Spinal Health Week is a timely reminder for Australians to check if their lifestyle behaviours are not causing any damage to their spinal health that can lead to serious health issues down the track.
• COVID-19 pandemic sees Australians spending more time on their phones: Since the pandemic, many Australians have increased the usage of their mobile devices to scroll through social media (50%) stream content (44%), shop (48%), and work (27%), sacrificing exercising (28%), sleeping (22%), and meeting with friends/family (20%) to do so at the same time.i • Spike in hours spent scrolling through mobile devices giving the nation ‘Tech Neck’: 60 degrees of neck flexion can place up to 27 kg of weight through the spine, causing an increase in the mid-back curvature, commonly known as ‘Tech Neck’, which can potentially generate a burden on physical and mental health.ii • Australians’ wellbeing and social life affected by neck issues: 39% of Australians have been experiencing neck pain in the last 12 months, and while over a third (34%) admits it has caused physical exhaustion, its impact goes far beyond physical symptoms, including sleep loss (52%) and mental exhaustion (32%).i • The nation is encouraged to safeguard their neck health this Spinal Health Week: The Australian Chiropractors Association (ACA) has developed a five-step cheat sheet to help Australians care for their neck health. This Health Spinal Week (23 – 29 May 2022), the Australian Chiropractors Association (ACA) is encouraging all Australians to check if their lifestyle is affecting their neck health and seek professional help if needed. The call from chiropractors comes as the ACA's new consumer research shows that in the past year, Australians have been experiencing an increase in neck-related health issues, which have been impacting not only their physical health but also emotional and mental wellbeing.i Neck discomfort (42%), neck stiffness (42%), neck pain (39%), tension headaches (36%), and migraines (25%) were the most common neck-related issues reported by Australians in the past 12 months. While over a third (34%) admitted their pain has caused physical exhaustion and forced them to be less mobile (21%), the impact of neck pain goes far beyond physical symptoms, with more than half of those surveyed experiencing sleep loss (52%), mental exhaustion (32%), lowered concentration levels (39%), feeling more irritated (38%) and affecting people’s ability to work (21%).i Since the outbreak of COVID-19, people all over the world have been using the internet 50-70% more than before the pandemiciii, with 50% of the time spent on social media, resulting in a whopping 5.5 hours per day on their phones on average,iv and, according to ACA, there is a clear link between a pandemic-related spike in neck issues and hours spent on scrolling through web pages or applications on a mobile device: “The human head weighs about five kilograms. However, as the neck bends forward and down, the weight on the cervical spine begins to increase: research shows 60 degrees of neck flexion can place up to 27 kg of weight through the spine, and this prolonged time spent hunching over the phone can cause a wide range of symptoms including an increase in the mid-back curvature, commonly known as ‘Tech Neck’.ii Over time, Tech Neck can lead to early wear-and-tear on the spine, degeneration, and even the need for surgery to address damage caused,” said Dr David Cahill, ACA President. ACA’s research shows that as a nation, Aussies have been spending more time on mobile devices. Many said that the increased time is spent on scrolling through social media (50%) working (27%), shopping (48%), streaming content (44%), and communicating (37%). The increase in mobile phone use has meant a decrease in other, healthier lifestyle practices with many admitting to sacrificing exercising (28%), going for walks (26%), sleeping (22%), meeting with friends/family (20%), taking care of the house, and reading books (19%). As a result, almost a third (30%) said that, on average, every hour they reach for their phone between 5-30 times, and one in ten (9%) admitted to even doing so more than 30 times.i The nation’s tendency to sacrifice healthy lifestyle choices is taking its toll on Australians’ spinal health. Dr Cahill explained: “We know that regular exercise can improve pain and quality of life in those with neck pain.v However, our research shows that over a quarter (28%) of Australians are sacrificing their physical activity to spend more time on their phones and admitted that they have been working out less in the last 12 months”. Chiropractors - healthcare professionals who specifically care for a patient's neuromusculoskeletal system and help manage back and neck pain through the use of spinal adjustments to maintain good alignment - want Australians to safeguard their quality of life and wellbeing by taking the time to assess their spinal health and address any aches or pains they may be feeling and seek the appropriate treatment. Dr Cahill suggested: “Taking care of your spine does not need to be complicated or expensive. There are many things people can incorporate into their day-to-day routine that can improve their spinal health or assess if they need professional assistance. For example, these are five easy things people can incorporate into their daily life to help safeguard and improve their neck health: • 20/20 breaks: when using your phone or working take short, 20-second breaks, every 20 minutes to stand