In this age of multimedia I find podcasts a very accessible way to keep up with current thinking and evidence in modern physiotherapy practice.

I recently came across a PhysioEdge podcast titled ‘Know Pain’ with interviewee Mike Stewart, a clinician and lecturer in pain management at the University of Brighton in the UK. 

The podcast focused on the problem of persistent pain and how to better manage it within what’s known as a biopsychosocial approach. The biopsychosocial approach sits well alongside hands on manual therapy, medical acupuncture including dry needling as well as prescription therapeutic exercise when required.

The Neurostructural Integration Technique (NST) is a manual therapy technique developed by Osteopath Michael Nixon-Livy, a reinterpretation of the Bowen technique.

At Mount Merrion Chartered Physiotherapy we have further adapted and modified aspects of the technique for the benefit of our patients who are suffering with persistent pain.

NST is a gentle form of soft tissue manipulation, applied in a systematic manner to the back, neck and head, abdomen arms and legs. By contrast to massage, the technique involves a gentle strumming across the muscles, mainly near their attachments to tendons which in turn attach to bones. This may be important for some of the physiological effects, more below.

We use adapted NST alongside evidence based pain management counselling and therapeutic exercise mainly in the treatment of Fibromyalgia, but also for other persistent pain conditions which are a consequence of the central sensitisation phenomenon. These would include chronic low back pain, migraine and tension type headache for example.

Lorraine learnt the technique about 10 years ago on an intensive course in the UK. She found it very effective for helping her Fibromyalgia sufferers manage their widespread pain symptoms. It also helped with mood and sleep.

When she took some time from the clinic after Toby was born, I learnt the technique so I could look after her patients in her absence. NST has since become a very important part of our physiotherapy practice.

Coffee has been proposed to have many health benefits. It is one of the richest sources of polyphenols which act as antioxidants, it also regulates insulin and blood sugar levels, assists with concentration and attention as well as boosts athletic performance.

One to three cups a day seems to be the general consensus for health benefits according research, but this could be very variable between individuals. Too much can stress the cardiovascular and nervous system.

If you are not overly caffeine sensitive, tolerate coffee well and wish to avail of its health benefits (and pleasure of a good cup), it’s worth being aware that mould in ground coffee is prevalent.

Mould is naturally occurring, but high levels may result in serious health problems. As such, the governments of Japan and South Korea have banned the sale of coffee with mould levels above a certain limit. Of course what constitutes a safe limit is controversial.

That said, to reduce the likelihood of high mould levels in your coffee, the following is advised:

- Avoid buying overly cheap coffee, spending a bit more and maybe drinking a bit less?

- Try and buy single origin coffee, grown in a single geographic region or farm, usually mentioned on the label.

- Coffee shops that roast their own beans and grind beans for you to order (hard to find I know) are likely to have lower levels of mould

Drink healthy and enjoy!

By Simon.

We know that low back back is a problem

The worldwide burden of low back pain is increasing and despite the best efforts of the various health professions.

Grain based foods are made from wheat, rice, oats, cornmeal, barley or other cereal grains. Bread, cakes, pasta, oatmeal and breakfast cereals are examples of grain based food products

There are many nutritionists, dieticians and researchers who are of the strong opinion that grains should be largely avoided.

Why?

Grains naturally have a high carbohydrate content, even whole grains, especially if prepared using added sugars. Put simply, if we eat more carbohydrate than we need for our basic energy requirements (about 150 grams a day for most people), the rest gets converted to fat and stored.

This promotes weight gain and obesity as well as heart disease and type 2 diabetes over time. The typical western diet will have us eating 300-400 grams of carbohydrate a day, mostly from poor quality, refined grain based sources.

Excessive of poor quality grains, often containing added sugars has been a large factor driving the obesity epidemic we face. Refined grains also promote higher than optimal levels of insulin, which in turn can promote systemic inflammation. This may be a factor in certain chronic pain and autoimmune conditions.

We are welcoming Katie Farrell who joins the clinic as a full time associate physiotherapist as of today. In March and April Katie completed further training in medical acupuncture.

In this blog, Katie gives us an overview of what she learnt and and how these skills will benefit her clients.

Over to Katie...

Over the past two months, I spent two full weekends completing the British Medical Acupuncture Society’s Foundation Course here in Dublin. The course content was extremely useful and very interesting, and was taught by Dr Mike Cummings and Simon Coghlan, Practice Principal here at Mount Merrion Physiotherapy.

We discussed many topics around medical acupuncture, including safety, neurophysiological mechanisms, clinical aspects and how we can apply it into our own practice as healthcare professionals.

The course had both theoretical and practical elements, with lots of time for interactive discussions and questions throughout. There were 10 of us taking the course. This small number allowed for great learning opportunities, and time for one to one guidance and help when needed.

The afternoon nap, around 20 minutes, no longer than thirty.

It's been shown to enhance productivity and creativity, reduce fatigue and improve employee wellbeing. The Japanese take their napping seriously.

Most of us tend to experience an energy slump mid afternoon which may also affect mood and decision making, a nap may help.

I was lying in bed a few nights ago, reflecting upon my day and thinking how fortunate I am to be doing something I really enjoy and am passionate about.

Physiotherapy allows me to work with, and help my clients overcome physical problems which are usually impacting on quality of life. To be able to help is very rewarding. Being able to work, exercise and recreate without pain and with relative ease is so important to most of us, and for good reason. It's what makes us feel alive and well.

That said, as an introvert, treating patients, interacting and engaging closely with many different people on a day to day basis is not an activity I am naturally predisposed to. My personality type would usually be more inclined towards more solitary types of work, such as computer programming perhaps.

I recently attended a further education course on low back pain run by Dr Johnson McEvoy, a practising musculoskeletal physiotherapist in Co. Limerick. He presented us with the latest research regarding the assessment, diagnostic criteria and treatment for lower back pain. Given clients with lower back pain make up a large proportion of those who come to the clinic for treatment, I had a particular interest in furthering my skills and knowledge in this area. I immensely enjoyed this course and have gained valuable knowledge in treating this area of the body.

Here are a few of my learning highlights: