Do you suffer from headaches?

 

everyday health headache
Have you ever thought of physiotherapy treatment for your headache?

There are numerous different types of headaches including migraine, tension type headaches and headaches arising from the neck. Many headaches can be caused by reduced movement in the neck, having the neck in a certain position, increased tightness or tension in the neck muscles and sustained poor postures e.g. sitting at a computer.

Physiotherapy treatment may involve mobilising the joints of the neck, soft tissue massage, trigger point release and stretching of neck muscles and retraining muscle strength and coordination.

Why a Strong Core is Your Best Guard Against Back Pain

A group of adults are taking a fitness class together at the gym. They are working out on exercise mats and are holding a high plank.
A group of adults are taking a fitness class together at the gym. They are working out on exercise mats and are holding a high plank.

A physical therapist answers your questions

If you suffer from back pain, you’ve probably heard that strengthening your core can bring you some relief. But is this always true? And if so, how do you do it? We spoke with Cleveland Clinic physical therapist Patti Mariano, DPT, to find out.

Q: What is your core?

When most people think about the core of the body they think of the abdominal or six-pack area just below the ribs. While the abdominal muscles are an important part of the core, we consider other areas important, too.

Your core includes:

  • Front abdominal muscles — the rectus abdominis
  • Muscles along the side of your body — the internal and external obliques
  • A deep muscle that wraps around the front — the transverse abdominis
  • Muscles in your back that are located between your spine bones and run along your spine — the erector spinae and multifidi

Your core also includes the diaphragm and muscles of the pelvic floor. I also consider the gluteal muscles as core muscles.

Q: What is the relationship between core strength and back pain?

Theoretically, if your muscles around the low back are weak, your body will rely more on passive structures, including ligaments — the tissue that connects bone to bone — as well as the spinal bones or discs, which lie between the spinal bones, for stability, which can cause pain.

But some studies have shown that specific core exercises are not any more beneficial than general exercise for low back pain. What we know is that exercise in general can help, and focusing on core muscles may provide some additional benefit.

Q: What are some exercises for the core that can help with back pain?

Here are my top five:

  • Side plank — Sit on the floor with your right hand below your right shoulder and feet stacked. Lift your body, keeping your legs long, abdominals engaged and feet stacked. Hold. Repeat on the other side. You can modify this pose by dropping your bottom knee to the floor for extra support.
  • Plank — Kneel on all fours. Pull in your abdomen and step your feet behind you until your legs are straight. Keep your hands directly under your shoulders and your neck straight. Hold your abdomen and legs tight and avoid letting your lower back sag. Hold and breathe for 30 seconds. You can modify this pose by lowering your knees.
  • Bird dog — Kneel  on all fours. Reach one arm out in front of you, draw in your abdomen, and extend the opposite leg long behind you. Repeat on the other side.
  • Scissors — Lie on your back with your arms at your sides and legs pointed straight into the air above your hips. Press your lower back into the mat and tighten your abdomen. Lower your right leg until it’s a few inches from the floor. Raise your right leg up and begin lowering your left leg the same way. Continue switching right and left.
  • Upward dog — Lie face down with head slightly lifted and hands palm-down under your shoulders. Point your toes. Exhale, then press through your hands and the tops of your feet and raise your body and legs up until your arms are straight and your body and legs are off the ground. Keep your neck relaxed and long and thigh muscles tight as you hold and breathe.

For the plank exercises, start by holding them for 15 seconds to 30 seconds. For bird dog and scissors, try three sets of eight or 10 repetitions. For upward dog, do one set of 10 repetitions.

Q: Can you injure your back by trying to strengthen your core?

Any exercise performed incorrectly, whether it is core-strengthening or otherwise, has the potential to cause discomfort.

Twisting exercises or even incorrectly completing the exercises cited above can cause pain in the low back. But it’s highly unlikely that one repetition of an exercise will seriously harm your body, unless it’s an exercise using a very heavy weight.