up, move and stretch. • Chin tucks: incorporate chin tucks into your daily routine – when working or using your phone, do 5-10 chin tucks every hour. Start in a seated position with your shoulders relaxed, look straight forward, place a finger on the chin, and without moving the finger, pull the chin and head straight back until a good stretch is felt at the base of the head and top of the neck (there should now be some separation between the chin and finger). Hold for 5 seconds if possible and bring the chin forward again to the finger. • Change how you hold your phone: Bring the screen to eye level so your head is not slouched forward or too high. Instead, keep a neutral spine so your ear is in line with your shoulders. • Consider your sleeping position and set up: if you sleep on your stomach and wake up with a stiff/sore neck consider switching to side sleeping. Having the right sleeping setup also matters, ensure that your pillow is supportive, and is the right height for your body size and sleep position. If you lie mostly on your side the pillow should keep your neck in a straight position, without tilting up or down. If you lie mostly on your back, the pillow will need to be thinner so that your head is not pushed forward. • Stay active: Include regular walks in your day, minimum of five minutes, every hour. If you work out regularly, focus on your core muscles as they help keep your body stable and balanced, and protect your spine, including the neck.” If you are concerned about your neck health following two years of lockdown and disrupted routine, consider visiting your local ACA chiropractor to help support good spinal health and improve overall wellbeing. About the Australian Chiropractors Association The Australian Chiropractors Association (ACA) is the leading voice for chiropractors in Australia, actively working to further the profession of chiropractic by improving the health of all Australians. About the survey A nationally representative survey of Australian adults was commissioned by the Australian Chiropractors Association and conducted by Pure Profile in April 2022, to explore experience with neck-related pains and issues, pain management and the change in lifestyle behaviours, physical and mental health in the past 12 months. 1,003 Australian adults from all states and territories completed the survey. References: i Consumer research conducted by Pure Profile, April 2022. ii Text Neck Syndrome in Children and Adolescents. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7914771/ . Accessed in April 2022. iii Social Connectedness, Excessive Screen Time During COVID-19 and Mental Health: A Review of Current Evidence. Available at: https://www.frontiersin.org/articles/10.3389/fhumd.2021.684137/full . Accessed in April 2022. iv Aussies spend almost 17 years in a lifetime staring at their phones. Available at: https://www.reviews.org/au/mobile/aussie-screentime-in-a-lifetime/ . Accessed in April 2022. v Effectiveness of exercise in office workers with neck pain: A systematic review and meta-analysis. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093121/ . Accessed in April 2022 Blog post by Chiropractor, Mihajlo Danilovic. Activ Therapy Gladesville https://www.activtherapy.com.au/gladesville.html
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All these three manual therapy modalities are categorised as primary healthcare practitioners, meaning you do not need a doctor’s referral to see them. Their primary aim is to help people get better. Their methods of treatment tend to overlap, which to a layperson would seem all very similar, but the philosophy behind their techniques differs. ChiropracticChiropractors are health professionals that play an important role in spinal healthcare by using a variety of non-surgical, non-invasive techniques, such as specific spinal adjustments to improve joint mobility, soft tissue therapy to release muscles, exercise prescription to strengthen and correct mechanical imbalances, and low-force manual interventions to cater for patients that need a softer approach like children or the elderly. Chiropractors university degrees train them to diagnose, manage and help prevent musculoskeletal injuries, especially spinal conditions that lead to neck and back pain. PhysiotherapyPhysiotherapists are university trained health professionals who help treat injuries, reduce pain and stiffness, increase mobility and prevent further injury. Treatments can consiste of muscle releases, joint mobilisation and exercises prescriptions. Physiotherapists can help with a range of conditions including rehabilitation after surgery, sports injury, stroke and general injuries. OsteotherapyOsteopaths are also university trained and complete a 4-year degree. Osteopathy focuses on how the skeleton, joints, muscles, nerves, circulation, connective tissue and internal organs function as a whole. Osteopaths treat conditions using techniques such as muscle releases, stretching, joint manipulation and visceral manipulation. For most people and most types of injuries seeing any one of a chiropractor, physiotherapist or osteopath would be suitable. All professions are qualified to deal with the full range of musculoskeletal conditions and have university qualifications. It is often dependent on the individual practitioners experience and treatment apporach that determines who would be most suited to help you. This article was written by Mihajlo Danilovic. Senior chiropractor at Activ Therapy Gladesville.
