Do you think our early ancestors wore half-length or full-length orthotic shoe inserts? Would their video-recorded gait assessments have revealed more under or over-pronators in the general population?

If we try to imagine how life was back in the day of the caveman we could safely assume that his ability to run both short sprints and long distances was necessary for surviving in a wild environment. Without the ability to track food or flee from dangerous predators the human evolution may not have been possible. What we can also be sure of is the caveman did not run in a pair of Asics trainers with rear-foot gel-cushioning outer soles structured for either a neutral or over-pronating gait . Nope, our early ancestors would have been running barefoot.

Many thousands of years later and despite our advances in footwear design and technology there is a ‘barefoot running’ revolution gaining traction in some circles. The idea is that we as a species have spent more time running barefoot than we have in our fancy high-tech shoes and therefore we are more physiologically suited to running barefoot.

Know your risk level and how best to self-manage pain in pregnancy

Pelvic girdle pain (PGP) is common in pregnancy with some studies[1] indicating as much as 33-50% of pregnant women will experience PGP before 20 weeks of gestation, possibly increasing to 60-70% prevalence in the late pregnancy stages.

Pelvic pain as well as associated low back pain can vary in severity and its degree of debilitation which does not necessarily subside postpartum.

Not all pregnant women develop PGP and some women are more susceptible than others. Women at higher risk may include those with a past history of PGP, lower back pain or any past pelvic trauma. Other contributing factors considered in some studies include high stress levels and psychological variables such as catastrophising and fear-avoidance beliefs[2].

Widespread pain, such as the symptoms associated with Fibromyalgia, is a type of aching pain that affects multiple areas of your body. The unpleasant experience of such symptoms can negatively impact mental health as well as physical functioning. A Physiotherapist experienced in managing the condition of Fibromyalgia can offer effective pain relief and a better ability to cope, but sleep quality is also an important factor the individual can focus on by themselves.

Poor quality sleep can impact all aspects of our health in undesirable ways. When it comes to sleep consistency is as important as quality and that is because we rely on something known as our circadian rhythm. This internal body clock programs our wake and sleep cycles and influences the healthy functioning of our bodies.

Although the precise cause of Fibromyalgia is unknown contributing factors are believed to be such things as infection or injury and more focus is now being placed on sleep quality too. Disturbed sleep may not cause Fibromyalgia but is often associated with the condition and may impact of the severity of the symptoms as well as the ability of the sufferer to remain functional in day to day life.

Do you sit at a desk all-day long?
Are you feeling stiff with rising tension in the shoulders and neck?

Posture related tension in the upper back, shoulders and neck area is a common complaint for desk workers and those who drive a lot due to the prolonged periods of time in the same position. People who work in high-stress jobs will also be familiar with this type of neck tension.

Eventually this ongoing state of tension can lead to headaches and migraines which become more difficult to treat.

This 1-hour 'Neck Tension Release' session will provide you with effective relief at intervals which suit you and your lifestyle in order to prevent more chronic conditions from developing.

Who will benefit?

• Those who feel generally stiff through the upper back as well as tight in the muscles across the shoulders and up into the neck
• May occasionally get headaches which feel they start in the neck and creep up the back of the head, sometimes around to the front
• Desk workers and drivers
• Anyone in stressful working environments who do not get an opportunity to take regular breaks

The idea that the common back pain, specifically lower back pain, can be a result of our modern lifestyles does make some sense. In general people are sitting more for extended periods of time which contributes to lower activity levels. These factors alone can negatively affect posture which often lead to problems in the synovial joints of the spine, nerves and surrounding muscles which all play their role in causing back pain.

The medical history of any back pain sufferer is an important consideration for the Physiotherapist when understanding how best to help relieve the symptoms. There is not a single most effective approach for all conditions of back pain and in fact sometimes the seemingly sensible treatment only makes the symptoms worse. We wrote about such back pain confusion in a previous article.

Over-reacting to back pain can cause both patient and Physiotherapist to take unnecessary measures and potentially over-treat the condition. The most important factor is intervening early before the pain progresses to a more chronic state. An experienced musculoskeletal Chartered Physiotherapist will be able to suitably educate you on your type of pain, potential causes and other important considerations such as the risks of fear-avoidance behaviour.

Do you suffer from frequent episodes of Low Back Pain?

We offer a 1-hour physiotherapy 'Low Back Pain Maintenance' treatment session specifically designed to help reduce the frequency and severity of your painful episodes.

Who may benefit?

Frequent episodes of low back pain has many causes. These may include generally poor conditioning of the spine, muscle stiffness with ‘trigger points’, low levels of activity, stress and other lifestyle factors. Your low back pain may also be due to a degree of 'wear and tear' of the spine, what is medically referred to as spondylosis or osteoarthrosis of the spine.

Recurrent episodic mechanical low back pain can be well managed with intermittent 'maintenance' physiotherapy sessions.

Our team of Chartered Physiotherapists have designed this 1-hour treatment session to assist you in the management of this type of low back pain with the intention of reducing how often and how severely the episodes occur.

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.

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.

Trigger points can be found anywhere throughout the body but often give us most trouble causing neck pain and low back pain, both regions which can be implicated in the development of ‘muscular tension’ headaches.

Trigger points are the tender almost nodular feelings in generally taut bands of muscle. They are very good at creating a sense of vague achy, deep dull or boring pain, even sometimes sharp and ‘nervy’. They also result in stiffening and weakening of muscles such that they cannot do their job in supporting an upright posture for example.

Have a feel of the muscles between the neck and the shoulder, those that may feel tense when sitting all day or stressed. If the muscles feel ropey, stringy or hard with one or two spots that are exquisitely painful to press on, these are likely to be trigger points in your upper trapezius muscle.

The below statement was a recent message taken by our receptionist indicating a level of dissatisfaction from a client of ours, Mrs K. With the intention of resolving the client's concern as soon as possible I met with the attending Physiotherapist and together we reviewed the client case notes. This particular scenario has raised an important consideration about the healing process that I would like to share in this article for the benefit of our readers.

Can you call Mrs K back please, she is not happy that after 4 sessions she is still in pain and wants to know where she goes from here?