Physio

Chronic / Persistent Pain

Chronic / Persistent Pain

Chronic / Persistent Pain 1000 700 Ace Health Centre

Chronic/Persistent Pain

What is chronic/persistent pain?

Why is it that some pains last much longer than we expect them to? And why is it that if we have had a similar pain in the past which went away quickly is sticking around longer this time around? If we use the example of a muscle strain which we typically see muscle strains recovering in as little as 4-6 weeks, but when it lasts for 3-6 months why does it still hurt? Or why is it that when talking to two different people about their knee osteoarthritis, one has pain and limited with their activities while the other is reporting no pain and has no limitations?

Why is my pain lasting so long?

The short answer is there are numerous factors playing a role into how we experience pain and how long it can last. The longer answer is that our body/brain are very smart and very protective to keep us functioning. The brain and body use a lot of pathways to communicate to decide on the appropriate response to a stimulus (injury or event). The brain doesn’t want to waste time processing everything that happens to us so it creates shortcuts and calls on old memories, or things we’ve seen, how people have reacted to similar situations, or our expectations, stress levels, mental health, and mood. With this being said the brain decides to react to the stimulus or decides its not important enough to react.

So what does this mean?

In a sense this means that an injury that has caused pain and has recovered, may continue to persist due to our experiences and an ongoing fear avoidance to prevent ongoing pain. As we continue to build into that fear avoidance the body becomes more sensitive to pain and more restricted leading to longer recovery times. This is not to say that you should push through pain either though as that can also increase the bodies sensitivity. Discussing with a physiotherapist can help you find the right track back to your usual activities with graded exposure.There are also a few interesting cases out there that will further show how interesting the body is in reacting to different stimuli.

https://www.psychologytoday.com/au/blog/pain-explained/201911/tale-two-nails

And if you prefer TED talks instead of reading you can google “why things hurt” with Lorimer Moseley

Or contact us today to see how our physios can help you with pain management. 

The Importance of Exercise

The Importance of Exercise

The Importance of Exercise 800 864 Ace Health Centre

The Importance of Exercise

 

Why exercise?

Exercise has so many benefits which go beyond just being able to lift heavier weights. Exercise has been shown to benefit mental health, energy levels, weight management, injury prevention, decrease falls risk, decrease mortality, decrease the risk of type 2 diabetes, increase muscle and bone health, reduce in risk of chronic health conditions, and can even help decrease the risk of some cancers.

 

What if I don’t like going to the gym?

We typically think of exercise as going to the gym and lifting heavy weights. However, exercise can mean different things to different people. Exercise should be something you enjoy or doing something with a group of friends to make it more enjoyable. Exercise can be as simple as going for a daily walk, swimming laps in the pool, riding a bike, surfing, and of course, going to a gym. What if you don’t like the gym environment but like the idea of using weights or other gym equipment? There are plenty of ways to build up a home gym with weights and equipment if you have the space, or you can join an exercise class with others to help make it a more social event throughout the week. The important thing is that you continue to ask your body to move within your limits and gradually increase the challenge as you see fit.

How should I get started?

Finding something you will enjoy should be the main thing and something that you will want to do. A few ideas include getting 8,000-10,000 steps a day if you enjoy walking. If you do enjoy some weight lifting try to incorporate 2-4x/week to help increase muscle strength and bone health. If you find compliance difficult, start small with 10min a day and increase gradually as you make it part of your daily and weekly routine. Other tips could be after work try changing into exercise clothes so you build a habit of getting ready for exercise. You can even tell a friend or family member that if you don’t meet your exercise goal for the week you owe them a prize ($100, dinner out, picking up a house chore for them). If you’re starting small that’s great, the important part is that you’ve started. If you already do some exercise but are not sure if it’s enough, you should be trying to perform at least 150min/week of moderate-intensity exercise.

So whether you’re there already or getting there, keep up the good work and remember to continue building a habit that is sustainable so that you can enjoy more of life. And remember you can’t go wrong getting strong. Contact us today to help us prepare an exercise programme. 

Rotator Cuff Injury

Rotator cuff injury

Rotator cuff injury 1500 750 Ace Health Centre

Rotator cuff injury

Have you ever experienced continuing shoulder pain in the upper arm/shoulder blade? It’s more than likely related to rotator cuff injury/weakness

But what is a rotator cuff injury?