The Quadratus Lumborum (QL) muscle lies deep in the lower back and is one that can make or break your low back health. Read on to learn what the QL muscle is, how to determine if it causes you pain, and how to fix it. Function: Quadratus Lumborum is critical to spinal stability and strength. The QL muscle is very active during physically active sports, lifting objects, and carrying weight. When performing all of these activities, Quadratus Lumborum is active with the intention of keeping the lower spine neutral and stable. In addition, Quadratus Lumborum functions in side bending the spine, as well as in extending the spine. Carrying a heavy object with one arm requires effort from Quadratus Lumborum on the opposite side of the body to keep the torso upright. Quadratus Lumborum Pain & Symptoms The Quadratus Lumborum muscle is susceptible to causing pain in the body when tightness, trigger points, and/or weakness are present. QL muscle pain can be generally described as low back pain, but can also refer pain to the upper glute and outer hip [1]. The image below describes the pain pattern felt by QL trigger points, with the pain areas shown in bright red [1]. In addition to low back pain and pain referred above, Quadratus Lumborum can cause other atypical symptoms:
Quadratus Lumborum Release The first step to eliminating Quadratus Lumborum pain is effective deep tissue massage. Targeted deep tissue massage will break up any knots, trigger points, and tightness contributing to pain. This can be done by the hands or elbows of a physical or massage therapist, or at home with a targeted muscle release tool like QL Claw. QL Claw was designed to release the Quadratus Lumborum and the other 4 muscles that contribute to low back pain when tight, and it is unmatched in at home deep tissue massage. Effective deep tissue release should eliminate your pain at rest. To know if you released a knot/trigger point, a massage at a higher pressure will feel less painful. You also may feel yourself physically sink deeper into the massage in a therapeutic manner. Strengthening Quadratus Lumborum After effective release of the Quadratus Lumborum, the QL muscle should not be causing pain at rest. However, life is more than rest. We want to build strength and endurance in the QL muscle to be ready for whatever life throws at us, and to avoid falling back into QL muscle pain. A few great exercises for improving QL muscle strength and resilience are the side plank, suitcase carry, and overhead paloff press. Check out this video for a walkthrough of each exercise! Sources: [1] Donnelly, Joseph M. Travell, Simons & Simons Myofascial Pain and Dysfunction: the Trigger Point Manual. 3rd ed., Wolters Kluwer Health, 2019. [2] Davies, Clair, and Amber Davies. The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. 3rd ed., New Harbinger Publications, Inc., 2013. If there’s one thing that our locals all love, it’s their gardens! With the warm weather shining around the corner, it’s a great time to soak up the sun and spend time absorbing some much-needed Vitamin D in our great outdoors. Just a quick word of caution – take it slow and steady. You’ve spent a lot of time indoors and not moving around as much. This means your joint and muscles are likely to be stiff, tight and inflexible. They won’t function as well as they’re supposed to, leaving you prone to developing aches and niggles quite easily. You need to get the engine going again before you pull up those weeds (Or you might regret it later!) >> Click here to enquire about our services <<Opening the Upper Back: Book Opener The upper back is the link between your neck and your lower back/pelvis. Stiffness in this area will lead not only to poor breathing and endurance, but also contribute to neck pain and lower back issues. The Book Opener is an effective way to get your ribcage moving and allow you to breathe all that fresh air again! Lay on your side with your knees up and arms on top of each other. Smoothly rotate your ribcage and open up as far as you can comfortably go. Getting the Lower Back Moving: Upward Dog Most people develop stiffness in their pelvis and lower back as they get older. The yoga move (“Upward Dog”) is a great way for you to restore movement and free up your lower back. Getting Your Hips Flexible: Hip Flexor Stretch The muscles, ligaments and connective tissue at the front of our hips all get short and tight when we are sitting or standing a lot. It’s a common culprit for lower back pain, neck tightness and headaches. The Kneeling Hip Flexor Stretch allows you to open up your hips again, helping you feel that sense of “openness” and freedom when you’re walking. If you found this useful, send Lawrence an email at lawrencek@activtherapy.com.au and let him know what else you would like to learn about! You can find also him at Activ Therapy Dural (located at Round Corner), just opposite from Petbarn and the newly built Duke of Dural. If you’re simply fed up with your pain, aching and stiffness and want to fast track your recovery, click on the