Calf pain is more often a muscular complaint and we regularly treat such conditions here in our Physiotherapy clinic. However, calf pain can indicate a far more serious and dangerous health concern as I have been cautiously reminded of by a recent experience.

As Chartered Physiotherapists we are first-contact practitioners where patients can schedule consultations directly with us without having to go through their GP first. We therefore see many patients presenting with what they believe is muscular pain and dysfunction. In a recent case where calf pain was the complaint the more serious symptoms of Deep Venous Thrombosis (DVT) were presenting.

The medical training of Chartered Physiotherapists equips us with the knowledge and ability to identify these "red flag" symptoms and immediately refer for further medical review and investigation. As medical practitioners it is important we keep the differential diagnosis in mind and refer on if necessary.

Have you been caught up in the wave of polarised generalisations relating to health and fitness? Debates such as whether we should be running in our structured shoes or going barefoot, whether villainous sugar is the ultimate cause of rising obesity levels or is the low-carb and high-fat diet the universal solution?

Bold claims and prophet-like exclamations may be more effective at catching our attention but most of the time these are only half-truths.

For example; weight-resistance training is very effective for shifting excess fat and the many miles covered on the treadmill may indeed be doing you more harm than good. However, we shouldn't leap to broad generalisations and label either of these activities as right or wrong for everyone. Simplicity might be easier to sell but in reality we are individually complex with unique preferences.

Modern life seems to be getting busier for most of us and it seems the quest for ultimate efficiency is running away with itself. It's no surprise why sleep-time would be the obvious area to skimp on because sleeping does not seem to be a very productive activity for go-getters.

Notable persons in history have proclaimed their disdain for sleep

Thomas Edison described sleep

as a criminal waste

while Margaret Thatcher said

sleep is for wimps

In this article I offer some insight about nutrition and what to eat during pregnancy to complement Lorraine's recent article - 10 Top Tips for Coping With Back & Pelvic Pain During Pregnancy.

Lorraine provided some insightful advice, some based on her own experience in dealing with the physical demands of pregnancy and also offered some realistic self-managing techniques.

Firstly, I feel compelled to point out that our food choices are personal and we all need to discover what works best for our own bodies which is not necessarily the easiest of tasks. Personally, my own journey of discovery is constantly aided, sometimes challenged, by picking up ideas and insights from other people. It is for this reason I 'follow' a number of health related websites, blogs, journals, etc. I recently came across two articles over on the primaldocs website related to the choices you can make about what to eat during pregnancy. These articles, referenced below, served as my inspiration for this blog post. I hope to inspire your curiosity on a topic that perhaps you may not have given important consideration to in preparation for your pregnancy.

Its that time of year again when I am fortunate and privileged to offer my experience and clinical expertise at the UCD School of Physiotherapy. I am currently teaching as an external lecturer on the Musculoskeletal module with my main role to cover the more practical ‘hands on’ aspects of managing patients with spinal conditions.

There is a bridge to gap between the world of academia and course work as offered in the University setting, and the application of this knowledge in a real world clinical setting. This is where I come in as I try to help students learn the manual therapy, exercise and patient management skills to be able to help the patients they encounter as students and upon graduation.

This brings me to some criticism of the University system, which is that of attendance. Given that these skills are only taught once in this setting, I am concerned when the lecture and practical classes don't have a 100% attendance by the physiotherapy students. These are the basic skills anyone wanting to work in musculoskeletal physiotherapy requires to be effective, they are the bread and butter of our practice. The time to gain the knowledge is now, so why not make attendance a priority? The University are trying to address the issue by making practical attendance contribute to the final module grade, however as yet this has not quite made the full impact. I feel that students have to want to learn and that if the passion and enthusiasm is there, attendance would never be an issue.

Having gone through two pregnancies myself in the past three years I've had first hand and recent experience in dealing with the physical demands of pregnancy. Combining my own experience of back and pelvic pain with my knowledge and insights from my Physiotherapy practise I am able to offer you these ten top tips to help you cope.

1. POSTURE:

Your posture will change during pregnancy especially as your pregnancy progresses and as your baby grows. Your centre of gravity changes and moves more forwards, as such you tend to lean backwards to compensate for this and to avoid falling over. This can pinch the lower back region and make your back muscles work very hard which can lead to back pain during pregnancy.

When standing remember these tips:

• Head up straight & tuck your chin in slightly
• Shoulders back & your chest forward
• Knees straight but not locked
• Weight balanced evenly on both feet
• Lower tummy gently tightened which helps support your bump and flattens the lower back slightly
• Avoid standing in the same position for too long
• Alternate resting one foot at a time on an small elevated surface for short periods
• Take regular breaks from prolonged standing

Related article - Pregnancy Posture

Are you planning on making any New Year Resolutions for 2014? If you are then consider why it is necessary to spend more time considering how to keep your New Year Resolutions rather than what they are.

It is estimated that about half the population will commit to new year changes but maybe it is not so surprising to learn that most good intentions don't ever result in long lasting, positive change.

So why do we bother making such resolutions when we have such a high chance of being disappointed with ourselves when we break them? In fact, this raises a very important point about the habits we create in our lives. New Year Resolutions are usually about reforming old habits or achieving new goals. However, if we loosely create a whole bunch of unachievable or half-hearted resolutions that we fail to achieve then we are in fact creating a habit of failure. What started out as positive intentions for the new year actually end up causing longer term issues with feelings of self-doubt and lack of self-motivation.

Peaceful family gatherings and indulgent festive feasts is how I like to think of Christmas time. But there is the less harmonious side of Christmas too - the drunken office parties and the over-crowded shopping experience of gift buying.

Our social complexities mean that many of us find some or all aspects of Christmas rather stressful. Maybe the sense of obligation to attend the work Christmas party or the battling of the crowds at the shopping malls is the source of your anxiety. Large crowds, especially the seemingly intense crowds of Christmas consumers, really do spark the fight or flight response in me.

'Social Anxiety' is defined as the persistent fear of or anxiety about one or more social or performance situations that is out of proportion to the actual threat posed by the situation. For example, the fear of not attending the office Christmas party for fear of what others may think of you.

Okay, I admit the threat posed by an unusually large crowd at the local Blackrock shopping centre is probably minimal in reality but is enough to send me on a hasty retreat back to my desk and amazon.com

It would appear that according to the research evidence anti-inflammatories are indeed effective for pain relief but have shown no proven benefit in actually reducing the signs of inflammation, such as swelling, in a sprained ankle for example.

So, the answer is yes, but not in the way most of us would expect.

In a recent British Journal of Sports Medicine podcast, the effectiveness, use and safety of these commonly used drugs are discussed. The research would suggest that Paracetamol may be as effective in alleviating pain so this should be tried first as it has a lower risk of side effects.

The best pain relief may be achieved by combining Paracetamol with an anti-inflammatory such as ibuprofen (Neurofen) and often a lower dose of the anti-inflammatories is therefore required, thereby reducing the risk of side effects.