounding the painful area.
  3. Red streaks extending outward from the affected region.
  4. Fever, ranging from low grade (38.5° or below) to more severe (above 38.5°).
  5. Flu-like symptoms, including body aches, joint pain, nausea, and a sense of lethargy or fatigue, often with a rapid onset.

Treatment

  • Most importantly keep removing the milk either via breastfeeding or expressing. And don’t worry its quite ok for your baby to continue drinking this milk
  • Apply warmth to the breast, especially prior to feeding or expressing. This can be achieved with a gently warmed heat pack and/or nice warm shower
  • Gentle massage can be effective but be careful to massage towards the areola and not hold your breast in a way to create another blockage.
  • Ultrasound therapy provided by a physiotherapist is highly underrated for the management of mastitis. This treatment technique is incredibly effective, pain free and quick.  The ultrasound waves help to loosen and break up the clogged duct allowing milk to flow once again.

The Physio’s at Robina Physio on the Gold Coast have additional training to provide this treatment technique so please BOOK NOW.

If you are experiencing severe systemic symptoms don’t hesitate to seek medical advice as there is a good chance you will also require antibiotic therapy to help treat your mastitis. Happy Baby Smiling Mastitis

A Quick Word of Support

After watching my wife struggle with repetitive bouts of mastitis and even bigger issues with keeping her supply up with the demands of our little bubs I realised the mental toll on mums with breastfeeding babies is incredible. She tried everything ranging from the above treatments to diet changes, supplements, booby bickies, and even medication to help increase her supply. Eventually she was forced to make the tough call and switch to formula. It was obvious this made her feel like a failure as a mum and was a really hard transition for her, although was an easy change for our babies. In the end our babies have grown into 3 amazing kids (most of the time), so please don’t be too hard on yourself and get down with these early struggles, cause at the end of the day breastfeeding is bloody hard work and everything will work out perfectly in the end.Happy Kids Mastitis

If you’re struggling with mastitis the team at Robina Physio on the Gold Coast are here to help, share our knowledge and support you in a caring and compassionate manner. Contact Us on (07) 55787233 or BOOK NOW online.

Shin Splints

Shin Splints (Periostitis)

By Aaron Woolley, Physiotherapist Gold Coast.

Shin splints and shin pain while running is a common and often frustrating issue which can affect all runners ranging from the causal/recreational runner, to the elite athlete.

Shin pain can be felt in two distinct regions. Firstly, the anterior (front) portion of the tibia which is often related to a muscular origin. Secondly, medial (inside) shin pain along the inside border of the tibia is due to inflammation the periosteum (periostitis) which lines the outside of our bones. Clinically this condition is called medial tibial stress syndrome, but it is often called shin splints.

Shin Splints Robina Physio

It’s important to note that specific pain and tenderness along the bone the of the tibia (lower leg) can also be a sign of a bone stress injury/stress fracture. Therefore, seeking medical advice is recommended for all people suffering with shin pain. If you’re experiencing shin pain but unsure of its origin the Physiotherapists at Robina Physio on the Gold Coast can help diagnose and treat you effectively.

What Causes Shin Pain/Shin Splints?        

Shin splints typically occurs following sudden changes in physical activity, particularly running loads. These changes include frequency, intensity, volume, terrain or even changes in technique and/or footwear. Examples can include, sharply increasing the number of training days, running longer distances or trying to adopt a forefoot running style incorrectly. We also see shin splints occurring frequently after returning to running from a period of rest e.g. after the offseason.

How Does Shin Splints Present?

Shin splints are characterised by pain along the inside border of the tibia. Swelling in the area may or may not be present. It is common for shin splint related pain to:

  • Be dull and throbbing progressing to sharp and razor-like
  • Occur both during and after exercise
  • Often worse at the beginning of running, gets better as you warm up, then worse again following running
  • Aggravated by touching the inside portion of the shin

Common findings?

Muscle weakness and reduced flexibility of the ankle are major features associated with shin splints. The major muscles affected are the Gastrocnemius and Soleus (calf muscles).

The human body works as one large functional unit and not just a combination of separate limbs. So, it is crucial we look above and below the shin as well. Foot biomechanics can often be altered in shin splints. But more commonly we see hip and pelvic muscle weakness on both the affected and non-affected side.

At Robina Physio on the Gold Coast, we have an added layer of knowledge and therefore understand that it is never as simple as one specific region or joint causing the issue and will explore all components that are leading to your shin pain.

How Are Shin Splints Treated?