The best way to keep your body safe is to listen to body cues such as pain during and immediately after an exercise, and the next day after exercising.

Q: When should you talk to a doctor about your back pain?

If any of the following is going on you should consult with your doctor:

  • Your pain has been going on for longer than a month, despite resting from activities that make it worse.
  • Your pain is getting worse.
  • Your pain wakes you from sleep.
  • Your pain is in your low back but also is going down one or both of your legs.
  • You notice that one leg is becoming weaker than the other.

Q: Where should you turn if you want help in creating a plan to address back pain?

Physical therapists train as musculoskeletal experts — they are the experts on muscles, bones and human movement. These professionals are the most qualified, aside from an orthopedic doctor, to assess back problems.

Since there are many factors that impact low back pain and many types of low back pain, it is a good idea to visit at least one time with a physical therapist for an evaluation and subsequent plan of care. This will give you an individually tailored plan with exercises that progress safely.

The idea of core strengthening, while beneficial, is just one piece of the low back pain puzzle.

https://health.clevelandclinic.org/2016/07/strong-core-best-guard-back-pain/

 

Ways to be Happy & Healthy in 2020:

I heard on the radio this morning that the top new year’s resolution amongst Irish people is to become healthier. As someone who’s had cancer this year, I can truly attest to the old adage of “your health is your wealth”;

I’m not a health “guru” or life coach or wellness warrior. I’m a normal GP with a normal life but I do think I have learned some things in my 32 years about what truly living healthily looks and feels like. Good health can generally be summed up as good physical health, a healthy social life and psychological or mental wellbeing.

I feel like I’ve lived two very distinctly different lives – one unhealthy and one which is now thankfully much better. As a junior doctor I was pathologically sleep deprived. Working up to 100 hours a week for 7 years took its toll on my physical and mental health.

Due to work demands I was socially isolated; this isn’t conducive to good mental health. My physical health wasn’t good; stress, lack of sleep and overworking meant I had a number of problems; a knee injury from regularly walking for 24 hours non–stop on call, regular IBS flares resulting in hospitalisation, kidney stones from dehydration…..and unknowingly having cervical cancer and sarcoidosis. I was sick. In every sense of the word.

Now I am healthy. That’s a bold statement but I believe it.

So in this blog post I’ll share some tips for being healthier in 2020…

1. Sleep.

The main reason I’m healthier now is because working in general practice means I can sleep at night. Sleep is the single most important thing that’s turned my life around. Sleep deprivation is linked to depression and anxiety, obesity (due to an increase in the hunger hormone ghrelin), dementia and cancer. I often think the reason I got cancer is because of 7 years of chronic sleep deprivation. I can’t prove it of course but I knew what I was doing to my body wasn’t right.

If you want to make one change for 2020 to be healthier, make sleep a priority. Aim for 8 hours a night. Look up sleep hygiene for ways to make sure that you get a good, restful night’s sleep. I’m fitter, healthier and happier now than I ever have been and I owe a lot of it to sleep.

I know some people can’t get 8 hours a night. Small babies, long commutes and shift work mean it’s sometimes physically impossible. I’ve been there myself. But any small steps you can take to improve your sleep will make you healthier – physically and psychologically.

2. Movement

I’ve always loved to move. I love being physically active. Exercise is like a miracle cure. It helps reduce risk of heart attack, stroke, cancer, obesity and depression. When we exercise, endrophins that mimic the activity of morphine are released. This has a calming effect. And the beauty of exercise is that all we have to do is put on shoes, walk out the front door and put one foot in front of the other.

