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Physiotec Updates

Physiotec Updates

END OF YEAR ROUNDUP!

2015 in Review

2015 was a year of exciting change and growth for Physiotec. The clinic expanded physically, new staff came on board, our technology advanced, our physiotherapists further expanded their already high level of knowledge and we reached out to the community with involvement in sporting events, teaching locally and abroad and with social media.

The clinic expanded upstairs this year providing another large gym space, two more treatment rooms, a second waiting area, a meeting/teaching space for our staff and a second office. We have also taken on board a Patient Liaison Coordinator, Toni Corta. You may have heard from Toni who is responsible for helping track the progress of our patients with the aim of providing the best quality service possible. We pride ourselves on providing treatment that is up to date and informed by cutting edge scientific evidence. The information Toni collects will further help us determine which treatments provide the best outcomes in our patient population. Better outcomes achieved more rapidly for our clients continues to be our primary focus.

We also invest in technologies that can help us achieve this goal. Physiotec invested in an additional real time ultrasound machine used for muscle and tendon assessment, rehabilitation and biofeedback. Our ViMove system (wireless accelerometers for assessing movement) has undergone considerable advances with new programmes to assess and improve ‘core control’ and neck movement as well as advances in the knee and running modules. Our second gym has been equipped with a new reformer with a tower attachment and we also added a ladder barrel allowing a host of new exercise challenges. A spine corrector, two TWS sliders, a ballet bar, balance equipment, band stations, a weights station and much more can also be found in our new exercise area.

pilates gym new

Our physiotherapists are passionate about continually increasing their expertise. Our staff have been involved as treating physiotherapists in university research trials and have attended national Physiotherapy and Sports Medicine conferences and many workshops and lectures on topics such as Hip Pain, Hamstring Injuries, Bone Health, Women’s & Men’s Health (pelvic pain and pelvic floor function), Hypermobility, Dance Medicine, Running Injuries & Rehabilitation and Tendon Pain & Rehabilitation.

Our principal physiotherapist, Dr Alison Grimaldi has also contributed to the knowledge of other physiotherapists and health professionals in Australia and overseas through multiple presentations at the recent Australian Physiotherapy Association Biennial Conference at the Gold Coast and lectures and workshops presented at Pure Sports Medicine(London), PhysioUK (London), Centre for Sports and Exercise Medicine, William Harvey Research Institute (London), Neath Port Talbot Hospital (Wales, UK), the Sports Surgery Clinic (Dublin, UK) and the Australian Institute of Sport (Canberra).

Dublin lecture 2

Sports Surgery Clinic, Dublin

Alison also presented weekend courses for physiotherapists in Brisbane, Sydney, Melbourne and Canberra. She has continued her research involvement into management of gluteal tendon pain and hip joint pain through the University of Queensland and University of Melbourne and has co-authored three papers in peer reviewed scientific journals such as Journal of Orthopaedic & Sports Physical TherapyMedicine and Science in Sports and Exercise and Sports Medicine Journal.

Physiotec has been more connected to the world in 2015, with increased activity on Twitter and Facebook. We aim to help keep our followers up to date with the latest research in physiotherapy by providing information on useful links, blogs and tips on injury prevention.  Not only are we active on social media, but we also launched a new and easy to navigate website where you can browse our services, get to know the staff, and read more news in physiotherapy. Here is link to our new website: Physiotec

As part of our goal to get our clients more fit and active throughout their recovery, Physiotec staff and patients participated in the International Women’s Day Fun Run which raises money for Breast Cancer.

international women's day

We have also worked hard to help our patients to achieve their own activity and work related goals. Staff physiotherapist, Eric Huang, who is the founder of Brisbane-based cycling group M.I.A, helped some of our clients earn cycling medals while managing to gain podium placings himself.