The first step in managing shin pain is all about load management. This often requires slightly decreasing your running initially, followed a graduated build-up of running volume and intensity. Getting this process right is the key to success, this enables re-building of tissue tolerance of the bones, tendons and muscles of the lower limb. Bone can be very unpredictable with how it responds to training, so guidance from an expert practitioner like at Robina Physio on the Gold Coast is very important.

The next step of the process involves 2 equally important parts. Firstly, we need to loosen the tight structures around the lower limb. This can be done with soft tissue massage, dry needling and stretching exercises. Secondly, we need to strengthen your calf muscles and the muscles controlling the biomechanics of you lower limb. This would include calf raises, glut maximus, medius/minimus and core stability exercises.

Finally, in some cases footwear modification or orthotics may be considered. According to the research, the jury is still out as to whether orthotic therapy works for shin splints. In certain people orthotics will be very helpful, but not everyone. A great way to test if shoe modification or orthotics will help is to briefly strap the foot and replicate what a foot orthosis might do. A positive outcome is suggestive that a more supportive shoe or orthotic will be useful.

If  you are experiencing shin pain here are a few of things you can try at home to help manage your shin pain. Calf Stretch On Step

  1. Calf Stretch – Hold for 30 seconds and repeat up to 3 times. (Pic from Telehab)
  2. Foam Roller – Roll your calf muscles for 10 mins following every run.
  3. Ice Cube Massage – Firmly massage the ice cube up and down the shin until it melts. It ok for this to be a little sore.

If you’re struggling with shin pain and/or shin splints the team at Robina Physio on the Gold Coast are here to help and share our knowledge and expertise. Contact Us on (07) 55787233 or BOOK NOW online.

Plantar Fasciitis

Plantar Fasciitis

By Aaron Woolley, Physiotherapist.

Plantar fasciitis is a highly prevalent condition, impacting millions of individuals annually and standing as the primary cause of heel pain globally. Despite its widespread occurrence, many individuals lack a comprehensive understanding of its nature and underlying causes. At Robina Physio on the Gold Coast, we possess exceptional expertise in effectively treating this condition, and it is our sincere hope that this information empowers you on your journey to recovery.

What is Plantar Fasciitis?

The plantar fascia is a dense and fibrous band of connection tissue much like a tendon. This structure spans the bottom of the foot, originating from the heel, attaching to the ball of the foot and functions to support the arch.

Foot Anatomy

The plantar fascia is designed to absorb the high stresses and strains we place on our feet. But, sometimes, too much pressure damages these tissues. As a result, inflammation is produced by the body which then results in the pain and stiffness associated with plantar fasciitis.

Heel Spurs

Heel spurs can develop when there is prolonged and intense tension on the plantar fascia, resulting in the fascia’s attachment site experiencing overload. It is important to note that the spur itself is not the primary issue, but rather a secondary outcome of the strain on the fascia. Surprisingly, approximately 1 in 10 people may have heel spurs, but only about 1 in 20 individuals with heel spurs (5%) experience foot pain. Hence, it becomes evident that the presence of the spur does not necessarily cause plantar fasciitis, and the pain associated with it can be effectively treated without the need to remove the spur.

Foot Xray Heel Spur

How Does Plantar Fasciitis Present?

The most prevalent symptoms of Plantar Fasciitis encompass:

  1. Pain on the underside of the foot, near the heel.
  2. Pain experienced during the initial steps after getting out of bed in the morning.
  3. Pain that arises after extended periods of sitting or standing.
  4. Pain exacerbated by physical activities such as walking, running, or jumping.

Several risk factors contribute to the development of Plantar Fasciitis, which include:

  1. Tight calf muscles.
  2. Poor arch control, such as having flat feet or extremely high arches.
  3. Engaging in repetitive impact activities like running or jumping.
  4. Starting or intensifying exercise or activity levels.

How is Plantar Fasciitis Diagnosed?

At Robina Physio, an accurate diagnosis of Plantar Fasciitis is achieved through a comprehensive examination conducted by our experienced physiotherapists. This process involves a detailed discussion of your symptoms, followed by a thorough physical assessment of your foot structures and lower limb biomechanics. In certain instances, additional investigations, such as X-ray, Ultrasound, or MRI scans, may be recommended to complement the evaluation and provide a comprehensive understanding of your condition. Rest assured, our team is dedicated to delivering precise and effective diagnoses to guide your treatment plan.

How Do We Treat Plantar Fasciitis?

