By Senior Podiatrist Michael Johnston
A staggering 48% of Australians have experienced heel or arch pain in the last 12 months but 56% of us don’t know what a Podiatrist does.
Podiatrists are specialists in the foot and lower limb so can treat foot, ankle, knee and hip pain.
Here are some of the most common issues we manage;
- Heel pain – Plantar Fasciitis, Achilles injuries
- Shin Splints
- Ankle injuries
- Knee Pain
- Ingrown and fungal infection of toenails
- Corns, callus and verrucas
And here are some of the things we can do to fix you;
- Custom orthotics
- Shock wave therapy
- Dry Needling
- Gait re-training
- Footwear advice
As part of Foot Health Week we are offering 15 minute Walking/Running assessments with video analysis at our Melbourne clinics for the rest of October.
Introduction, background & context
What do you do for work? Do you sit down at a desk all day? How often do you move? Have you or are you experiencing neck pain and/or headaches?
If you have experienced headaches or neck pain in the past, this series is perfect for you and hopefully give you a bit of context to your personal experience with this recalcitrant condition.
It’s important to read this because neck pain and headache can and will:
Decrease quality of life
Decrease work productivity
Increase stress and have an impact on your personal and professional relationships
This blog series aims to provide a background for the different types of ‘headaches’, address some possible causes and what you can do to achieve:
A pain-free and ‘well’ lifestyle
Maximise your quality of life
Maximise productivity and quality of interpersonal relationships
Prevalence And Types Of Headaches
Headaches, migraines, dizziness, head throb, sore head, tension-type headaches… Chances are, if you have had any of these experiences, you are not alone. Up to 7 million people in Australia (42% for women and 36% for men) have suffered or are suffering from tension-type headaches, up to 3 million people (10-15% population) have suffered from migraine and the direct and indirect costs of migraine alone would be around $1 billion per annum (HeadacheAustralia.org).
We tend to throw around the terms migraine and headache interchangeably. Are there any differences between them and what types of other ‘headaches’ are there?
In simple terms, I have broken them down into 3 umbrella categories for you.
- Cervicogenic headaches (CGH) – Most common
- Tension-type headaches (TTH)
Cervicogenic headaches (CGH) is a syndrome characterised by acute or chronic hemi-cranial (one side of the head) that is referred to the head from either bony structures or soft tissues of the neck (Biondi, 2005).
We often find patterns with CGH clients:
Localised to one side of the head
Restricted neck movements
Pain triggered by movement or sustained awkward postures
Same side neck, shoulder and/or arm pain
What can you do?
Your next posture is the best posture – change it up, sit to stand to sit desk
Stretching – moving your neck by looking up, down and rotating to the side a couple of times every hour
Fortunately, physiotherapy treatment such as joint mobilisation, manipulation and exercise therapy has shown excellent efficacy and outcome with CGH (Racicki et. Al. 2013). These types of headache typically resolve around 2-3 months of successful treatment.
Migraines are a type of reversible neurological deficit with alternating one-sided head throbbing and/or pulsating sensation, which can be accompanied by paraesthesia (numbness). It can last anywhere from 10 minutes to 72 hours.
Unique triggers such as smell, stress, food, light, physical activity and/or sound.
Possible psychosocial factor influences such as stress, depression, anxiety, burnout, family issues etc.
Associated with sleep deprivation, skipping meals, weather changes and genetics.
As you can see, the underlying causes of migraines are so multi-factorial. Therefore, it is imperative to consider not only the physical aspect of a migraine sufferer, but the psychological and social aspect also.
Tension-type headaches are a primary form of headache; unlike Cervicogenic headache, which is secondary to structural referral pain from the neck. Tension-type headaches stem from the central or peripheral nervous system (Bendtsen, 2000).