The Rotator cuff is a group of 3 muscles that help stabilise and move the shoulder. The rotator cuff is a commonly injured area resulting in tear, Tendinopathy or bursitis.

#Tear is an acute episode of overstretching the tissues until they are damaged. These injuries typically cause intense and immediate pain. Usually occurs with some sort of traumatic mechanism car accident, fall onto the shoulder, lifting heavy items etc.

#Tendinopathy is an injury caused by chronic overuse. Repetitive strain is placed on the muscles with not enough recovery time in-between. This causes the muscle to become inflamed and poor in integrity.

#Bursitis is the inflammation of a bursa that helps protect structures in the shoulder (like a cushion). This can be acute or chronic. This is caused by the shoulder being too unstable, usually from rotator cuff injury/weakness.

Although the rotator cuff has individual actions its main role is shoulder stability.

The shoulder joint itself is a ball and socket joint, but with one large ball (arm) and one small socket (shoulder blade). This allows for a great range of motion but poor stability of the joint (can pop out easily). The group of muscles called the rotator cuff comes off the socket, grab the ball and pull the ball back toward the socket to increase the stability of the joint. Thus they are working most of the time in all different positions to hold the two together.

Common symptoms

Rotator cuff injury can be but is not restricted to the following;

  • weakness through shoulder
  • Loss of shoulder full range of motion 
  • Pain when lying on the effect side
  • Clicking or grinding noises 
  • Pain with overhead or lifting activities
  • Trouble reaching behind your back

Individuals at risk

  • older age groups (>40yrs)
  • Sedentary lifestyle
  • Jobs with a repetitive shoulder strain
  • Sports with repetitive shoulder strain (throwing/gym)
  • Previous shoulder injuries

This conditioning is diagnosed either by imaging (US or MRI) or assessment by a skilled practitioner such as a physiotherapist or sports Dr. 

This article was written by our physio Christian. Call us today to book in with him if you have a shoulder injury.

Time for bone to heal?

How long for a bone to heal?

How long for a bone to heal? 600 449 Ace Health Centre

How long for a bone to heal?

Time for bone to heal? So, you’ve just broken a bone. Not only having to deal with the pain associated with it, you have to wear a cast and potentially may need surgery. We are given general time frames as to when the bone will heal. But what does this process entail and why are we told 6-8 weeks for bone healing? Bone healing occurs over 5 phases. Initially we will see tissue destruction and haematoma formation (blood clot). Followed by inflammation. Soft bone formation. Hard bone formation, and finally a remodelling phase.

Haematoma formation and inflammation

Within the first week following a broken bone the body will respond by creating a blood clot. This is to provide the bone with increased blood supply and nutrients. Within the blood other responses occur to help begin clearing out dead bone fragments. As well we will see growth factors influence the bone to begin bone healing. Furthermore we will also see increased formation of blood vessels within the blood clot to help supply the area with the needed nutrients.  Similar to tissue healing this is the beginning of the healing phase, and starts from the beginning of injury and may overlap with the next stages of recovery.  This phase can last up to a week before moving on to the next phase.

Soft and hard bone formation

Now following the initial phase and the cleaning of dead bone fragments, the body will begin to form a connection between the two bone ends.  It does this by creating a soft bone made of cartilage in order to help stabilise the break.  From this increased stability the bone is able to continue with the healing process, and will continue to use the methods used in phase one and two to progress to a healthy bone.  As the process continues the soft or cartilaginous bone shifts to a harder bone (trabecular).  This bone will now be evident on imaging and appear swollen with respect to the rest of the bone.  These phases of the healing process can last up to 3 months.  Within this stage you may be given the all clear from your doctor to remove any casts and begin using the affected area again.

Remodelling phase of bone healing

Within the remodelling phase you may have been given the go ahead from your doctor already to start using the area again in a safe manner.  This phase can be simply put as a use it to improve it principle.  As bone is formed around the injury, it constantly reshapes itself to provide more support where its needed.  This phase can last up to 2 years.  This length of time will not prevent you from doing the things you enjoy. Although it is important to understand that although we are back to activity, the bone is still recovering.

It is important to note that with bone healing you should always listen to the advice of your doctor as to when you can return to activity.  Furthermore, it is important to work with physiotherapists to help prevent other complications. Complications may arise, as well as maintain movement in the surrounding areas.