link below to make a booking. Stay safe and happy gardening! >> Click here to enquire about our services <<Do you know the what the main cause is for knee and hip replacements? Advanced Osteoarthritis. Poor muscle strength and control leads to degeneration of your joint capsule, causing pain and eventually leading to advanced osteoarthritis when the condition worsens. This is a common issue we see in our Senior clients who have been active all their life, but over the last couple of years has really been held back by achy and painful joints. They’ve seen their GP for years who has prescribed them every medication under the sun to relieve the pain. But it just doesn’t fix the problem. Here are the top 3 tips from our Senior Physio at Dural, Lawrence, to help you stay strong and keep your joints healthy: >> Click here to enquire about our services <<#1 Lower back stretchThis is a classic stretch and is well known – but so many people do it wrong!! Lay on your back and twist your pelvis to one side WHILE keeping your upper back flat. This is very important to make sure the lower back/pelvis is getting a good stretch! #2 Hip/glute strengtheningThis exercise is to target the glutes, the major muscles that control your hips. Without good glute muscles, your hip can be “out of whack” or “out of alignment” which causes your hip and knee joint to suffer. Place a band around your knees. Sit back into your hips and stay nice and low – you should feel a burn in your buttock muscles. From there, slowly slide one hip outwards to stretch the band – you should feel the glutes on BOTH legs start to work hard. Enjoy the burn. ![]() ![]() #3 Reverse lungeThis is the best way to work the quads, hamstrings and glutes together at once. Keep your weight over the front leg as you step back into a lunge. Your chest should be directly vertical to your foot. Don’t go too low, just as far as you can control. A common mistake with this exercise is lunging too deeply and taking tension off the muscles and placing too much load into the hip and knee joint. If you found this useful, send Lawrence an email at lawrencek@activtherapy.com.au and let him know what else you would like to learn about! You can find also him at Activ Therapy Dural (located at Round Corner), just opposite from Petbarn and the newly built Duke of Dural. If you’re simply fed up with your pain, aching and stiffness and want to fast track your recovery, click on the link below to make a booking. >> Click here to enquire about our services <<Tennis elbow – or lateral epicondylalgia – is inflammation of the tendon which connects the forearms muscles to the elbow. Although it is called ‘Tennis Elbow’ you don’t have to have played the sport to get it. It is usually associated with highly repetitive activities that require a lot of gripping, or wrist and hand movements. Pain is the most common symptom that people experience, however you may experience a loss of grip strength, reduced ability to lift heavier objects, tingling or pins and needles in the forearm and hand in more extreme cases, and loss of fine motor control movements. The above symptoms mean that tennis elbow can really start to affect your ability to perform activities of daily living and work-related tasks. Although it is usually self-limiting – that means that it will eventually go away – it can occasionally last for weeks and even months before settling unless an intervention is made. Some of the things that your therapist may suggest to help your symptoms include:
Forearm stretches help to reduce some of the tension in the muscles which develops as we use them for everyday activity. Increased tension in the muscles puts added stress where the muscles connects to the bone, thus causing your symptoms. 2 Eccentric forearm exs Eccentric exercises help to strengthen the connective tissues in our bodies, which is the main tissue affected in tennis elbow. 3 Wrist Pronation/Supination We use our hands to do movements in all different directions, that’s why it’s important to strengthen our wrist and forearms the same way. The pronation/supination movement helps to mimic some of the different ways we use our hand everyday
Give these exercises a try and see how they can improve your elbow pain! by Matthew Calabrese Activ Therapy Clemton Park One of the most difficult shoulder problems to improve is a frozen shoulder. So what is it? Also called adhesive capsulitis it is characterised by a stiff shoulder, pain and a loss of range of movement. It involves the capsule of the shoulder thickening and becoming inflammed, often associated with other shoulder injuries like rotator cuff tears and bursitis as well as surgery or when immobilised for long periods. The true reason for this developing isnt fully known. Frozen shoulder will proceed in 3 stages 1. Freezing (painful) stage. This is at the beginning and is characterised by the shoulder getting more and more stiffer as well as high levels of pain in the shoulder joint. 2. Frozen stage. Where the shoulder is stiff and limited in movement but usually no longer painful unless stretched. 