You don’t have to engage in a fitness program or join a gym or buy fancy gym gear. (By all means do this if you want to though!). I’ve always found it easier to just aim to move more. Go at your own pace. Do what you enjoy. Do it when you can; and don’t beat yourself up when you can’t. Life is busy. Sometimes there isn’t enough time in the day. There were times when I was working a 24 hour shift and I’d see fitness people on Instagram telling me “no excuses” and “make time”. Well, for normal people with normal lives, families, commitments and jobs, there sometimes simply isn’t time. And that’s ok too. Move when you can; small things like taking the stairs or maybe a walk during lunch hour with a colleague can make a difference.

Remember that there’s no such thing as bad weather, just bad clothes. If it’s raining (which it’s highly likely to be here in Ireland), put on rain gear and go. And also be safe in the knowledge that cold weather doesn’t cause a cold!

I enjoy going to the gym. I don’t set targets. I’m not strict with myself on it. But I do notice myself getting fitter and stronger over time. Consistency will naturally lend itself to progress. So do what you can when you can and you will see changes slowly creep in.

3. Positive Connections

Psychological wellbeing is a core component of health. As is a good social life. Who you surround yourself with impacts your health. Whether it’s people in real life or on social media, nurture connections that make you feel good and valued. Disconnect from people or situations who leave you feeling bad or anxious. Life is too short to maintain connections with frenemies. Do what you have to do for a happier, calmer, healthier you.

4. Gratitude

Being thankful for what we do have as opposed to being uneasy about what we don’t have goes a long way when it comes to mental wellbeing. Every night I get in to my bed without a bleep I’m thankful! You’d think the novelty would have worn off by now but it still hasn’t. The promise of uninterrupted rest still fills my heart with joy.

I’m also thankful for my physical health; I’m thankful that my body can move and can LIVE! I’m thankful for Peter and the joy having a life partner brings. I’m thankful for being able to get up and have a coffee in the morning. I’m thankful I’m still alive and can walk on a wild Irish beach and inhale fresh Atlantic air. There were times when I was going through cancer treatment I didn’t know if those things would be taken from me forever. I think of my late sister who can no longer experience these things. I’m grateful to be alive. I’m grateful for all of the simple yet wonderful things in my life.

5. Positive thinking 

I know this can seem like quite an abstract thing to practice but I’ve definitely become a more positive and optimistic person as I’ve gotten older. My biggest “Ah hah moment” of the decade was realising that the core skill for coping with adversity is being optimistic. I’ve learned positive thinking from Peter who is unshakably optimistic! Something that’s also helped me with optimism is written reminders. I write a to-do list everyday. This usually includes things like “take out bins”. But at the top of the list every single day I write “let go of negativity” and “don’t ruin a good today because of a bad yesterday”. I’ve been doing this for about the last 6 years everyday without fail and I really believed its helped me think in a more positive way. Some days it resonates with me more than others. But its always there and it’s most powerful on days I need it most.

6. Work place

We spend so much time at work that it’s bound to play a critical role in our wellbeing. I feel profoundly fortunate to love what I do. Being a doctor doesn’t feel like work to me. It’s not what I do. It’s who I am. (I struggled for a while with inextricably linking my profession with my identity but I now see that it’s a positive thing for me and I’m very comfortable with it).

If you’re unhappy in your workplace make a change. Of course you can’t just hand in your notice and walk away. But plan an exit strategy. It might take a few years to make a transition but when you know there’s an end in sight you’ll feel less drained by a job you don’t enjoy. I disliked being a hospital doctor. But I knew it would be for a finite amount of time. There was always the goal of general practice at the end. That kept me going. Plan your exit and aim towards it. Even if it will take years.

7. Don’t let perfect be the enemy of the good

This mantra has been something I’ve lived by a lot more in 2019 and I plan to bring it in to the next decade with me. I’m pretty sure perfection doesn’t exist so chasing it is setting yourself up for failure (failure isn’t necessarily a bad thing but you know what I mean). In 2019 I threw myself in to situations in which I maybe wasn’t fully prepared but I did it anyway. And it helped me grow and learn. I do my best. I strive to do things well. But I don’t seek perfection. I’ll be doing more of this in 2020.