 

Following this a physiotherapist can begin to progress exercises to further strengthen the area and mobility following the prolonged time of inactivity. Contact us today and see how we can help you.

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Gold Coast Women’s Health Physiotherapist

Gold Coast Women’s Health Physiotherapist 1000 667 Ace Health Centre

Gold Coast women’s health physiotherapy

At Ace health center on the Gold Coast, we are lucky to have a women’s health physiotherapist. Heres some of the most common women’s health conditions that can be treated by women’s health physiotherapy –

  • urinary incontinence
  • frequency
  • fecal incontinence
  • pre and post-pregnancy musculoskeletal pains and rehabilitation.

Unlike the muscles that we use to walk or to carry things throughout the day. the pelvic floor is therefore not a group muscle that we exercise regularly. For most parts of our lives, we neglect it. Often it isn’t until during pregnancy or after pregnancy, we start to find incontinence symptoms or prolapse symptoms.

Symptoms

There are many different symptoms women’s health physiotherapy can help. These include –

  • pee leakage during laughing
  • coughing or sneezing
  • urgency when we have to rush to the toilet quickly
  • empty our bladder multiple times during the day
  • heaviness and dragging sensations

Therefore these troublesome symptoms commonly persist even after menopause. It often seems that it is a taboo subject to talk about. We need to keep in mind that common does not mean it is normal. Common does not mean that there is nothing that can be done to treat it. For more info click here

Factors

Many factors can come into play that women’s health physiotherapy deal with. Incontinence including lifestyle factors such as fluid intake, bladder irritants, and bowel management. It can also include the need for behavior retraining, trigger retraining, and bladder retraining.

In addition, a further internal assessment may be warranted to gather a more complete picture of your condition. Internal assessment is often performed to determine structural changes. These changes could be contributing to the symptoms.

  • A women’s health physio will look at your
  • pelvic floor contraction technique
  • strength
  • co-ordination
  • pain
  • any indication of overactivity

Book Now For Gold Coast women’s health physiotherapy

In conclusion, if you have any of these symptoms or conditions then contact a women’s health physiotherapist. In other words, you don’t have to live with these problems. It can be helped. Please call today and book an appointment. We promise you won’t be disappointed.

shock wave therapy gold coast

Shock wave therapy now avalible

Shock wave therapy now avalible 1000 667 Ace Health Centre

At Ace Health center, on the Gold Coast now has Shockwave therapy available.

What is Shockwave?

Shockwave therapy is a great noninvasive rehabilitation method that is getting more and more popular over the Gold Coast and the rest of the world.

Shockwave is a handheld device that emits low-frequency acoustic shockwaves that aim to kickstart the body’s natural healing.

The body responds differently to shockwave then it doesn’t to medication or other forms of rehab. This means shockwave is great to uses and multi-treatment therapy, but also if other conservative methods of treatment have failed.

What happens during treatment?

A gel is put onto the area of injury. The handpiece is then put on the gel and the machine is turned on. the gel helps the shockwaves transmit through the skin as they do not transfer well via air. Pulses of low-frequency sound are then emitted.

The area can be a little sore during the treatment feeling like little electric shocks. They can also be a little sore and bruised after. That said some people get pain relief right away, whereas some others may take a couple of days.

Success rate

Clinical trials on some injuries have come back with a 90% success rate. This shows that no matter what your injury, having it combined with shockwave can give it the boost it needs. Things like exercise therapy, custom orthotics, cortisone injections, and dry needling can also be used alongside shockwave therapy.

Who cant have shockwave?

Shockwave therapy on the gold coast doesn’t have many contraindications. A few though consist of

  • pregnancy
  • blood clotting disorders
  • pacemakers
  • taking oral blood thinners
  • cholesterol medication
  • open wound
  • had cortisone in the last 6 weeks

Shockwave treatment works especially well for injuries such as

  • heel pain
  • plantar fasciitis
  • shin splints
  • tendinopathy
  • tennis elbow
  • Achilles injuries
  • frozen shoulder
  • spurs
  • patella tendinopathy
  • and more……

Book today with our physio or podiatrist at Ace Health Centre on the Gold Coast to experience this miracle breakthrough in medicine and rehab.

Top 5 things to consider BEFORE you start running

Top 5 things to consider BEFORE you start running

Top 5 things to consider BEFORE you start running 1000 667 Ace Health Centre

This year, Ace Health Centre has entered a team for the Gold Coast Marathon. The Gold Coast Marathon weekend is July 6-7 and includes a range of distances for all ages and abilities!