MIA

mia podium eric

We have helped clients achieve lifelong goals of overseas travel and returning to work after years of disability, but it is often the everyday things that have the most impact – walking upstairs painfree for the first time in months, being able to attend family or social gatherings, achieving a good night’s sleep. We always love to see our clients overcome their difficulties and reach their personal goals.

What’s up in 2016?

In this coming year, our physiotherapists will be attending conferences and courses around the world. Alison will be attending the Low Back & Pelvic Pain Congress in Singapore and lecturing and presenting at the International Federation of Orthopaedic Manipulative Physical Therapists in Glasgow, UK. She will also be teaching in London, Wales, Ireland, Paris, Hong Kong, Singapore and New Zealand, as well as her regular Australian courses. Sharon will be attending the First International Ehler-Dhanlos and Hypermobility symposium in the USA. Kirsty, will once again be working with elite tennis players at the Australian Open in Melbourne. Eric will be continuing to further his knowledge and performance in all things cycling. Megan will be furthering her expertise in Women’s Health and Tony & Louise will be sharing their knowledge with some part time tutoring at the University of Queensland.

We will also be joined by visiting psychologist, Carolyn Uhlmann, who has a focus on providing support for patients coping with acute and chronic pain, chronic illness or caring for a loved one with health problems. She can also assist those who are learning to adjust and cope with changes in health, medical events, mobility and independence.

With the new staff members, new gym, new Pilates programs, running assessments and spinal assessments, you can expect that we will be offering more at Physiotec as we continue to grow.

 

Osteoarthritis and Running

Osteoarthritis and Running

Does running accelerate the developing of osteoarthritis?

There are so many misconceptions about running and how bad it can be for your joints. You may have heard many friends and family members comment on this and they may have even tried to convince you to stop running and go swimming instead. Here is what the scientific research tells us so far:

Osteoarthritis (OA) is a musculoskeletal condition that involves degeneration of the joints and impact during weightbearing exercise such as running and may contribute to joint loads. There is very little evidence however, that running causes OA in the knees or hips. One study reported in 1985 by Sohn and Micheli compared incidence of hip and knee pain and surgery over 25 years in 504 former cross-country runners. Only 0.8% of the runners needed surgery for OA in this time and the researchers concluded that moderate running (25.4 miles/week on average) was not associated with increased incidence of OA.

In another smaller study of 35 older runners and 38 controls with a mean age of 63 years, researchers looked at progression of OA over 5 years in the hands, lumbar spine and knees (Lane et al. 1993) . They used questionnaires and x-rays as measurement tools. In a span of 5 years, both groups had some participants who developed OA- but found that running did not increase the rate of OA in the knees. They reported that the 12% risk of developing knee OA in their group could be attributed to aging and not to running. In 2008, a group of researchers reported results from a longitudinal study in which 45 long distance runners and 53 non-runners were followed for 21 years. Assessment of their knee X-Rays, revealed that runners did not have a higher risk of developing OA than the non-running control group. They did note however, that the subjects with worse OA on x-ray also had higher BMI (Body Mass Index) and some early arthritic change in their knees at the outset of the study.

Is it better for your joints to walk than to run?

It is a common belief that it must be better to walk than to run to protect your joints. In a recent study comparing the effects of running and walking on the development of OA and hip replacement risk, the incidence of hip OA was 2.6% in the running group, compared with 4.7% in the walking group (Williams et al 2013). The percentage of walkers who eventually required a hip replacement was 0.7%, while in the running group, it was lower at 0.3%. Although the incidence is small, the authors suggest the chance of runners developing OA of the hip is less than walkers.

In the same study, Williams and colleagues reinforced that running actually helped keep middle-age weight gain down. As excess weight may correlate with increased risk of developing OA, running may reduce the risks of OA. The relationship between bodyweight and knee OA has been well-established in scientific studies, so running for fitness and keeping your weight under control is much less likely to wear out your knees than being inactive and carrying excess weight. 

How much is too much running?

