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Emma James Physio Blog

Chartered Physiotherapy and Clinical Pilates

Treat your Pelvic Floor to more!

Pelvipower_bio-feedback_training_EJPhysioThere is a new Swiss technology-driven treatment for increasingly common issues such as incontinence, pelvic girdle pain, sexual health/dysfunction, and back pain.

The treatment (called PelviPower) is conducted in the form of a customised therapy chair, where specific impulses (Magnetic Field Therapy, PFT) and high-accuracy sensors (Biofeedback Training, BFT) can target an individual’s particular issues whilst producing results that are measurable and can be replicated.

Conventional Approach

Until very recently, both clinicians and patients have been limited to abstract descriptions and poorly located/defined areas of symptoms, relying heavily on vague and subjective instructions to address various pelvic girdle complications; while most of these issues are often sensitive topics to discuss, and the physical assessment itself being quite intimidating as well. Understandably this has led to a general reluctance for both men and women discuss/seek treatment for their pelvic issues. The PelviPower system addresses these obstacles by providing precise real-time data to the clinician without any invasive procedures, and it also gives the patient a much better information and direction throughout the treatment process.

Incontinence

At least 30% of woman experience some degree of urinary leakage in their lifetime especially during and after pregnancy and soon after menopause as oestrogen levels decline. 1 in 4 women will avoid activities such as sports, going to the gym or daily social activities as a result. There is common misunderstanding that it is a normal or inevitable consequence of childbirth or ageing, when in fact it is an issue that needs to be addressed. Common forms of Incontinence include:

  • Stress incontinence: This is urinary leakage due to weakened pelvic floor muscles and tissues. It generally occurs when pressure on your bladder increases — such as when you exercise, laugh, sneeze, or cough.
  • Urge incontinence: You have a sudden, intense urge to urinate followed by an involuntary loss of urine. You may need to urinate often, including throughout the night.
  • Bowel Incontinence: Bowel (or faecal) incontinence is the inability to control bowel movements. Severity can range from an occasional leakage of stool while passing gas, to a complete loss of bowel control. Some people have recurring or chronic faecal incontinence.

Mens Health

A healthy pelvic floor muscle(s) can prevent incontinence, erectile dysfunction/premature ejaculation, complex pelvic girdle pain, and lower the incidence of back pain. Amongst men who require a prostatectomy, it is also imperative to optimise the pelvic floor muscle before and after the surgery to prevent these unwanted leakage and/or incontinence.

PelviPower Treatment

Pelvipower_magnetic_field_training_EJPhysioThe PelviPower treatment chair is currently utilised globally, and receiving excellent feedback from expert pelvic floor clinicians in leading-research areas such as Ireland, Australia, and New Zealand.

Your clinician will conduct a thorough non-invasive examination with you, noting the subjective history, symptoms, and your particular goals/expectations from the treatment. You will then be asked to sit in the PelviPower chair so that your pelvic floor contractions can be assessed, and your clinician being provided with specific data about your contraction patterns. From there the clinician will be able to tailor an individualised treatment plan for your needs, which would typically involve 2-5 sessions per week of no more than 20 minutes in the chair per chair (depending on your situation). The entire process is conducted whilst fully-clothed, and is complete non-invasive.

My Conclusion

  • Convention/past diagnosis and treatment of pelvic floor issues can be inaccurate, lacing specific focus
  • Can be a daunting and embarrassing process for the patient
  • A lack of awareness and support
  • PelviPower is non-invasive, relatively easy to use
  • The treatment is measured and can be replicated
  • Noticeable improvement within a short space of time
  • Guided by a trained clinician throughout the entire process

Exciting News!

You will have the opportunity to try PelviPower for yourself as this service will be available at our Hemel Hempstead practice from December 2019.

For more information please visit our PelviPower page, visit the PelviPower website or contact us for more information and how to book.

kelvin

Kelvin
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Blog post by Kelvin
Senior Physiotherapist at Emma James Physio

 

Tendon Pain Treatment and Management

The best part about tendon rehab is you need to facilitate your load to optimal levels, so it doesn’t mean complete cessation of exercise! Tendon rehab is fundamentally based around loading the affected musculotendon unit, so strengthening exercises are key. Research shows best outcomes are associated with a long term (average 12 weeks), progressive and individualised loading programme. So as long as you put the hard graft into your rehab; you’ll go the extra mile!