At Robina Physio on the Gold Coast, we use a variety of treatment modalities to manage your heel pain.

Calf Stretch On StepTreatment options we commonly use include:

  1. Soft tissue massage and trigger point therapy of the calf and foot
  2. Acupuncture and dry needling
  3. Supportive taping
  4. Footwear and orthotic advice
  5. Exercise and activity load management
  6. A lower limb stretching and strengthening program
  7. Rolling Foot On Frozen BottleTechnique correction and return to running advice
  8. Use of pain-relieving devices e.g. Strassburg sock and my favourite rolling your foot on a frozen bottle.

Unfortunately for some people conservative management does not fully resolve their pain. For these people combining physiotherapy with injection therapy can be very effective. The next tier of treatment available would include:

  1. Steroid Injections
  2. PRP Injections

If your suffering with Plantar Fasciitis or foot pain the Robina Physio on the Gold Coast is has to expert care available to help get you pain free and moving again. Contact Us on (07) 55787233 or BOOK ONLINE.

Exercise

Exercise

By Aaron Woolley, Physiotherapist.

Exercising and being physically active is essential for good mental and physical health and wellbeing. It reduces the risk of many diseases, including some cancers, and helps maintain a healthy weight.

Based on self-reported data from the 2017–18 National Health Survey, more than half of adults (55%) didn’t participate in sufficient physical activity. Women were more likely than men to be insufficiently active (59% compared with 50%). The rate of insufficient activity increases with age, with more than two-thirds of those aged 65 and over (69% of men and 75% of women) were insufficiently active.

Unfortunately, insufficient exercise does significantly increase the risk of getting many associated diseases including:

  • Type 2 diabetes = 19%
  • Bowel Cancer = 17%
  • Uterine Cancer = 16%
  • Dementia = 14%
  • Coronary Heart Disease = 12%
  • Breast Cancer = 11%
  • Stroke = 10%

 

Activity trends across the ages

The trend of insufficient activity is also a major factor leading to overweight and obesity rates in Australia, which are not improving. An estimated 1 in 4 (25%) children and adolescents aged 2–17 were overweight or obese (1.2 million children and adolescents).

Children Obesity Trends

For adults, 2 in 3 (67%) Australians were overweight or obese (36% were overweight but not obese, and 31% were obese). That’s around 12.5 million adults. Men had higher rates of overweight and obesity then women (75% of men and 60% of women), and higher rates of obesity (33% of men and 30% of women).

The health impact of overweight and obesity does also carry a large burden to the community. In 2015, 8.4% of the total burden of disease in Australia was due to overweight and obesity. It also increases the likelihood of developing many chronic conditions, such as cardiovascular disease, asthma, back problems, chronic kidney disease, dementia, diabetes, and some cancers. It is also associated with a higher death rate when looking at all causes of death.

Adult Obesity Trends

Now for some good news!

It is possible for everyone to take control of their activity levels in many cheap and easy ways. At Robina Physio on the Gold Coast we can help you get started in a safe and effective manner.

Exercise prescription is an integral part of physiotherapy practice and is clinically used to:

  • Optimise musculoskeletal strength and function
  • Improve cardiovascular fitness
  • Improve psychological well-being
  • Increase bone density
  • Decrease hospital length of stay
  • Speed rehabilitation
  • Prevent future injuries

Being physically active is important across all ages and contributes to healthy growth and development in children and adolescents. The physical activity guidelines help us provide evidence-based recommendations that outline the minimum amount of physical activity required for health benefits.

Children should aim for:

  • Energetic play (such as climbing, running, jumping and dancing)
  • Going for a swim, walk, jog or bike ride
  • Playing a sport like tennis, football or basketball

Children aged 2–5 should spend at least 180 minutes a day on a variety of physical activities, including energetic play, with no more than 60 minutes of screen time per day.

Children and young people aged 5–17 should accumulate at least 60 minutes of moderate to vigorous activity per day, and no more than 120 minutes of recreational screen time per day.

https://www.health.gov.au/health-topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-infants-toddlers-and-preschoolers-birth-to-5-years

https://www.health.gov.au/health-topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-children-and-young-people-5-to-17-years

Kids Exercise Robina Physio

Adults:

  • Should be active most days per week, preferably every day.
  • Accumulate at least 150 minutes of moderate exercise/activity or 75 minutes of vigorous exercise/activity each week.
  • 65 and over should accumulate at least 30 minutes of moderate exercise/activity each day.
  • Include muscle-strengthening activities as part of your daily physical activity on at least 2 days each week. (e.g. push ups, squats, lifting objects etc)
  • If you are pregnant and you and your baby are healthy you should aim to meet the requirements for adults.
  • Keep in mind that any exercise or activity is better than none.