3. Resolution (or thawing) stage. In this stage the shoulder is able to gradually regain its movement. The timeframe for frozen shoulder can be difficult to predict. It can often last for 1-2 years and in many cases resolving on it's own. Treatment for frozen shoulder in each phase is focusing on managing pain and inflammation as well as improving or maintaining range of movement. Physiotherapy techniques, like capsule releases, dry needling and stretches may improve movement and pain and in some cases a cortisone injection may help. In the early phase of a shoulder injury if there isn't improvement in movement then it may br progressing to a frozen shoulder in which case progression to movement maintenance is important as a fast recovery may not be realistic. Below some of our senior physiotherapists show us exercises to improve movement in the early phase of frozen shoulder. The first is from our physio Paul at our Clemton Park clinic demonstrating the pulley range of movement exercise. Paul's second exercise is the wall crawl. Again a good exercise to use in the early phase when the shoulder is stiff and sore. The third exercise from Paul is our laying down shoulder flexion exercise. and our third is from Steve, our head physio at Sans Souci demonstrating the external rotation movement exercise for the shoulder. These exercises are all useful to do in each phase of frozen shoulder even the early phases. It is likely to be more painful and difficult early on so it is important to check with your therapist how many repetitions is appropriate and how far you should take the movements.
One you reach the resolution or thawing phase of frozen shoulder it is important to include strengthening and stability exercises to rebuild the shoulder strength and function as the movement returns. In most cases there are minimal lasting effects once the recovery from frozen shoulder is complete but it can be a challenging condition to live and work with while you have it. To reduce the risk of getting frozen shoulder make sure that you manage any shoulder injury promptly and correctly and ensure that recovery after surgery is done as the specialist recommends (even if it is a relatively mild one), If you feel like you are getting a sore shoulder and movement is very limited see a physiotherapist or a doctor and get it diagnosed in a lot of cases it may not be frozen shoulder and a quick recovery with treatment is very much possible. Leave a comment if this has been helpful and thanks for reading! By now everyone is probably aware that we all sit more than we should and it is having a huge impact on our health. We sit at a desk for work, sit at home, look down at our phones more often and sit longer on our way to and from work. Not only is this having an impact on our obesity levels, cardiovascular fitness and core strength but it is also a big reason behind persisting neck and shoulder pain. This is tied in most cases to 2 things: Sitting for too long at a time, and Sitting with worse posture. We will chat about what good posture is in another blog but today I wanted to focus on what is causing that pain and few easy exercises you can do to help reduce these pains. What most of us feel is a sense of stiffness in the back and tight shoulders and neck. This comes from that rounded upper back position we all haev when we are hunched at a laptop, looking at our phone or have been sitting at a computer for too long. We all know we should sit up straight but lets face it, that isnt easy to keep up.. The muscles in your neck and shoulder that get tight are usually one of two. The first being the upper trapezius muscle which runs from the top of your shoulder up to your neck. When you get that big knot on top of your shoulder, that's the upper trap. below our senior physio Michael shows how you stretch out the uppper trapezius muscle. The other big muscle in the neck and shoulder is the levator scapulae. This also runs from the top of the shoulder and up to the base of the skull. Michael is back below to show us the best stretch for the levator scapulae (it is also a really good exercise for headaches that are caused by the neck). Now all of that neck and shoulder tightness happens because of that stiff upper back and that hunched position we all spend too much time in. It's a big complex area so we have got 3 different ways to relieve stiffness, improve movement and reduce pain in that area. First one is Michael again showing us a mckenzie extension exercise you can do against the wall. The next 2 exercises are with the foam roller. Below we have our chiropractor Michael (I know it gets confusing and they both work at the same Moorebank clinic as well!) showing us a rotation exercise for the thoracic spine. And chiro Michael is back to show us a thoracic extension exercise for the upper back with the foam roller. These exercises are great to reduce the effects of sitting in the short term and also potentially reverse the effects of years of sitting. So give them a try.