Affects both sides of the head
Tight/pressing – mild to moderate
NOT aggravated by routine physical activity
Duration: 30 minutes – 7 days
Exercise and lifestyle changes
Physiotherapy – Deep muscle training
With Tension-type headaches, an underlying cause of deep muscle impairment is often present. A study conducted in the Netherlands investigated the efficacy in physiotherapy deep muscle retraining, and found that the treatment has reduced headache frequency, intensity and duration (Ettekoven & Lucas, 2006).
Chin Tuck Exercise
This simple exercise to tuck your chin, making a double chin, can be performed easily from your desk. It aims to train the deeper stabilising muscles in your upper neck, improving its endurance and decreasing the chances of being fatigued.
If you’re sick of neck pain and/or headaches and you want to live pain free and improve productivity and reduce stress, book a session with our Physiotherapists. Here at Pinnacle Health Group, we have experienced Physiotherapists, Psychologists, Massage Therapists, Myotherapists, and Dietitians working together to help you reach your wellness goals.
- Bendtsen, L. (2000). Central sensitization in tension-type headache – possible pathophysiological mechanisms. Department of Neurology. 20(5):486-508. Retrieved from http://journals.sagepub.com.ez.library.latrobe.edu.au/doi/abs/10.1046/j.1468-2982.2000.00070.x#articleCitationDownloadContainer
- Biondi, D. M. (2005). Cervicogenic Headache: A review of Diagnostic and Treatment Strategies. The Journal of the American Osteopathic Association. 105(S16-22). Retrieved from http://jaoa.org/article.aspx?articleid=2093083
- Ettekoven, H. V. & Lucas, C. (2006). Efficacy of Physiotherapy including a craniocervical training programme for Tension-Type headache; A randomized clinical trial. International headache society. 26(8):983-991. Retrieved from http://journals.sagepub.com.ez.library.latrobe.edu.au/doi/abs/10.1111/j.1468-2982.2006.01163.x#articleCitationDownloadContainer
- Prevalence and cost of headache in Australia. (2018). Headache Australia. Retrieved from http://headacheaustralia.org.au
- Racocki, S., Gerwin, S., DiClaudio, S., Reinmann, S. & Donaldson, M. (2013). Conservative physical therapy management for the treatment of cervicogenic headache: a systematic review. Journal of manual & manipulative therapy. 21(2):113-124. Retrieved from https://www.tandfonline.com/doi/abs/10.1179/2042618612Y.0000000025
Clinical Myotherapy is the evidence based assessment, treatment and rehabilitation of musculoskeletal pain and associated conditions. Clinical Myotherapists can treat various issues such as sporting and occupational injuries, stiffness and sore body, chronic overuse syndromes, symptoms associated with arthritis, back pain, neck pain, stress and tension, pregnancy and more. Techniques often used by Myotherapists are: manual therapies, myofascial dry needling, physical therapy such as exercise prescription and rehabilitation, joint mobilisation and pain management.
What is the difference between Myotherapy and Remedial Massage?
Massage therapy is a type of manual therapy. Remedial therapists are the specialists in massage and focus on treating soft tissue injuries or soreness with different techniques of therapeutic massage. In contrast, clinical myotherapists use manual and physical therapy as well as pain management techniques and advice. Certain conditions, soreness or long term disease respond better with a mix of physical therapy and manual therapy. Clinical Myotherapy may help alleviating symptoms and be a powerful ally in chronic pain and acute pain management.
By Josh Lambert
As November strikes us with a bang, the reality of a sprint-to-the-finish-line conclusion to the year begins.
For many of our wellness partners, this not only signals the need to start measuring the effectiveness of their wellness programme for the current calendar year or previous financial year – but also the need to start preparing to engage and inspire employees to be healthy and well for 2018, and beyond. And all whilst going to Spring Carnival events, Christmas parties and more….
Therefore, this is an opportune time to share some expert insights that we have gained from planning and delivering wellness calendars for the many organisations and buildings that we consult. More to the point, insights into how to actually make these programmes exciting, motivating and effective to ensure your staff or tenants want to participate and improve the wellness culture in your workplace.