Recent studies have shown that we should be doing 30 minutes of moderate exercise daily to prevent cardiovascular disease and diabetes. But with running, researchers still have not established the exact dosage of runners that has optimal health effects. Hansen and colleagues’ review of the evidence to date reported that the current literature is inconclusive about the possible relationship about running volume and development of OA but suggested that physiotherapists can help runners by correcting gait abnormalities, treating injuries appropriately and encouraging them to keep the BMI down.

We still do not know how much is “too much” for our joints. However, we do know that with age, we expect degenerative changes to occur in the joints whether we run or not. Osteoarthritis is just as common as getting grey hair. The important thing is that we keep the joints as happy and healthy as possible.

What is the best way to start running?

If you are not a runner and would like to start running, walking would be a good way to start and then work your way up to short running intervals and then longer intervals as you improve your fitness and allow time for your body to adapt.

Therefore, running in general is not bad for the joints. It does not seem to increase our risk of developing OA in the hips and knees. But the way you run, the way you train and how fast you change your running frequency and distance may play a role in future injuries of the joints.

But that’s another story. Watch this space for more running gems....

Are you just starting to run?

Do you have pain during or after running?

Would you like a running assessment?

Our sports physiotherapists can provide you with a thorough assessment to assess your 'run-readiness' and help you build or re-build your running routine.

References:

Cymet and Sinkov 2006. Does Long Distance running cause OA. The Journal of the American Osteopathic Association, June 2006, Vol. 106, 342-345.

Hansen et al 2012. Does Running cause osteoarthritis in the hip or knee?. Physical Medicine and Rehabilitation. 4 (5) 117-121.

Lane et al. 1993. The Risk of OA with Running and Ageing. Year Longitudinal Study. Journal of Rheumatology (20) 461-468

Sohn et al. 1985. The Effect of Running on pathogenesis of OA in hips and knees. Clin Orthop Res (9) 106-109

Williams 2013. Effects of Running and Walking on OA and Hip Replacement Risk. MedSci Sports Exerc. 45 (7) 1292-1297

Why should I exercise during and after Pregnancy

Why should I exercise during and after Pregnancy

For Mums and Mums to be…

Have you ever experienced some pain in the pelvis  or in the hips during or after pregnacy?

Poor pelvic control or instability is a condition more common in women and is most likely to occur during or post –pregnancy.  During pregnancy, a hormone called relaxin is released in the body to allow the ligaments to stretch to accommodate the fast growing baby. With another human being growing rapidly, the pelvis does undergo an increase in loading, which some women cope with a little better than others – this can be due to genetic factors such as natural pelvic and ligamentous structure, or the background muscle conditioning you had prior to the pregnancy.

DON’T WORRY THOUGH…. remember that “instability” does not mean your pelvis is physically out of place but rather your muscles around the pelvis are not providing adequate’ force closure’ or mechanical compression or support around the pelvis while the ligaments are lax.

Who is more at risk of developing Pelvic pain due to pelvic instability?

Research has shown that  women who are involved in strenous work, or have a previous history of low back pain and a history of lumbo-pelvic (lower back and pelvis) pain during previous pregnancies are at risk. Although, direct trauma to the pelvis such as a fall can also result in pelvic instability.

How can Physiotherapy Help?

Use of Physical Aids

Physiotherapy can help by identifying the cause of the pain around the pelvis, whether it is originating from the lumbar spine or from pelvic instability. Off loading the pelvis may be important in reducing the symptoms such as using crutches or walking sticks. Tape or pelvic/abdominal belts  can also provide some compression around the pelvis, assisting with stability in the shorter term.

Postural and Movement Education

Being aware of movements or postures that may overload the pelvis, and optimising muscles support around the lumbar spine and pelvis are the most  important factors in managing this condition. Some specific advice on what movements or positions you may need to avoid or adjust can make a big difference in avoiding pain aggravation.