With that being said there is one thing is very important to note. Exercises and treatment can help manage the effects of poor posture and reverse some effects but it will always be an uphill battle unless you look at your sitting posture first. Sit for less time and sit in better positions. These 2 simple things will make all the difference. Foot drop can happen with a range of conditions, most typically when there is irrtation or damage to the common fibula nerve including the sciatic nerve. In itself it is a symptom so it's important you see a physio to get to the cause of it. While addressing the underlying cause it is important to address the footdrop itself. Below are a few simple exercises that might help. Foot drop can be a difficult condition to live with because it makes it hard to walk. It is also an issue that can lead to trips as the toes can get caught on small cracks or edges on the walking surface. The last thing you need is a fall! One of the consequences of a foot drop is tightening of the muscle groups at the back of the calf. The first two exercises focus on stretching the gastrocnemius and soleus muscles. Below Matt (head physio at Clemton Park) demonstrates these). Gastrocnemius stretchSoleus stretchOnce you have started work on flexibility of what is tight you then need to strengthen the muscles that raise the foot back up. The first exercise to try is a simple foot lift. Below, our Senior physio at Activ Therapy Casula Lawrence shows how to do this exercise. Ankle dorsiflexion exerciseThe next exercise is resisted peroneal strengthening. Lawrence again shows how to perform this exercise. Peroneal strengtheningThe last in this series is the tibialise posterior exercise. Along with the peroneals they function to lift up the foot. Lawrence shows how to perform this in the video below. Tibialise posterior strengtheningGive the exercises a try. If you have any issues get in touch with one of our physios with your questions.
Do you sit for work? Even if you don't chances are you sit for a good part of your day. Recent research has suggested that on average we sit for 9 hours each day!!! All this sitting position does a lot of things to our bodies. Weight gain, reduced leg strength, muscle density and neck and lower back issues. One thing that we find increasingly that often is forgotten is gluteal weakness. The sitting position puts the the hips into a bent position leading to tightness of the hip flexors (at the front) and weakness of the gluteal hip extensors (at the back). Weakess of the glutes then can lead to a spiral of further tightness of the hips and gradually increasing load and reliance on the lower back. There are a LOT of exercises that can improve gluteal strength but a staple is the glute bridge and its progressions. The glute bridge is a favourite because it is relatively simple to perform, safe and it can be beneficial for everyone from elderlies that have trouble getting around through to athletes. So let's start with the simple hip bridge, the most basic version. Paul Truong, Senior physio at our Casula clinic shows how its done. If the hip bridge gets easy you can add holds or place a weight like a bar or dumbell on your hips to make the exercise more difficult. You could also progress to a one leg version for a real challenge. Another of our favourite progressions is the elevated bridge. This helps to increase the range through which the hip works. To add some stability challenge to this you can perform the exercise on an exercise ball. check out Paul's video below. If you can do this version then the final version in our sequence is the walking bridge. We love this exercise because it also challenges your trunk stabilisers (core muscles) while also using your glute muscles. Paul demonstrates it in the video below: Give these a rtry and build your hip strength and save yourself from tight and weak hips!
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