TIMING IS EVERYTHING
One of the most sought-after and rewarding health initiatives that we deliver are skin cancer checks for employees and tenants in a range of settings – and the upsides to detecting a serious melanoma or skin lesion are literally life-changing for the people involved. However, engagement of participants in skin cancer checks can vary significantly for a range of reasons, and a seemingly-obvious variable to get right is delivering skin checks at a time of the year when employees actually see the sun. The same goes for any part of a wellness calendar – matching your wellness initiative with the appropriate time of the year will increase participation, as it is relevant and in context.
Wellness Calendars will often involve a mix of staple health initiatives such as flu vaccinations and health checks, and some more stimulating and educational items such as wellness seminars, exercise or meditation classes and expos. Throwing in some fun and innovative ideas is crucial in getting the attention of your staff or tenants to consider participating in the first place. Consider balancing or prefixing the “standard fixtures” of your programme with some ideas from left field – such as pedal-powered smoothie makers, foyer Zumba classes, health skill tester challenges, employee manicures, table tennis competitions and anything you can think of that gets people involved.
Along the same lines as the above – is there anyone these days that doesn’t like to know how many steps they have taken, kilometres they have cycled, hours they have slept, calories they have consumed, etc etc? Probably – but increasingly so, the average employee’s thirst for knowledge these days is a big motivator for them to engage in healthy activities in the first place. Technology can be used for “wow” factor in health initiatives, and also appeal to the data analyst in all of us – we have engaged innovations such as Heath ATMs (health score and key metrics in a few minutes), online platforms and apps that generate curiosity and interest from a wide population. Even the wellness calendar itself can be accessed by an interactive app with notifications that entice employees.
ACTIVATE WORK SPACES
Nothing shows a company or building’s commitment to encouraging a healthy and well culture, like physically living and breathing wellness in full view of the workplace. Foyer pilates classes, seated massage, meditation meeting rooms, roaming healthy snack suppliers – there are so many ways to deliver aspects of your health programme that showcase various parts of your building (from break-out areas to end-of-trip facilities). Activating these spaces is essentially marketing for your wellness programme and building layout, but also showing the workplace that you expect a positive attitude towards being healthy.
LINK WITH NATIONAL OR INTERNATIONAL INITIATIVES
Finally – it’s a good idea to mirror at least a few of your wellness calendar initiatives with the corresponding “Health Week” or relate your workplace focus areas to those of the broader Australian or global population. Examples of these can be Heart Health Checks in Heart Health Month, Mental Health Initiatives in Mental Health Week, and fun events such as National Ride2Work Day that already have large reach, marketing material and awareness campaigns that can help promote and engage.
By Josh Lambert
It is absolutely clear in the modern workplace that if you haven’t heard or overheard any of the above terms – you are now definitely in the minority! With so much hype, and a wide range of media saturation, one could be excused for cynically referring to these as “buzzwords”. Nevertheless, we spend on average 48% of our waking hours, and approximately one-third of our adult life at work.₁ Furthermore, a 2016 Australian survey concluded that nearly half of us would leave our jobs if our employers failed to meet our health and well-being needs.₂
So fair enough – we now value “wellness” more, and we know it is getting bigger and bigger. At minimum, our HR and Health & Safety teams across the country are focusing on redefining “health” at the forefront of traditional health and safety practices.
But what does it all mean, you might ask?
Is wellness a fad? Do I need to wear yoga pants to work? What’s in it for me?
The World Health Organization defines wellness as “… a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.”₃ In essence, wellness is viewed as a more holistic feeling or process of wellbeing and fulfillment (note the “process” key term given that health is a continuum and we can always improve on our current state).