Specific and Appropriate Strengthening Exercises

Improving activation of the deep supporting muscles around the pelvis is also extremely important for providing dynamic control, so despite laxity in the ligaments, your muscles can assist in compensating for the reduced support that ligaments can give during your pregnancy. Using real time ultrasound to train deep abdominals and pelvic floor muscles, and some of the deep hip/pelvic muscles are beneficial to someone who has pelvic instability. This is followed by a progressive strengthening program matched to the needs of the individual. Your physiotherapist can recommend appropriate Pilates and Pilates-based exercises as well as monitor your progress throughout your pregnancy and even after your pregnancy.

Transversus Abdominis Ultrasound At Rest
Ultrasound retraining of the abdominal wall – Transversus abdominis

If you are suffering from pelvic pain due to instability, see a Women’s Health Physiotherapist and get some good advice on pain management, training in deep muscle activation and an appropriate exercise program.

 

Are you currently pregnant?

Do you have pain in your pelvic region?

Not sure what exercises to do?

Our physiotherapists can provide you with a thorough assessment, and provide you with appropriate recommendation on how to approach your pelvic pain, or safely exercise during your pregnancy.

 

Image Courtesy of keerati of freedigitalphotos.net

References:

Vleeming et al. (1992). An integrated therapy for peripartum pelvic instability. A study of the Biomechanical effects of Pelvic Belts. American Journal  of Obstetrics. 166 (4): 1243-1247

Wu et al. (2004). Pregnancy-Related Pelvic Girdle Pain (PPP)I: Terminology, Clinical Presentation and Prevalence. European Spine Journal. 13:575-589

Hypermobility and Injuries: What is their relationship?

Hypermobility and Injuries: What is their relationship?

Hypermobility and Injuries

Have you been told that you are double jointed? You may have heard this term before to describe being more flexible than usual. Well, your joints are not “ double” but passive structures such as ligaments and connective tissue allow more stretch than normal.  Continue reading

Back into the Spring of Things

Back into the Spring of Things

Back into the Spring of Things: How to get back on track after the lull in the Winter

In winter, it is normal to feel less motivated with exercise and physical activity. Now that the days are getting longer and nights are shorter we can help you get into the spring of things! Research has shown that being active has many health benefits and helps decrease your risk of chronic disease. But if you don’t know where to begin, here’s a list of activities that are inexpensive and fun, especially if you do them with friends, to help you get started:

Outdoor Activities

Gladwell and his colleagues in 2013 reported that exercise performed outdoors helped increase levels of physical activity and decreased the rate of perceived exertion – that is, for the same amount of energy burnt, it felt easier to exercise outdoors than indoors. Psychological benefits of exercising outdoors include improvement in mood and reduced stress levels. Outdoor activities are not only confined to thrill seeking activities but also include simple activities such as walking or cycling around the neighbourhood, around the park or hiking or trail-riding in the bush. Green exercise is good exercise! Trade the treadmill walking for outdoor walking near the river or amongst the trees.

Walking & Running

An outdoor activity such as walking, especially one that accomplishes 10,000 steps a day, can help reduce the risk of developing chronic diseases such as cardiovascular disease, obesity and diabetes (Brown et al 2006) and in a study done in Rockhampton where they walked 10,000 steps for 15 weeks, it was found that the participants reported improved well-being and fitness levels. Using a pedometer to track the number of steps has been found to be effective in increasing physical activity (Chan et al 2004) and significantly decreases Body Mass Index (a measure of determined by height and weight) and blood pressure (Bravata et al 2007). Walk to work if you can and incorporate it to your daily activities.

If walking on the streets is not exciting enough then hiking or nordic walking (walking while using poles) also benefits resting heart rate, exercise capacity and improves quality of life of people with various diseases (Tschentscher et al 2013).

You then may be able to progress to increasing your pace and start adding some jogging or light running intervals to increase the intensity of the exercise. If you have never been much of a runner though, it might be a good idea to have a running assessment and get some instruction on good form and training techniques from your physiotherapist. Always progress a new activity slowly, and if you do develop niggles anywhere, don’t ignore it, pop in for a check-up and advice so we can keep you on the road.