For the kids, there are two races- a 2km and a 4km dash. For the big kids, there are the Gold Coast Airport fun run (5.7km), Southern Cross University Run (10km), Asics Half Marathon (21.1km) and the Gold Coast Marathon (42.2km). Ace Health Centre has a number of entrants in the Asics Half Marathon as well as two runners who are attempting their first ever Marathon,

There are lots of things to consider when you are planning your next (or your first) running event of any length! It is all well and good to have a goal in mind, but you need time to physically prepare your body and your mind for what you will endure on race day.

With the Gold Coast Marathon fast approaching maybe some of you are slowly but surely starting to panic because of the lack of training or because they haven’t trained at all. Something our head physio knows a thing or two about as well!

Scrambling to maximize her preparation time, Amelia compiled a list of things she really needs to get in check BEFORE starting her GC Marathon training program to maximize her chances to cross that finish line on July 7.

Small but crucial little details such as the right footwear, weather or mood, made it into her list. Despite her knowledge as a physiotherapist, Amelia found out the hard way and made mistakes you can avoid!

Here are Amelia’s top 5 things to consider before running. Read them, learn them and never forget them

 

1. ARE YOUR SHOES THE RIGHT SHOES FOR YOU?

Podiatrist are experts in all things feet! Before you start any kind of new exercise, be sure to make an appointment with a podiatrist.

They will:

– assess your gait

– evaluate your current footwear

– recommend the perfect shoes for you

– suggest where to buy the right shoes (we can’t rate anyone higher than Athlete’s Foot Pacific Fair)

– discuss the need for orthotics if required

– flag any biomechanical issues that may require further intervention from a physiotherapist, exercise physiologist, remedial massage therapist or strength and conditioning coach.

 

2. ARE YOU STRONG AND FIT ENOUGH TO START RUNNING?

Over the years, running has developed a bit of a reputation for injuries. However, most running injuries occur due to overuse. If you continue to run on structures that are not strong enough to take the excessive force that running can cause, you are an injury waiting to happen! Get into the gym and build up some baseline strength and fitness before you attempt to tackle running. If you are clueless on where to start, see a physiotherapist for an assessment and to run a specific strength program.

 

3. HAVE YOU CHECKED THE WEATHER?

If you want to reduce your risk of injury when running, be sure to not only listen to what the weatherman has to say but also take a look outside on the day. Too hot? Wait till the afternoon to cool down a little. Too rainy? We live in Queensland- it won’t last long. Running in excessive heat is not recommended, especially for novice runners. Save yourself the pain and the risk of heat stroke, and wait for more suitable weather before you take on a run. Running in the rain can create slippery surfaces and puddles- both of which can lead to a fall or trip.

 

4. ARE YOU FUELING YOUR BODY FOR RUNNING?

We recommend that EVERYONE spends some time with a dietician to create an ideal eating plan for you. Consuming the right food can provide you with the fuel required for all activities, running included. As you then increase your running distances, a sports dietician can teach you more about substrate usage and when gels and fluids may improve your performance.

 

5. HAVE YOU GOT A PROGRESSIVE PROGRAMME IN PLACE?

Sure you could just run 10km every day from now until the day of the race, but there are far more superior training programs out there. Your training program should allow for enough time for the goal event (hurry up;) ), and should gradually increase work volume. There will be periods of scheduled rest and cross training to reduce the chance of overuse injuries, and it should be malleable, should injuries arise. A physiotherapist, running coach or decent podiatrist should be able to help you out with a comprehensive training program.

If you haven’t started your marathon training, then you have to start now! Amelia’s tips will help you to get the most out of a very short timeline. Who says there are no shortcuts to success?

Whiplash-Associated-Syndrome

Whiplash Associated Disorder: What a pain in the neck

Whiplash Associated Disorder: What a pain in the neck 1000 682 Ace Health Centre

About 7 and a half years ago I had a car crash. I pulled a U-turn outside my house in the quiet suburb of Figtree in Wollongong, NSW and was struck on the front drivers’ panel by a car that I guessed was doing about 90km/hr. Unfortunately, I was deemed at fault (the Police effectively said that they weren’t able to prove he was speeding because there were no skid marks – my argument was that he didn’t have time to brake because he was going so fast – but I digress). Fortunately, the other driver did swerve because otherwise, he would have T-boned me and chances are I wouldn’t be here writing this. For that, I consider myself incredibly lucky.