Workplace wellness and Corporate Wellness are often used interchangeably in any work environment – defined as “any workplace health promotion activity or organisational policy designed to support healthy behaviour in the workplace and to improve health outcomes.”₄
Whilst this definition is universally accepted, the actual manifestation of “wellness” as a practice at workplaces can range significantly, and include anything from:
- On-site health services eg. Doctor, Physiotherapist consultations
- Online health information, assessments and behavioural change programs
- Executive and senior management health assessments
- Annual health checks
- Voluntary one-on-one health coaching for individuals with multiple risk factors
- Health insurance subsidies
- Employee Assistance Program
- Work/life balance arrangements
- Chronic disease-specific offerings (e.g. weight loss programs, Diabetes prevention)
- Events and challenges (e.g. Global Corporate Challenge)
- Physical environment (e.g. accessible stairwells)
- Provision of fruit
- Service availability (e.g. onsite gym)
With the cost of absenteeism in Australia currently estimated at $7 billion each year, and presenteeism (defined as not fully functioning at work because of a medical condition) costing the economy more than $34 billion a year ₅ – wellness programmes will be closely monitored and refined to maximise results.
As a corporate health and wellness company, we really enjoy how differently wellness can be perceived or practised by employees – for example, our wellness centres have anything from on-site doctors and physiotherapists to barbers and beauty therapists! As the “wellness revolution” continues to grow, our interpretation of wellness may continue to develop, but one thing is very certain – the importance of health and wellness in a workplace environment will only increase with Australia’s ageing population, and the sheer time we spend in the workplace.
Today we’re going to debunk a few ‘un-truths’ around Physiotherapy, particularly the role of Physiotherapists. We’ll shed a little light on what they go through to become the knowledgeable medical professionals they are!
What is Physiotherapy? Who are Physiotherapists?
Put simply, Physiotherapy or Physical Therapy is a branch of rehabilitative medicine. The focus is on helping patients to recover, improve or maintain their physical abilities, delivering targeted treatment and relief of pain, disease and injuries, using physical means. As a widely popular healthcare treatment, Physiotherapists are the specialists who work with patients in need of the aforementioned treatments. Patient treatments vary greatly, as causes of pain and symptoms can be a result of any number of reasons, such as disease, age, sports or environmental factors.
Physiotherapy is a Clinical Health Science
Contrary to popular belief, Physiotherapy is not an ‘alternative therapy’. In fact, it is a clinical health service that requires lengthy studies and training. Physiotherapists study medical science subjects such as anatomy, neuroscience and physiology, coupled with intense educational training for prevention, treatment and diagnosis of patients with physical problems. Like many other medical professionals, Physiotherapists often work in Hospitals.
In many countries, like Australia, Physiotherapists are legally required to be qualified and registered. A proper graduate degree in physical therapy or health sciences is a minimum requirement to be a professional physiotherapist at our Melbourne clinics, on Flinders and Collins Streets.
Experts In The Treatment Of Neuron, Muscle Or Cardio Related Diseases
Qualified Physiotherapists are experts in the treatment and examination of people suffering from neuron, muscle or cardio related diseases, and preventing disease!
Qualified and registered, our Physiotherapists at Pinnacle Health Group specialise in treatments that will fast track you back to optimum health.
What Exactly Is The Job Of A Physiotherapist?
By employing their training and skills, Physiotherapists assess, diagnose and treat a wide range of physical ailments. Given the interconnected nature of the body, your Physiotherapist may further diagnose deeper issues linked to different systems in the body, such as:
- Musculoskeletal systems – This organ system gives us the ability to move using our muscles and bones, or the muscular and skeletal systems. Composed of our bones, muscles, cartilage, tendons, ligaments, joints, and other connective tissue, the musculoskeletal system gives us form, movement and stability.
- Neuromuscular systems – This encompasses both the nervous system, including the brain and spine, and the muscles. Neuromuscular refers to neuromuscular junctions (where nerves and fibres connect), and neuromuscular transmissions (the transference of information and impulses from the nerve to the muscle).