Back into the Spring of Things - beach_running

Cycling

Is your work near your home? Then ditch the car and ride the bike. In Brisbane city, we have access to public bicycles and they are situated in different, easy access locations around the city. Just like walking, researchers have found strong evidence for fitness and health benefits and moderate evidence for risk factors for cardiovascular disease (Oja et al 2013).

Did you know that countries such as Netherlands and Germany have included promotion of safe walking and cycling in their campaign for improving public health (Pucher, Dijkstra 2003). Just recently in July, the Australian Walking and Cycling Inc (AWCC) was formed and it is the only national forum in Australia that has focused on research and promotion of mobility in Australia. They have recently joined forces with the Heart Foundation, which aims to prevent premature death caused by cardiovascular disease in Australia. Be part of the movement! Live long!

mountain_biking

Pilates

Now, if you are limited by time or musculoskeletal injury, Pilates is a good way to get active if grunting in the gym and crossfit are not your thing. Pilates-based exercise and functional strengthening have been very popular in recent years, especially for people who enjoy performing slow, controlled movement. In fact, for rehabilitation, this form of controlled movement retraining and strengthening under the guidance of a physiotherapist, can provide an ideal foundation for return to normal daily activities and for dynamic higher level sports or work tasks. There is evidence that Pilates helps improve functional ability and decrease pain in people with chronic low back pain (Wajswelner et al 2012). It can also help improve dynamic balance (Johnson et al 2007) which would be beneficial both if you are feeling a little unsteady on your feet, or for higher level sporting activities where balance and control is critical for performance and injury prevention.

As we mentioned above, green exercise is good exercise. You get the best of both worlds with the outdoors all around with our Pilates classes. Try it out.

barrel exercise annie

Now we have given you something to think about, have you decided what activity you would like to spring back into? Once you have decided, set a goal and train for it.

Here are some useful links to activities around Australia for events you may be interested in:

https://www.runningcalendar.com.au/

http://www.cycling.org.au/Events/Events-Calendar

If you are still not sure where or how to start, come and see one of our highly trained physiotherapists to help you spring back into action.

References:

Bravata et al (2007). Using Pedometers to increase Physical Activity  and Improve Health: A Systematic Review. The Journal of the Americal Medical Assoc. 298 (19)

Brown et al (2006) 10,000 Steps Rockhampton: Evaluation of a Whole Community Approach to Population Levels of Physical Activity. Journal of Physical Activity and Health 1:1-14

Johnson et al (2007). Effects of Pilates-based exercises on Dynamic Balance. Journal of Bodywork and Movement Therapies . 11 (3)

Oja et al (2103) Health Benefits of Cycling: A systematic Review. Scandinavian Journal of Medicine and Science in Sports. 21(4)

Pucher,Dijkstra (2003). Promoting Safe walking and Cycling to Improve Public Health: Lessons from the Netherlands and Germany. American Journal of Public Health . 93(9)

Tschentscher et al (2103).Health Benefits of Nordic Walking. American Journal of Preventive Medicine . 44(1)

Wajswelner et al (2012). Clinical Pilates vs. General Exercise for Chronic Low back pain: Randomized Control Trial. Med Sci Sports Exerc . 44 (7)

 

 

 

 

 

 

 

Heels are not always good for the sole

Heels are not always good for the sole

As physio's we often see a link between high heels and pain, but so many people are attached to their heels and these fashion items have been worn for many centuries. Did you know that men used to wear high heels? According to historians, way before the famous high heel was part of the female wardrobe, they were used by soldiers in the 16th century to give them stability in stirrups while riding on a horse so they could shoot their bows while standing up. High heeled shoes have evolved over the centuries with Christian Dior making them popular after World War II and today they are a part of most women’s wardrobe. But apart from being a fashion statement, what do heels do for you?