8. Supplements

This is something I’m asked about day in and day out! If you want to take something in 2020, ask your GP to check your vitamin D and vitamin B levels. Take those if you need them and if there’s proof you’re lacking in them. There’s no health benefit from blindly taking a multivitamin. Find out what you need and take that. Probiotics are good for IBS. Evening Primrose Oil can help with cyclical breast tenderness. Biotin can help with nail and hair growth. Vitamin B6 can help with PMS. Don’t take something that an influencer is being paid to tell you has changed their life. (Lauren Goodger literally agreed to promote cyanide).

Take these things in a focused way for your own individual needs. If you’re interested in taking something like a supplement ask your GP about it. Ask if there’s scientific evidence for it. And make sure it’s safe with any other medicines you take.

9. Cancer screening

Get your smear test if it’s due. Attend breast check if you’re called. Screening saves lives. It certainly saved mine.

10. SPF

Wear SPF 30-50 on your face daily. Without fail. It will help prevent wrinkles and skin cancer. Your face in 20 years will thank you for it.

11. Detox

Your liver and kidneys will do this for you. Next.

12. Diet

If you’d like to lose weight I recommend not doing quick fixes or 12 week programs. Speak to your GP and or a dietitian who can help you with weight loss done in a sustainable and healthy way. Starvation and being miserable isn’t sustainable. Healthy weight loss is. Aim for health. Not to fit in to jeans or to be skinny for a wedding. Aim for health and a healthy weight will follow. Sleep also helps with weight loss. It helps regulate the hunger hormone ghrelin so the more sleep you get the less likely you are to overeat.

I want my diet in 2020 to be more plant based. The more I read the more health benefits I see. I’m a slow burner and I make changes over time. So I’ll gradually make more plant based choices and will hopefully reach vegetarian status eventually.

13. Sustainability

I have two flights booked to The US for 2020. I will not be sailing across The Atlantic like Greta any time soon but I will be more mindful about my carbon footprint going in to the next decade. In 2019 I ditched petrol starting coffee cups and converted to a reusable bamboo cup for my morning coffee. I plan to go electric for my next car. I’ll do my best to play my part for a better environment for us all.

14.

I have no number 14. But I’m not finishing on 13.

Good health is multifactorial. Identify the areas you want to do better in. Nurture them slowly. Rome wasn’t built in a day.

Dr. Doireann.x

 

BRIDGING: one of a physiotherapist’s staple exercises

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BRIDGING
This is the one of a physiotherapist’s staple exercises, if in doubt…bridge 😂
Often when children are growing, they come up against muscle imbalances, which can lead to aches and pains. A great way to protect the body from these is by keeping a good strong core!
A tip my top #pilates friend showed me was rolling the spine up and down, like a Mexican wave 👋🏽! Go follow @excellencepilates @excellence_physio for much more specialist knowledge than I can offer 😁

HOW TO INCORPORATE INTO PLAY
Get some lovely little cars or animals on one side of your child, and help them create a BRIDGE (!) so you can drive those little toys under their bottom!
….a traffic jam can always help you keep their bottom up for little longer 😏

#physio #pilateslovers #physiotherapy #physiotherapist #yoga #yogateacher #paediatricphysiotherapy #childrensphysio #normaldevelopment #strongcore #therapyplay

Why a Strong Core is Your Best Guard Against Back Pain

A group of adults are taking a fitness class together at the gym. They are working out on exercise mats and are holding a high plank.
A group of adults are taking a fitness class together at the gym. They are working out on exercise mats and are holding a high plank.

A physical therapist answers your questions

If you suffer from back pain, you’ve probably heard that strengthening your core can bring you some relief. But is this always true? And if so, how do you do it? We spoke with Cleveland Clinic physical therapist Patti Mariano, DPT, to find out.

Q: What is your core?

When most people think about the core of the body they think of the abdominal or six-pack area just below the ribs. While the abdominal muscles are an important part of the core, we consider other areas important, too.