- Cardiovascular systems – This is the heart and circulatory systems. We all know how important the heart is! Meanwhile, our circulatory system carries vital nutrients and oxygen to body tissue via the blood vessels, as well as removing waste and carbon dioxide. A healthy circulatory system is crucial to healthy body function.
- Respiratory systems – This includes organs such as lungs, bronchi, trachea, larynx, throat and nose; basically, any organ that’s involved in breathing.
Consult With A Physiotherapist
From your insides out, top to toe, Physiotherapists have a long-standing history of improving many aspects of health and well-being. Tailored and specific health and lifestyle plans for each patient post treatment ensures you maintain the new and improved you!
Physiotherapy continues to gain steady recognition and admiration for its remarkable success in the treatment, prevention and management of pain, injuries and illnesses. Across the globe, doctors are increasingly referring their patients to Physiotherapists, resulting in more people being aware of and seeking out Physical Therapy treatments without having seen their GP first.
Our clinics at Flinders and Collins Streets are centrally located in Melbourne. Our highly trained and experienced Physiotherapists will work with your GP, as we understand how to integrate physical therapy with other forms of medical treatments. We accept personal visits as well as GP referrals.
Contact us for more information, or jump straight to booking your appointment online! Your better tomorrow, starts today.
By GP and Skin Expert, Dr Sachin Deshmukh
At this time of year, it is important to tick the right boxes in regards to your skin.
During the months of September to April, most Victorians need just a few minutes of mid-morning or mid-afternoon sun exposure for their vitamin D needs.
Here are some of my responses to common questions about your skin:
What is a skin check?
- in our skin checks, we assess your skin for any abnormal changes – on moles that you have already identified, or others you may not be aware of.
- we identify which moles we will need to watch, which are benign and can be left, and those that may need removal
What is mole mapping?
- Part of our skin check – we document locations and size of moles, for us to track any changes
- we also encourage you to use a mobile phone app – called “miiskin” to take images of moles and report back to us during consultations
What if I have a melanoma?
- If we identify a melanoma (or what we feel may be a melanoma), we remove the lesion – and it is sent off to pathology.
- We remove many melanomas – the entire purpose of skin checks is to find these and remove them
How often should I get a skin check?
- every 3-6 months if you have many moles
- every 12 months if you have few moles
- OR if you notice any change or are concerned about a mole – see your GP as soon as possible
How much sun is enough?
- The Sun is an important source of Vitamin D for us
- In the September to April period, you should always have sunscreen, hat, sunglasses on – and avoid being in the sun during the midday period where possible
- We require just a few minutes of mid-morning or mid-afternoon sun during September to April
- In May to August, it is encouraged to be outdoors around midday, with some skin uncovered
By Podiatrist Chris Mccormick
As the weather rolls out of the winter doldrums and into the bright light of spring, it’s the perfect time to dust off those running shoes and get moving again! The days are getting longer and warmer, and the running event calendar is building; it’s already less than 3 months to the Melbourne Marathon! As we increase our running distance and frequency in preparation for the running season, so too does the injury rate, especially to those beautiful, hard working pedals at the bottom of your leg – your feet!
Here are the most common running related injuries of the foot, and how to successfully manage them:
Plantar fasciitis: This is the most common injury that occurs to the foot due to running. While its name suggests it’s an inflammatory condition, this is misleading as this type of heel pain is due to many factors, including nerve compression, fascial adaptation and the loss of shock attenuation. People with this type of pain report morning stiffness out of bed, pain after rest and often report soreness while running. Thankfully, the Podiatry team at Pinnacle Health Group is well equipped to get your back on your feet! The range of treatment options includes: strapping or orthotics, footwear adjustments, foot mobilisation, running re-training and adjustments and strengthening of the foot or ankle through a tailored programme. We also offer treatments such as massage, dry needling and shockwave therapy. Shockwave therapy especially has been shown to be very effective in reducing pain quickly.