The HIGH behind the high heels

A recent study by Morris and colleagues studied female gait patterns in flat and high heeled shoes. They found when females wore heels, their perception of attractiveness was increased. They started to walk in a more feminine way with greater pelvic rotation and increased lateral pelvic tilt. Smith in 1999 reported that wearing high heels indicated status for women. No wonder researchers also found that the number of pairs of high heeled shoes owned by study participants was a minimum of 4 and maximum of 25. These may be the good reasons to own a few pairs! How many pairs of heels do you own?

The DOWNSIDE of wearing high heels

Wearing this type of footwear does have its ups, however long term they do take a toll on the body. Several studies have shown that long term high heel use impacts on the whole lower body, from the lower back all the way down to the feet.

High heels and lower back pain

Researchers  have reported that in a survey they conducted with 200 females who had been wearing high heels regularly for 1 year, 58% of them were complaining of low back pain (Lee et al 2001). This is not surprising considering standing and walking in heels has been shown to result in changes in the curvature of the lower back and increased levels of activity in the back muscles, both potentially amplifying loads on the joints of the lower back and fatigue in the back muscles.

High heels and hip pain

When wearing heels, weight is transferred forward towards the forefeet. This forward shift of the bodyweight at the feet means that the trunk and head need to shift relatively backwards to balance the body weight. This changes where the weight is transmitted through the hip and potentially places larger loads particularly through the front of the hip. The increased in rotation and tilting of the pelvis that occur while walking in heels can also place adverse loads across the hips joints and tendons. Even when sitting, high heels push the knees up higher than normal which can result in higher compressive loads across the hip joint. All of these factors may explain why wearing high heels often aggravates hip pain.

High heels and knee pain

The knee joint is also affected with increased compressive forces around the patellofemoral joint (kneecap) (Kerrigan et al 1998) and the inner compartment of the knee joint with forces increased by 23% (Kerrigan et al 1998, Stephanyshyn et al. 2000, Simonsen et al 2012). Landing on those heels while walking also means your quadriceps have to work harder as the foot tends to accelerate more quickly to its impact with the ground (Stefanyshyn et al 2000). Too much activity of your quadriceps can contribute to the higher compressive forces around the knee. Some researchers suggest that the wearing of high heels may make females more vulnerable to developing knee osteoarthritis (Kerrigan et al 1998, Simonsen et al 2012).

High heels and calf & ankle pain

The forward shift in bodyweight can lead to unstable postures (Lee et al 2001) and an increased rate of falls and ankle sprains. In the lower leg, calf muscles shorten while the Achilles tendon, the tendon at the back of the heel, stiffens up resulting in decreased active range of motion of the ankle (Csapo et al 2010). This can explain why regular heel users have discomfort when walking in flats.

High heels and forefoot pain

The biggest impact however occurs at the forefoot. Wearing high heels creates a doubling of pressure under the balls of the feet compared to walking barefoot (McBride et all 1991, Speknijder et al 2005). Bunions and callouses under the feet have also been associated with wearing narrow and shorter shoes (Menz 2005).

Stand more comfortably - Book Today with one of our physios

Physiotherapy recommendations around high heels

From a health perspective, high heels are not the greatest footwear. As physiotherapists, we commonly see lower back, hip, knee and foot problems aggravated with the use of heels.

Our recommendations for wearing high heels:

  1. Avoid or minimise use of high heels
  2. Save those heels for special occasions rather than wearing them on a daily basis
  3. Don’t walk to/from work in heels – change into sports/walking shoes
  4. Keep the heels to < 2 cm heel height (Ko et al 2009)
  5. When sitting, if you can slip those heels off and place your feet flat on the ground, do so.
  6. Take some ballet flats with you when going out so you can easily slip them on to dance

So, here’s your excuse to go out and buy some new shoes ladies!

Do your body a favour and choose the flats or the lower heels.