However, despite all the fortune, I do consider myself also slightly unluckier than some, and that is due to the daily pain and discomfort on the left side of my neck (Whiplash) that accompanies me everywhere I go. It is here right now as I write this (somewhat stronger now that I’m focusing on it).

Don’t get me wrong, I manage absolutely fine now, but I recall it being quite bad in the first few months. However, I did the right thing initially and booked in for a Physio consult.

 

I didn’t go back to see my Physio, and I didn’t do the exercises.

I saw a local physio about a week after the accident whom I believe – knowing what I know now – actually let me down, and he let the physiotherapy profession down.

From memory he did some massage, might have put a heat pack on and then prescribed me a weird neck exercise on all 4’s (speaking as an undergraduate exercise science student at the time) and told me to “see how I go” and call if I wasn’t getting better.

I wondered if he actually did want to see me again? Did he care if I was doing better? Maybe he was thinking of my back pocket being a student – but I certainly wasn’t.

I just wanted my neck to feel better. I didn’t go back…

 

 

Without a proper diagnosis – I felt confused

I was a young, fit, virile male who just turned 20 and I did not want to do some strange looking exercise that didn’t even bring on a sweat. All I wanted was to push and pull and throw and lift and sweat!

I grew up playing sports and running. I feared that I wouldn’t get back to those things. Mentally at the time, my ego-driven immortality shroud (seen predominantly in males under the age of 25 due to a still-developing pre-frontal cortex) had been shattered.

Also, mentally, I was having nightmares and was anxious about driving. two major things we did not talk about in my physio consult.

I guess I existed in a state of confusion about my pain for about six months, until one day during a practical class in the final year of my Exercise Physiology degree at the University of Wollongong. We covered exercises for neck and shoulder dysfunction, and I was the example patient for my classmates.

I remember my fellow students prescribing me these basic, boring textbook exercises until our musculoskeletal lecturer Deidre McGhee (a practicing physiotherapist) stepped in to ask them to think about who they are working on.

In doing so she reminded me too. She gave me exactly what I needed at the time. Permission and empowerment. Two very major things in chronic pain.

Whiplash Associated Disorder (WAD)

I then took a particular interest in chronic pain when I went to study my Masters of Physiotherapy at Griffith University. Now into my 5th year of clinical practice, I have developed my clinical skills to a point where I can now focus on a particular area of interest. For me? You might have guessed – Whiplash Associated Disorder (WAD).

 

There are some pretty alarming statistics out there – here’s just a few:

  • Whiplash doesn’t tend to recover well – if there is still pain at 3 months after the accident, there is a 50% chance there will be ongoing pain 5 years later.

 

  • After an accident, if you can’t turn your head as far as you used to, or you find cold stimuli painful, your risk of long term disability is much higher. This risk remains high if you have severe pain, or are having trouble doing everyday tasks (reading, lifting, concentrating, working etc).

 

  • After an accident, if you can’t turn your head as far as you used to, or you find cold stimuli painful, your risk of long term disability is much higher. This risk remains high if you have severe pain, or are having trouble doing everyday tasks (reading, lifting, concentrating, working etc).

 

  • High levels of post-traumatic stress go hand in hand with poor recovery.

 

Whiplash recovery needs a systematic approach

If you have any of these things and you’re within the first month or two after your accident, the timing is crucial to reduce your risk of pain becoming chronic and disabling.

Either see a physiotherapist or talk to your GP about seeing a physio (and a psychologist if you’re having flashbacks or anxiety). CTP insurance covers nearly all cases of Whiplash recovery and treatment.

 

Though please, in a bid to avoid the situation I found myself in, see if you can find someone who has done some advanced training in Whiplash Associated Disorder within the last 2-3 years.

Learning from the physio I saw, in my professional life, I tend to listen to the person in front of me and ask many questions. It allows me to focus on the needs and goals of the person that is sitting in front of me and then applying the most recent evidence to assist them to achieve those goals.

For those that are past the initial few months since their accident, there is still hope of reducing your overall pain and disability. I have seen significant improvement in people using any necessary manual therapy, some tweaks to their daily life, and an increase in their exercise and activity safely under supervision.

It’s amazing the difference in your life when you find the person who knows exactly what you need at the time.