It is often the case that the effectiveness of your treatment is a combined effort by our entire team. In this article I wish to share a brief insight in the amazing value of collaboration between healthcare professionals.

Starting with a coffee

Every Monday Katie, Paula, Lorraine and myself sit down to a cup of coffee (and often a treat from the Good Food Shop just next door to the clinic) for a team meeting.

We usually start by running through any household or general administration matters which may need discussing. This ensures the smooth running of the clinic and brings us all up to speed with any changes or advances in what we are doing to deliver our Physiotherapy service. Its essential we are all on the same page and to be consistency amongst us in terms of how we do what we do. It is also a great platform for feedback between team members which provides further opportunity for refinement and improvement our internal systems.

Chartered Physiotherapists are trained to assess an acute (recent) ankle sprain and using a specific set of assessment criteria known as the Ottawa Ankle Rules we can determine if a fracture is likely to have occurred. If we suspect a fracture we can refer you for an X Ray or MRI scan (In Ireland, depending on your health insurance policy, you may need your doctor to sign off on the request). The results of the scan will help us decide how best the ankle should be managed and depending on the extent of the damage, an orthopaedic specialist may need to be consulted in addition to receiving physiotherapy.

Most ankle sprains result in soft tissue injury, usually to the ligament structures which support the ankle joint. The lateral (outer) ligaments are more commonly injured which may result in pain, swelling, restriction of movement and a loss of function e.g. walking properly, or ability to run and take part in sports. If this type of injury is not treated correctly, on-going weakness and instability may result, making further injury much more likely down the road. Simply taking anti-inflammatories is not sufficient.

Are you suffering an episode of acute lower back pain? I encourage you to stay calm and don't panic. Lower back pain is common and it does heal, most of the time full activity is restored over a number of weeks.

There is a worrying trend to over-treat back pain with unnecessary and aggressive techniques while all that may be needed is rest and gentle manual therapy. An interesting article related to this issue is available on the Harvard Health blog and I encourage anyone who has had or is currently suffering from lower back pain to read.

Harvard Health blog excerpt:

Most routine back pain will improve on its own with conservative therapy in three months, often shorter than that,” says Dr. Bruce E. Landon, professor of health care policy at Harvard Medical School. “Even more importantly, when we do more aggressive things - such as injections, imaging, and surgery - the long-term outcomes don’t change at all. These things have very little impact on what is going on, and they have the potential to make things worse.

As human beings we are ambulatory creatures, that is we walk upright and are very reliant on our legs to move us about. How the foot strikes the ground and the knock on effect this has up the lower limbs to the knee, hips, pelvis and low back in particular has become a subject of much debate and controversy in recent years.

Lower limb biomechanics refers to a complex interplay between the joints, muscles and nervous system which results in a certain patterning of movement, often referred to as ‘alignment’.

Much of the debate centres around what is considered ‘normal’ and what is considered ‘abnormal’ in biomechanical terms as well as the extent to which we should intervene should abnormal findings be found on assessment.

During your first consultation with us your Chartered Physiotherapist will conduct a thorough physical assessment. This essential first step will assist us in determining what the structural source of your musculoskeletal pain complaint is most likely to be and enable us to provide a diagnosis followed by a planned course of treatment.

Your assessment will involve a combination of you answering relevant questions and your Physiotherapist conducting a hands-on, physical assessment of the affected body area.

Questions we will ask you

Firstly we will need to understand, in as much detail as possible, the history of your condition. Your Physiotherapist will ask you:

• When did the problem start
• Was there an injury sustained, or
• Did the problem arise for no apparent reason

In order to get an impression of how your symptoms respond to certain activities we also need to know:

The effectiveness of acupuncture as a treatment for Fibromyalgia very much depends on the individual being treated. Factors such as how long the Fibromyalgia has been present, the state and responsiveness of the central nervous system, patient expectation and belief, levels of pain and physical activity, etc, can all have a bearing on how well someone may respond to medical acupuncture treatment.

The key to a successful course of treatment, from my own clinical experience, is getting the ‘dose’ of treatment correct. This usually means having to be careful not to over-stimulate and not cause too much sensation with the acupuncture needles. Given that individuals with Fibromyalgia are usually already very sensitive, much care is needed when needling to ensure that is is done comfortably. Sometimes this requires some trial and error in the first couple of sessions to discover the right dosage for the individual.

Striking a tiny ball with a small club face at the end of a long shaft is the respectable skill of the golf swing. Making that tiny ball travel the distance and direction intended requires great skill as well as good body position technique with sufficient specific golf flexibility throughout the full range of motion.

This post is an excerpt from a more extensive article I wrote recently called - Golf Flexibility, The Golf Swing & Common Injuries

Let’s get into the golf swing of things; the arms move through a large range of motion while linking the golf club and the power-generating torso of the golfer. The golf swing involves 5 phases: the backswing, the downswing, acceleration, early follow-through and late follow-through. With each phase requiring an evolving recruitment of muscle activity and fluid technique there is risk of soft tissue damage throughout the full swing movement.

The original golf swing is said to have evolved in Scotland some hundred years ago. Modern equipment and material as well as advancement in performance technique has led to the 'modern golf wing' changing the dynamics of required golf flexibility.

The current economic climate has been challenging for most of us and consumer trends indicate that a higher proportion of us are being attracted to discounted goods and services as we are becoming far more aware of price.

Of course this is understandable given falling incomes, higher costs in some cases and lower disposable incomes. This approach makes a lot of sense in a retail environment for example where getting a trolley full of groceries, or having your car serviced at a lower price means savings without necessarily having to compromise on quality to any great extent.

But what about healthcare?

I feel we need to consider primary healthcare and related costs from a different perspective.

The best sleep position may be slightly different for each person but to avoid back and neck pain there are simple sleeping position techniques that are common for most. We spend about a third of our day sleeping in a mostly still position. This extended period of motionless can leave us feeling stiff the next morning and potentially cause or aggravate back or neck pain. Fortunately it is not difficult to achieve an aligned, pain free sleeping position with the help of some simple techniques and an extra pillow or two.

In my clinic I get asked regularly about what are the best sleeping positions and in fact it was just the other day a client queried specifically about neck pain and sleep positions which inspired me to write this post.

My first answer is usually to suggest finding a position which is most comfortable. From years of clinical experience and understanding sleep related pain issues I am usually able to offer some suggestions as to how best to achieve better sleeping positions for pain relief.

One of the most common types of headaches is the cervicogenic headache which is the name given to a headache originating from the neck. When a part of our neck such as the joints, muscles, nerves or ligaments are damaged or put under strain we can experience referred pain to our head area. This is due to the fact that the nerves which supply the neck area also serve the skin surrounding the head, eyes and ears.

Damage or strain to the neck does not necessarily need to be severe in order to cause a referring pain headache. It is quite often the case that such headaches begin after a build up of muscle tightness and imbalance caused by poor posture while sitting at a desk for prolonged periods of time, for example.

Neck pain left untreated will often cause a headache of varying intensity, sometimes made worse by specific movements.