The Physio who Gave up on Drugs

The new doco ” The Doctor who gave up on Drugs” has re-assured me that more and more patients are seeking alternative ideas for reducing pain without medication. So let’s dive right in! Some Ideas from my Physio Friend Doug Carey – AAP Education.

When considering what medications to use, individuals need to make informed decisions, balancing the research, the pros and cons (often a long list of side effects) and also examining alternative evidence-based options. Here are some alternative measures that can be used to modify pain.

Analgesic Alternatives

Pain Management Education

Now I must admit that a lot of people just want to pop a pill and part of our responsibility is to explain the obvious, that is, having a longer term plan (with more than one strategy) for a longer term problem. Research has shown that as load/stress (physical or emotional) increases, so do symptoms. As a clinician helping clients better manage their pain, teaching pacing and appropriate goal setting is critical. For further information on pacing strategies and goal setting. See here.

Appropriate Exercise – My Favourite

Tied in with pacing, exercise is known to creates so many positives;

  • ​Sense of accomplishment through planning and achieving
  • Enhancing mental wellbeing
  • Circuit breaker on brain worry/rumination
  • Counter production of stress hormones
  • Positive effect on muscles, bones, and joints
  • Create degree of physical fatigue and assist with sleeping
  • Helping maintain a healthy body weight, lower BP
  • Keep the GI tract functioning, resist constipation

The key is finding a baseline for our clients, agreeing on an appropriate form(s) of exercise and developing realistic expectations and time frame on progression. We have so many options at Movement Solutions. Feldenkrais for those with a LOT OF PAIN, and pilates, yoga, aerial yoga for those with mild levels wishing to strengthen and balance.

Mindfulness Awareness/Relaxation Training

Living in the moment seems obvious, but honestly, we can find ourselves dwelling a lot of time in the future (what ifs) or the past (Bruce Springsteen’s Glory Days), neither of which we can change. Mindfulness assists in quality of life and pain management through the process of breathing techniques and active relaxation. We all breath, yet in times of pain, anxiety, stress, it is often the first thing we change, going from relaxed deep breathing to shallow, apical and hyperventilation.

Learning how and practicing intentional slow breathing is beneficial in several ways;

  • ​Activates the vagus nerve, the primary cranial nerve, which is associated with a recuperative state
  • Increases alpha waves in the brain, calming mid-range waves that foster a relaxed yet alert state of mind
  • Slow breathing tends to increase heart-rate variability

I teach techniques like box breathing and diaphragmatic breathing to assist in pain management. Swimming is another form of intentional breathing where you rapid inhale and slow exhale.

 Anti-Inflammatory Alternatives

External

Lotions/Potions

We stock and use

Electrotherapy

Micro Currents (MC) & Trans Cutaneous Electrical Stimulators (TENS) https://en.wikipedia.org/wiki/Microcurrent_electrical_neuromuscular_stimulator

Not for everyone, but certainly worth a trial in regards to managing pain and as an alternative to or compliment with medications. We stock the PainMaster (MC) and NeuroTrac (TENS) ranges and provide advice on fitting and settings.

Supportive Aids

There is plenty of research that confirms what we see in the clinic; if you offload a painful structure, day to day activities become more enjoyable and comfortable. We use an extensive range of tape, braces, and orthotics to help modify loading.

Internal

Turmeric. Long used in Ayurveda medicine, the active ingredient is curcumin. A molecule that is difficult to be absorbed by the gut, but better when combined with a lipase = bioavailable curcumin. Research would indicate beneficial properties. See here

Glucosamine + Chondroitin Sulfate. The jury is still mixed research wise, but the supplement is safe to take and seems beneficial for those with moderate+ OA. See here.

Fish Oil. When sourced with caution (heavy metal toxicity), research indicates it to be beneficial. See here.

UC-II and nTHIAA. A new class of supplements, combined they provide demonstrated anti-inflammatory effects and effectiveness in clinical studies of osteoarthritis and rheumatoid arthritis. See here.

What have you found helps?

I am sure you have other ways to assist clients with pain, that don’t involve prescriptive medications. Love to hear your thoughts in the comments section below. Thanks for reading and your contribution.

What the Foot?