Your core includes:

  • Front abdominal muscles — the rectus abdominis
  • Muscles along the side of your body — the internal and external obliques
  • A deep muscle that wraps around the front — the transverse abdominis
  • Muscles in your back that are located between your spine bones and run along your spine — the erector spinae and multifidi

Your core also includes the diaphragm and muscles of the pelvic floor. I also consider the gluteal muscles as core muscles.

Q: What is the relationship between core strength and back pain?

Theoretically, if your muscles around the low back are weak, your body will rely more on passive structures, including ligaments — the tissue that connects bone to bone — as well as the spinal bones or discs, which lie between the spinal bones, for stability, which can cause pain.

But some studies have shown that specific core exercises are not any more beneficial than general exercise for low back pain. What we know is that exercise in general can help, and focusing on core muscles may provide some additional benefit.

Q: What are some exercises for the core that can help with back pain?

Here are my top five:

  • Side plank — Sit on the floor with your right hand below your right shoulder and feet stacked. Lift your body, keeping your legs long, abdominals engaged and feet stacked. Hold. Repeat on the other side. You can modify this pose by dropping your bottom knee to the floor for extra support.
  • Plank — Kneel on all fours. Pull in your abdomen and step your feet behind you until your legs are straight. Keep your hands directly under your shoulders and your neck straight. Hold your abdomen and legs tight and avoid letting your lower back sag. Hold and breathe for 30 seconds. You can modify this pose by lowering your knees.
  • Bird dog — Kneel  on all fours. Reach one arm out in front of you, draw in your abdomen, and extend the opposite leg long behind you. Repeat on the other side.
  • Scissors — Lie on your back with your arms at your sides and legs pointed straight into the air above your hips. Press your lower back into the mat and tighten your abdomen. Lower your right leg until it’s a few inches from the floor. Raise your right leg up and begin lowering your left leg the same way. Continue switching right and left.
  • Upward dog — Lie face down with head slightly lifted and hands palm-down under your shoulders. Point your toes. Exhale, then press through your hands and the tops of your feet and raise your body and legs up until your arms are straight and your body and legs are off the ground. Keep your neck relaxed and long and thigh muscles tight as you hold and breathe.

For the plank exercises, start by holding them for 15 seconds to 30 seconds. For bird dog and scissors, try three sets of eight or 10 repetitions. For upward dog, do one set of 10 repetitions.

Q: Can you injure your back by trying to strengthen your core?

Any exercise performed incorrectly, whether it is core-strengthening or otherwise, has the potential to cause discomfort.

Twisting exercises or even incorrectly completing the exercises cited above can cause pain in the low back. But it’s highly unlikely that one repetition of an exercise will seriously harm your body, unless it’s an exercise using a very heavy weight.

The best way to keep your body safe is to listen to body cues such as pain during and immediately after an exercise, and the next day after exercising.

Q: When should you talk to a doctor about your back pain?

If any of the following is going on you should consult with your doctor:

  • Your pain has been going on for longer than a month, despite resting from activities that make it worse.
  • Your pain is getting worse.
  • Your pain wakes you from sleep.
  • Your pain is in your low back but also is going down one or both of your legs.
  • You notice that one leg is becoming weaker than the other.

Q: Where should you turn if you want help in creating a plan to address back pain?

Physical therapists train as musculoskeletal experts — they are the experts on muscles, bones and human movement. These professionals are the most qualified, aside from an orthopedic doctor, to assess back problems.

Since there are many factors that impact low back pain and many types of low back pain, it is a good idea to visit at least one time with a physical therapist for an evaluation and subsequent plan of care. This will give you an individually tailored plan with exercises that progress safely.

The idea of core strengthening, while beneficial, is just one piece of the low back pain puzzle.

https://health.clevelandclinic.org/2016/07/strong-core-best-guard-back-pain/