Do you experience pain when wearing heels?

Our physiotherapists can assist you with your pain and get you standing more comfortably again.

References:

Csapo et al (2010)On Muscle Tendon and High Heels. Journal of Experimental Biology, 213,2582-2588

Kerrigan, Todd, O Riley (1998)Knee Osteoarthritis and high-heeled Shoes. Lancet, 351:1399-1401

Ko et al (2009) Relationship Between Plantar Pressure and Soft Tissue Strain Under Metatarsal Heads with Different Heel Heights . Foot and Ankle International , 3,11

Lee, Jeong,Freivalds (2001) Biomechanical Effects of wearing High Heeled Shoes. International Journal of Industrial Ergonomics, 28,321-326

McBride et al (1991) First Metatarsophalangeal Joint Reaction Forces during High- Heel Gait. Foot and Ankle International

Menz, Morris (2005) Foot Characteristics and Foot Problems in Older People. Gerontology, 51(5): 346-351

Simonsen et al (2012)Walking on High Heels Changes Muscle Activity and the Dynamics of Human Walking Significantly. Journal of Applied Biomechanics,28,20-28

Smith (1999) High Heels and Evolution. Psychology, Evolution and Gender ,1.3,245-277

Speksnijder et al (2005) The Higher the heel, the igher the forefoot –pressure in ten healthy women. The Foot,15, 17-21

Stefanyshyn et al( 2000)The Influence of High Heeled Shoes on Kinematics, Kinetics and Muscle EMG of Normal Female Gait. Journal of Applied Biomechanics, 16, 309-319

Thompson, Coughlin (1994) The High Price of High- Fashion Footwear, The Journal of Bone and Joint Surgery 76A,1586-1593

Dr. Alison Grimaldi goes global: UK Lecture Series on Assessment and Management of the Hip and related injuries

Dr. Alison Grimaldi goes global: UK Lecture Series on Assessment and Management of the Hip and related injuries

Hip injuries may be tricky to diagnose and manage as pain around the hip can stem from different parts of the body such as the groin, lumbar spine, and structures such as muscles, cartilage and tendons. Every year more and more questions are answered about the hip as more research is done. ( However, more and more questions still arise, so more research is needed. )

Our principal physiotherapist, Dr. Alison Grimaldi, who is very experienced with the hip and hip injuries and how to manage them has recently visited the UK and did a few lectures about the hip to physiotherapists and various clinicians in different clinics and hospitals in the UK.

Here is a recap of her tour:
First stop was the Centre for Sports and Exercise Medicine, William Harvey Research Institute at the Queen Mary University of London. Here, she shared her knowledge on Gluteal Tendinopathy and talked about how the injury develops, how to assess this and also discussed effective treatment and management.

On her second day, she gave an evening lecture to physiotherapists from various clinics in London titled : Hip Pain: Is your management helping or harming your patient in the longer term? She was hosted by PhysioUK

On the third day, she was hosted by Pure Sports Medicine Physiotherapy clinic for a day and conducted a practical course on Understanding Tendinopathies of the Hip and Pelvis. This day was also very interesting as she tackled diagnosis of common tendinopathies, as well as biomechanics on how they develop. In the afternoon session, participants also got to play around with different exercises using Pilates equipment like the reformer and other common apparatus such as the swissball, therabands and foam rollers and specifically targeting hip control and gluteal or buttock strength.

After her London stint, she then visited Wales and was welcomed by Neath Port Talbot Hospital and lectured on Motor Control of the Hip and Implications for Clinical Practice. This again was successful as the participants got to learn about those slow and controlled activations. (Yes if you have been to our clinic for hip pain, you must know about these really gentle exercises! )

Last but not least, not only did she visit Ireland and have some Guiness on the side, but also lectured on Early re-training of the deep hip musculature & considerations for higher level therapeutic exercise for the clinicians at the Sports Surgery Clinic Santry in Dublin!