Every now and again you realize that you know more than what you know. I am reading a great book, written by Gary Ward Titled “What the Foot?”. He describes it as a “game changing” philosophy of human movement, eliminating pain and maximizing human potential. I am not sure about ” game changing” because it is a philosophy I have been using for the past few years. Mosche Feldenkrais was actually the game changer. He was a pioneer of the idea that the way we organise our bodies in an upright posture is related to how our feet meet the earth. Anyway, Back to Gary. Gary is receiving rave reviews for his insightful book and his “crazy ideas”….

In my opinion there is nothing new in Gary’s “crazy ideas” it is just the way he has targeted the delivery of the concepts to the fitness and health professional industry. Most of them are still trying to work out neutral pelvis and core stability. So the common sense idea that the way you stand matters is still hard for them to grasp. That is could all be so simple, is threatening to those who feel the need to demonstrate their intellect.

For those of you that have been into see me, you will remember back to standing, closing your eyes, noticing your feet and noticing the weight distribution. The core concept is – the more we can work towards optimizing weight distribution through out feet between left and right, front and back – the less pain you will experience in your body. The art I believe, is in which tools we select to facilitate that quickly and to have it stick. The way we move, the way we stand, the way we get out of a chair are all memories held in our brain. To have any lasting change on these patterns the Brain is the key.

This is why I am such a fan of “mindful” movement practices. Mindful implies that you are thinking consciously about the flow, the speed, the quality, the directions, your breath, all whilst moving. Can you imagine how lit up your brain would be if it were tuning into all those factors of your movement. Its the same reason Joseph Pilates stated that 10 repetitions done with focus, was equivalent of 30 mindless repetitions.

Upshot of the book is that 1. I must give myself credit for knowing more than I know. Sometimes in the world of movement, neuroscience, subconscious brain pathways, it becomes overwhelming and I often feel I know so little. However when Gary is getting such praise for his concepts, all of which I have nutted out and been using already, it is reassuring. 2. I shall be sourcing some force plates for measuring standing weight distributions before and after treatments. Some of my patients love seeing numbers change (as I do) so it will be a great motivational and objective measure of progress. Keep an eye out for them soon. Check out Gary’s YouTube video highlighting the importance of stretching dynamically in multi-directions.

Cold Therapy and Breathwork – A Marriage Made in Heaven

My brother, Chris (in Holland) alerted me to a fellow called Wim Hof – a crazy Dutchman who meditates semi naked on ice, all in the name of health and wellbeing. Chris thought I would be interested in his work, and I was. Wim offers an online 10 week course which combines cold therapy and breathwork. Of course I signed up, anything in the name of scientific exploration. The first week starts with a 30 second cold shower and 3-4 rounds of Wim’s “hyperventilation style” breath technique.

My first 30 sec cold shower felt hard, real hard. A shock to my comfort zone. My first breath hold was 30 sec and it felt hard, real hard. Five weeks in and I am happy to report I have survived two 10 min cold showers, the second one easier than the first. And my maximum breath hold is 2 mins. I also observe that whilst others are commenting on the “freezing’ conditions at junior footy on a Friday night… I am blissfully unaffected. My fingers and toes still turn white (I suffer from Reynaud’s Phenomenon), yet I do not seem to perceive the cold. Weird, but a pleasant change for a previous self-confessed cold frog.

The end goal is for Chris and I to submerge ourselves in the frozen lake outside his door this Christmas day – we are off to celebrate a white Christmas. Not sure I will manage Wim’s 6 minutes submerged….. However I will be happy with 30 seconds!!! And a stiff rum toddy afterwards.

I enjoy Wim’s approach to health;

“Over time, we, as humans have developed a different attitude towards nature around us and we actually forgot one thing, “inner power.” This is the relationship by our physiological mechanisms to adapt and survive within our natural environment, which is direct and effective. Because we wear clothes and control the temperatures at home and work, we have changed the stimulation on our body, thus the old mechanisms related to survive and function. As these deeper physiological layers are not stimulated anymore we have become alienated from them, thus our bodies have weakened and we are no longer in touch with this inner power. The inner power is a force accumulated by full awakened physiological processes. It also influences the very core of our DNA.”