https://www.health.gov.au/health-topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-adults-18-to-64-years

https://www.health.gov.au/health-topics/physical-activity-and-exercise/pregnancy

https://www.health.gov.au/health-topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-older-australians-65-years-and-over

Exercise Robina Physio

As experts in exercise across the life span, physiotherapists play an important role in promoting, prescribing and managing exercise programs. Contact Us on (07) 55787233 or BOOK NOW so the team at Robina Physio on the Gold Coast can help get your activity and exercise journey started.

Knee Pain (Patellofemoral)

Knee Pain

By Aaron Woolley, Physiotherapist.

Knee pain is a widespread issue that can impact individuals of all ages and fitness levels. The causes of knee pain vary and can stem from acute injuries like fractures, ligament or meniscus tears, as well as chronic conditions such as arthritis, gout, tendinopathies, or patellofemoral pain syndrome (PFPS).

Among these, PFPS stands out as one of the most common knee injuries, affecting a significant portion of the population during their lifetime, with a higher prevalence among adolescent females. Often referred to as “runner’s knee” or “jumper’s knee,” PFPS is commonly experienced in the athletic community but can also occur in non-athletes. It is essential to address knee pain promptly and accurately diagnose the underlying cause to facilitate effective treatment and ensure optimal well-being.

Knee Anatomy Robina Physio

https://orthoinfo.aaos.org/en/diseases–conditions/patellofemoral-pain-syndrome/

Risk factors for getting Patellofemoral pain syndrome include excessive weight, muscular imbalances, rapid changes in activity levels and simply overuse from sports such as running or occupations that require repetitive squatting, hill or stair climbing.

PFPS is primarily caused from mal-tracking of the patella (knee cap) within the femoral condyles (end of the thigh bone). This can come from the following lower limb soft tissue changes.

  1. Tight Iliotibial Band (ITB)
  2. Tightness in the Hamstrings, Hip Flexors and Calf muscles
  3. Weakness in the Gluteus muscles. Particularly Gluteus Medius
  4. Weakness in the medial Quadriceps (VMO)
  5. Excessive pronation of the feet

Patella Tracking Robina Physio

https://orthoinfo.aaos.org/en/diseases–conditions/patellofemoral-pain-syndrome/

Knee pain can be effectively managed through conservative approaches, and in more severe cases, interventions like injections or surgery may be necessary. However, Patellofemoral pain syndrome (PFPS) is fortunately a condition that rarely requires invasive treatments.

At Robina Physio on the Gold Coast, we possess the expertise to accurately assess the cause of your knee pain during our clinic sessions. For PFPS, our subjective assessment focuses on identifying factors like insidious onset, overload events, and specific aggravating activities such as squatting, climbing stairs/hills, and pain with sustained sitting. During the objective examination, we thoroughly assess the entire structure of your knee joint, including range of motion, strength, ligament and tendon integrity, functional status (including running), and patella tracking.

Our physiotherapy treatments for knee pain are highly effective and encompass various techniques such as soft tissue release of tight muscles, dry needling, taping, orthotics, and targeted strengthening exercises for the glutes, quadriceps, and hamstrings.

Below, you will find three exercises that the physiotherapists at Robina Physio on the Gold Coast use with high rates of success in treating patellofemoral pain syndrome. If you are experiencing this condition, we highly recommend giving these exercises a try.

  1. Cycling: This is simple yet probably the best bang for your buck exercise for managing knee pain. Start within your limits and build steadily. Aim for 20-30 mins most days.

Cycling For Knee Pain Robina

  1. Wall Sit: This exercise is very effective at strengthening your quadricep muscles. Don’t go too deep when you start. If you get pain then simply go a little higher. Try getting to 3 x 1 min holds. (Pic from Telehab)

Wall Squat For Knee Pain Robina Physio

  1. Side Kick (Hip Abduction): This can be done in standing with or without a resistance band. Make sure your contracting your glute (bum) muscles properly and not using your hip flexors. Try 3 x 20 slow repetitions. (Pic from Telehab)

Side Kick Knee Pain Robina Physio

At Robina Physio on the Gold Coast we offer expert assessment, treatment and guidance for knee injuries. Don’t hesitate to Contact Us on (07) 5578 7233 or BOOK NOW and we will help get you moving normal again.