Did you know, that not only does she lecture overseas, but she has also contributed to a chapter about the hip in the 4th Edition of the prestigious Grieve’s Modern Musculoskeletal Physiotherapy textbook? (Physiotherapists out there, get your copy! It really is a good reference to have !)

She has been busy, staying on top of the research about the hip and is continuing to educate physiotherapists around the world and sharing her clinical expertise on everything and anything about the hip. Thanks Alison! Looking forward to more lectures.

Stay tuned for more lectures here and abroad and latest developments about the hip and pelvis.

Follow her on Twitter @alisongrimaldi , follow us @physiotecAUS.

How to cross the finish line of the 100 km Oxfam trailwalk and in good condition

How to cross the finish line of the 100 km Oxfam trailwalk and in good condition

The Oxfam trailwalk started in 1981 in Hongkong as a military training exercise for the Queen’s Gurkha Signals, one of the combat support arms of the British Army. Over the years, this has become a popular endurance challenge and at the same time has raised money to help developing countries.

The challenge is to walk 100 kilometers in under 48 hours. This is a very long walk and participating in this gruelling task has its challenges. In a study done in Hong Kong in 2007, medical risks of the 100 km walk were assessed. Researchers have found that the most common problems encountered were blisters of the feet, diarrhoea, skin irritation, wounds and acute joint pain. In fact, the number one reason for not crossing the finish line was blisters and at the Sydney Oxfam trailwalk in 2011, 73% of walkers developed blisters. In another study, they found that 60.8 % of the participants complained of muscle cramps.

For those participating in the upcoming OxFam Trailwalker event in Brisbane on the 17-19th June, we hope that as you read this, you have had ample time to train and prepare youhttps://trailwalker.oxfam.org.au/brisbaner body for the arduous task. So, before you embark on your 100 km walk with your team, here are some great tips for the hike:

SHOES:

Hiking boots or trail running shoes are the best shoes to wear. Make sure you that you have worn them before and have broken them in. Do not wear new shoes. Bring an extra pair with you just in case your shoes become too uncomfortable.

SOCKS:

Bring several pairs of socks. Wet socks due to sweat, can make the skin of your feet weak, making it prone to skin irritation and blisters. Cotton socks are not recommended as they keep the moisture in.

TREKKING POLES:

Research has shown that trekking poles reduce the risk of lower limb injuries especially going down the mountain. It was also mentioned that in another study, 71% of ankle injuries were sustained by walkers not using a pole during the descent. It is worthwhile to use some poles for this long walk.

NAILS and CALLUSES:

Clip

your toe nails before the walk. If you have any calluses that have developed over the months, file them so they will less likely to bother you while you walk.

BLISTER PREVENTION:

Some prevention strategies include using tape, powder, lubricants patches and for some people, orthotics. Make sure you have them handy in your backpack. Blister prevention strategies are listed at www. Blisterprevention.com.au: Here is a link to a good read on this.

CRAMPS:

This has been associated with dehydration, muscle weakness and lack of electrolytes. Make sure that you are well hydrated and do not forget to stretch once in a while during your walk.

We have given you some tips on how to survive the walk. We hope you have a good support team, keep hydrated, use trekking poles, look after those feet and have a happy smile. Enjoy the 100 km walk through the bush. Good luck.

Send us a picture of you crossing the finish line. We know your team will!

 

References:

Au, Ho. Injury pattern and factors affecting the performance in Oxfam Trailwalker 2006, Hong Kong Journal of Emergency Medicine.

Au,Ho. The walkers who finished Oxfam Trailwalker 2006: who were they? Hong Kong Journal of Emergency Medicine 2007; 14 (3)154-62

Howatson et al. Trekking poles reduce exercise-induced muscle injury during mountain walking. Medicine & Science in Sports and Exercise

www.blisterprevention.com.au

Photo Courtesy of Christopher Beavon and Gabi Meeson