Cold Therapy

The power of the “cold” burns fat, boosts your immune system, improves sleep quality, increases hormone levels, reduces inflammation and increase the “feel good” chemicals in the brain called endorphins (natures own mood boosters).

Breathing

The majority of us breathe shallow throughout the day resulting in ill health and low energy levels. The scientific breathing techniques you will learn in this course will significantly improve your energy levels, detox the body and release toxins, relieve stress and tension, and strengthen your immune system.

DIY Physio – A New Sideline

A few months ago, I had a patient travel over 2 hours to see me for some advice after having a total hip replacement. By the time she got to me, she was in a lot of pain simply for having been sitting in the car for so long. I knew there had to be an easier way, and I knew she would not have been the first person to have had to drive miles to seek expert healthcare advice, especially in a nation as big and remote as Australia. I was also fresh from rehabilitating my mother through a traumatic hip replacement which allowed me to experience firsthand, how limited our current care of these patients is. My mum was given the all clear when she was able to walk out of hospital.

No advice to seek further strengthening work, no assessment of her standing balance, or ability to negotiate a bumpy, gravel outdoors path or advice on when she could return to gardening or even how she was going to get on or off the floor.

So I developed an online course for those rehabilitating from Hip Replacement. I am very proud of the course because I have managed to bring together everything I know in one place so that anyone, anywhere in the world can access it. As usual, I hope I have taken a completely holistic approach; mental, physical and spiritual options to explore. Feldenkrais and breathwork get a large mention, as do my recommended nutritional supplements and oils.

For anyone you know about to have a hip replacement or recently have had one, here is the link to a FREE Educational Course they can take. Next up, I might tackle Knee replacements!!!

If you have any ideas about an online DIY Physio course, then I am all ears?

Getting Your Head Around Chronic Pain – There Is Hope

Years ago, whenever a patient with chronic pain presented for physiotherapy I admit I had a sinking feeling inside. Largely, because I did not have the answers and I did not understand their needs.

Standard exercise prescription seemed inappropriate for someone who was in pain just standing still, and manual therapy techniques seemed to only scratch the surface or offer short term relief.

Then people like Norman Doidge came along. Pioneers of the term “neuroplasticity’ which slowly helped us understand what was really going on in someone’s brain when they had chronic pain.

Chronic pain is defined as any pain which has been hanging around for longer than approx. 8 – 12 weeks. After this time frame, most soft tissue injuries have healed. For the pain to continue and to actually increase is a great indicator that the brain has become highly involved in the pain experience.

Understanding chronic pain helps us offer hope for those suffering it. Effectively, there are now techniques which help to re-wire faulty brain circuits which are keeping the pain alive. I have trained with Neil Pearson as a chronic pain provider of his very holistic pain care pro online education and prescription course for those suffering chronic pain. It is a great combination of education, breathwork, movement and mental strategies. As a Pain Care Provider, my patients receive a 30% discount on the online course he offers.

Please don’t suffer any longer. There are options which can now be explores which do not require surgery, excessive medication or psychologists. Anyone subjected to constant pain signals for any duration of time begins to suffer measurable changes in their brain which affect their ability to think, their ability to communicate and robs them of the joy of living and moving. Please share this blog with them.

I Love It When a Chiropract Talks MOVEMENT

Came across this great TED TALK by Eric Goodman. Explaining what I attempt to explain to patient’s all day, yet probably don’t do it as well as he does. The concept that pain is simply your bodies way of grabbing your attention. It is usually a sign of a movement system breakdown – either too much, too soon, or done too poorly. The pain is really not the issue to me – because i know if you sort your movement out, then it disappears. Restoring quality movement might involve releasing some tight fascia, but this wont stick if you don’t re-wire the brain into an alternative way of moving. Re-wiring brains sounds difficult. Ironically, re-wiring movement systems in the brain is very relaxing, very rewarding and highly enjoyable. Much easier than sweating it out at the gym, and twice as effective if what you are seeking is quality, pain free movement. The gym (in my opinion) is more about weight loss, sculpting definition in muscles or increasing their power for more robust activities like climbing mountains, or running marathons. If you are seeking pain free easy movement, please don’t think you will find it in a gym.