Forefoot pain: This is pain under the ball of the foot, commonly reported while running, especially under the 2nd and 3rd toe joints. People who are experiencing this pain often report a dull ache or shooting sensation under the ball of their foot. Most commonly, this pain occurs due to an inefficient movement pattern of the feet, resulting in injury due to overload. Treatment is focused on restoring normal foot function through orthotics, strapping or padding, foot mobilisation, dry needling, and foot or ankle strengthening.
Stress fractures: We most commonly see stress fractures when people ramp up their training too quickly. Our bodies are great at adapting to new stimuli, but we need time to do this. People will describe a dull ache like sensation through a bone, which can sometimes ache in bed at night. Stress fractures feel worse when undergoing high loading activities such as running or jumping. A period of modified rest is often needed initially to allow the bone to heel. During the rest period, we aim to address all the risk factors that contributed to the problem through dry needling, strengthening of the foot or ankle, foot mobilisations and possibly orthotics.
Our feet are amazing things, they have 26 bones, 33 joints and 33 muscles or tendons per foot. The best way to avoid any foot injury is to slowly build yourself up with your running frequency or distance, giving your body and feet the time they need to adapt. If you suffer from any pain in your feet or legs, don’t delay, book an appointment with our podiatrists.
Physiotherapy To Prevent Pain, Injury Or Illness
As we all know, PREVENTION IS BETTER THAN A CURE. However, and unfortunately, in today’s age, the preventative side to healthcare is somewhat overshadowed by the treatments and cures for after the fact. As a result, a number of people aren’t aware of the effective measures that can be taken to prevent any pain, injuries or illnesses from occurring in the first place. This includes what’s available at our Physiotherapy clinics, conveniently located in Melbourne CBD.
It’s important we learn to adapt. With our lifestyles demanding more than ever – longer hours spent at sedentary jobs, more time spent driving places instead of walking or cycling, increased consumption of processed or fast foods – our lifestyles must accommodate a programme or exercise which can successfully counteract some of these detrimental activities, in order to give us the best chance at a long, healthy life. Our Melbourne CBD Physiotherapists can help you get started.
It’s no secret that all of the above lifestyle factors can lead to a number of serious health conditions, some of which have high fatality rates, such as diabetes and cardiovascular disease. When it comes to your health and well-being, “what doesn’t kill you makes you stronger” is not a motto we’d recommend employing! If you already know what you want, book your appointment at any of our Physiotherapy clinics in Melbourne CBD.
So HOW does Physiotherapy prevent pain, injury or illness? It’s our job as Physiotherapists to know all about these conditions, including what needs to happen in order to suffer from any of them. Research shows that physical activity, combined with a healthy diet, is not only successful in managing and treating illness or ailments, but also for preventing them.
Our Physiotherapists have a sound understanding of the body, and when we combine this with individual and tailored assessments of our patients, we’re able to give help and advice that’s specific to you and your lifestyle.
It doesn’t require drastic lifestyle changes that consume your life; you can achieve important beneficial improvements to your health with a few small changes. It’s because of our Physiotherapists’ experience and knowledge that we’re able to identify the potential for illness or injury, based on your assessment and lifestyle. You’ll find our highly-trained Physiotherapists at our Melbourne CBD clinics on Collins Street and Flinders Street.
Some of the preventative programmes available at Pinnacle Health Group’s Physio Clinics in Melbourne CBD include:
- Cardiovascular exercise programmes
- Sports specific conditioning
- Injury and falls prevention
- Pre-operative rehab for reconstructive surgery, eg joint replacement
- Post-operative rehab for general surgery
- Workplace injury management and prevention
- Weight or diabetes management programmes
- Nutrition and dietetics
Physiotherapy is much more in depth and thorough than what some may realise. So, if you’re suffering from any pain, injury or illness and you’re ready to make a change in your life, book your appointment with our physiotherapists and experience the absolute Pinnacle in health care! A better tomorrow starts today.