My one criticism of Eric is prescribing the above exercise for everyone in the audience. It is an interesting exercise and worth experimenting with. However, no one exercise will fix everyone. To activate one muscle group over another is flawed. We should be striving for balance between our fascial lines, not dominance of one over the other. There are easier ways to activate our back line…. but more on that another day!

Lessons Learnt from #RunLarapinta

AS I sit here I can feel every muscle, every bone and every part of me physically sore and exhausted. Yet deep inside there is quiet satisfaction which comes from achieving a goal which you are never quiet sure you will be able to achieve. Six days ago I set out in rain, driving wind and cold to find the sunshine of Alice Springs. Over the next 4 days my body covered 80 kms of the most spectacular scenery ; rock hopping through gorges, sliding through sandy river beds, mountain goat descents, breathtaking ridge tracks, and on and on. The flight home was a great time to reflect on what I had learnt from this experience;

Trail running is the only sport I know where walking is not only ok, but actively encouraged on the ascents.

Small short steps are more economical and efficient than big powerful ones.

Eat while ascending, hydrate on the ridges and save your mental focus for the descents.

To descend a mountain like a goat you need to have “spinal rotation” in your movement repertoire.

Forget expensive running shoes, my $4 op shop ones lasted the distance and my feet arrived home with zero blisters. So many of my colleagues had invested $150 + in shoes which left them with welts. Comfort First.

The bond you form with strangers when you are near your physical limits is for a lifetime.

Most of my fellow runners had prepared with an average of 80 – 200 kms of running for the past 20 weeks. My preparation was about 20 kms! Having said that, I pulled up a lot better than most, purely by noticing my movement and adjusting it frequently. To know how to move is one of life’s greatest gifts: it protects us from injury, and improves our performance. Having options to access when one way becomes too painful, or too fatigued is the art of motion. After running 30 kms on one particular hot day… The reward is a MUG!!!

Sudoko or Surfing? You Choose

If I had a dollar for every time I read an article advocating the benefits of crosswords, sudoko, learning a new language or musical instrument on Brain development – Then I would be yachting my way through Cyprus right now. However, let’s not limit ourselves to the learning of “intellectual” pursuits, let’s also consider the same benefits from learning new MOVEMENTS. Learning a new sport, a new movement sequence, a new way to hit a golf ball can all improve an incredibly important part of the brain – the motor cortex – which controls how we move. Here is where you need to consider some possibilities ; Would you rather retain your physical movement capacity as you age? or your mental sharpness? or is keeping both possible?

After having worked in aged care many years ago, I broadly identified two major categories of aging, (admittedly, with a massive spectrum in between). Essentially, I realized that as you age you can lose your mind, but move well OR you can keep your mind sharp and therefore be completely, soberly, depressingly aware of the slow and gradual loss of your physical capabilities. For me personally, it was a startling revelation. The demented patients seemed happier (in general) than their mentally sharp colleagues, who were depressed as hell by the tortuous effects the aging process was having on their bodies.

As I age I think preserving my movement capabilities will take high priority. I value movement more than I value mental sharpness. That is a personal decision, however we all have to choose what we are going to focus on keeping. There is simply not enough time in the day for most of us to choose both? If, like me… You consider preserving your movement options a big deal, then consider that by focusing only on learning “mental hobbies” you may be short changing yourself!

Past neurological studies in people have shown that learning new physical skills as an adult, such as juggling, can lead to increases in the amount of gray matter in parts of the brain related to movement and motor control. Take home message = Learning a new sport, or learning a new way to do a familiar sport, is just as mentally beneficial as crossword puzzles, or other cognitively challenging tasks. Equally, learning pilates, tai chi, yoga, Feldenkrais, etc with the mindful approach has great mental benefits while also assisting in your overall physical health. Something a crossword puzzle can’t do!

Ancient Oils Proving Potent with Health Benefits

There is a new film out, called “Ancient Secrets of Essential Oils“, and it gives a fascinating history of where these oils have come from, from ancient Egypt to the times of Christ to how they were used during the World Wars and how their resurgence is changing the way people view healthcare.

The film outlines how peppermint oil can be used to increase tolerance to lactic acid, (Brilliant for me as I up the ante in training for the Anaconda!) and how frankincense can destroy cancer cells and outlines why essential oils can never be classified as a drug by the FDA (because they are natural plant based extracts) and therefore why big pharma is definitely not a fan of these natural oils.

Many of you whom have been into the clinic lately will have witnessed first hand my application of specific blends of oils depending on your condition and frame of mind. I myself have become a bit of an essential oil freak. Each day, without fail, I pop two drops of Frankinsense under my tongue for sublingual absorption, I down the supplements twice daily, my office, home and clinic pump out various blends depending on my state of mind. If I need focus or uplifting I use Basil, Peppermint, Lemongrass or if i need calming or grounding I use Lavender or Balance ( a blend). They are in my car, they are in my kitchen cupboard for cooking, they are under my sink for cleaning. In fact, my kids and my husband used to “pooh pooh” the oils, but not they are asking for the easy air when their noses are blocked or for the tea tree roll on when they have mosquito bites or sores that aren’t healing.

I would rather have a cabinet of oils, then a basket of prescription drugs. The applications are endless – antibacterial, antifungal, anti-oxidant, awesome for respiratory support, detoxing, weight loss, improving athletic performance, sleep, mental and emotional shifting/balancing, digestive health, immune support, etc. I see no problems with trying oils first… if you don,t get the results you seek, then you certainly have not harmed yourself in any way.

As for where to source? There are a number of great companies out there. I have opted to source mine from Rare Earth Oils – a great Aussie company which has a brilliant model supporting indigenous communities – they grow, harvest, blend and sell their products completely independently of big suppliers so that all revenue goes back to the local community. The only problem with these guys is that their range of oils is limited. So for all other oils I source through Doterra. Largely because they are 100% therapeutic Grade, sourced indigenously in sustainable practices.

Art of motion have our own Doterra shop Link and we do stock a good range of oils so you don’t have to wait on postage. Cookie – Aka Michelle Cooke — my receptionist, pilates instructor, all round knowledgeable lass has all the low down on oils and knows far more than me. A good person to hit up for more information.

Fascial Manipulation – The Latest Catchphrase for Manual Therapists

Fresh from a one day Stecco Fascial Manipulation Workshop in Perth and I am more convinced that ever that Fascia is the Glue linking our mind, body and spirits. To manipulate Fascia is to manipulate a entire system at once.

Think of Fascia as the spider web holding our organs, bones, nerves, blood vessels, muscles, etc in a big suspended matrix. The classic analogy is the rope pyramids you often see in playgrounds. One child climbing at the base is having an effect on the child hanging off the top row, and vice versa. So it is with Fascia. Contracture anywhere in one part of the body will be influencing other parts higher, lower, across, or deep to that contracture. Think of Contracture as sticking, or like someone grabbing your shirt at the front of the chest and notice the tension it creates in the back of your shirt. So fascial contracture, or sticking is what we as therapists are always trying to Free or Loosen.

We can achieve it through movement, or hands on manipulation. The process of unlocking sticky fascial points involves precisely located application of heat and friction to change the visco-elastic properties of the Hyaluronic Acid between the fascial layers. Think of custard and what happens to it when it is heated ( gets thinner and runnier) and when cooled ( gets thicker and gluier). Is that even a word? Hopefully you get the picture. So when we assess your movements and notice restrictions in range ( overall movement), or pain, or weakness, we have clues about which areas to manipulate. Once we touch your tissues and assess the areas of “bogginess” or ” sticking” we can take an educated guess that applying 3-4 minutes of local heat and friction will release this sticking. Your movement should improve, as should pain and the sense of “heaviness”. It is quiet simply amazing to experience it, see it with your own eyes and makes my job very rewarding.

Personally though, I see fascial manipulation as a stepping stone to recovery. We must always first explore our minds. Are they open to the possibility of healing? if not, nothing will work. If so, then movement assessments and fascial manipulation are a great second step. Once the movement has been restored we need a third step. We need to WIRE that new movement pattern into the brain, otherwise I fear it often returns. This is where any form of mindful movement practice will be useful. My favourites as you all know are Feldenkrais, Contemporary Pilates, Yoga, Tai chi, etc.

If you have not experienced Fascial Manipulation as yet, and are wondering if you could benefit, then Book an Appointment today. I am now working Mon, Tues, Wed and Fridays. Thursday remains a sacred day for TENNIS, laughs and good food.