There are other significant factors that will contribute to your management; such as foot and ankle biomechanics, BMI, psychosocial factors as well as other co-morbidities. As Kelvin stated in our previous blog post, each case of tendon pain is unique and is tailored to you as the individual.

So, what is the norm for Tendon Pain?

Due to the makeup of the tendon fibres and what their role is, it takes either a dramatic change in your load or a build up in load that exceeds your capacity over time to elicit a painful response. This may cause an inflammatory response for an acute change and/or structural change in a more chronic period of excessive loading. Either way, there will be an element of pain that is overriding in either your day-day activities or exercise-based activities.

So, What do we do?

You stop doing what hurts, dur? Well, with tendon pain it isn’t as straight forward, and that’s good news for you! Why? Because it doesn’t mean you have to completely stop all forms of activity. Our aim is to keep the healthy or injured part of the tendon active within our desirable limits and with suitable progressions in activity and exercise; our tolerance will improve over time!

So now we come onto the million-dollar question, what is the right amount of pain?

The criteria for tendon related acceptable pain is really straight forward, we take a subjective interpretation of your pain and provide scores of optimal, acceptable and undesirable intensities of pain. The presence and/or duration of symptoms after a reaction are also monitored and fall into the same categories. Remember, your pain is unique to you, as well as your exercise tolerance – this is all considered when your therapist constructs your rehabilitation programme.

adamSo don’t panic, tendon pain isn’t as debilitating as it seems. With patience and commitment, we will get you back to your goals, and back even stronger than before!

Adam

Blog post by Adam
Senior Physiotherapist at Emma James Physio

The upward surge in sports injuries around this time of the year

As the winter months slowly start to take over our skies, the balmy holidays in July and August already feel like a distant memory; what that also means for a lot of us is that we’re back in full swing with our gym routines, running trails, contact sport training and games – casual and professional athletes alike – and perhaps preparing for our next marathon/half-marathon.

Interestingly, we as Sports Physios tend to see an upward surge in sports injuries around this time of the year. And sometimes, as a figure of speech, we can even predict certain months being more “hip/knee/ankle injury dominant”, depending on whether there is a prominent sports events coming up e.g. London Marathon, or a finals series. In those months, we are bound to see and treat a few people with sore ankle tendons or painful knee tendons.

…but why is that?

Today I’m hoping to provide you with a little insight to how we as physios answer that question.

Tendons mostly are the thick, fibrous connective tissue that links a particular muscle to a bone, and is the main structure that converts a muscle contraction into an actual body movement. It is primarily made up of collagen tissue, and this tissue can be an incredibly robust, “workhorse” structure – being able to absorb impact, withstand multi-directional forces, convert muscle energy into movement, and generate power + velocity pertaining to our chosen sport.

However, tendons do have a major character flaw: they are very, very sensitive to change. Which means any drastic changes to one’s training routine – simply termed as Load in Sports Science – can have an irritating effect on the tendon structure, eventually leading to pain. Load, as we know, can be measured in a few ways:

  • Frequency: How often the training takes place e.g. How many runs per week?
  • Intensity: How hard the training session(s) is, e.g. How fast you’re running
  • Volume: How much the person is doing in a particular session, e.g. How far you’re running

When there is a sudden, drastic increase in load – or an “upward spike” – the collagen structure of the tendon is unable to cope with these changes, and can often begin an inflammatory process, leading to collagen/tendon breakdown, and in severe cases, loss of structural integrity. Broadly speaking, this is when the person begins to feel a persistent pain during and/or after the training, and the performance/output is no longer as well as before. Conversely, tendons also adapt to a decrease in load – or we refer to as “deloading” – whereby the collagen structure adapts to a lesser training load/regime, and in time is no longer at the capacity of its previous training intensity. So if we were to put two and two together: a deloading phase during our summer holidays/off-season followed by an upward spike around this time of the year…it’s not hard to see why some of us are getting aches and pains!

Luckily, most of the time these changes are not permanent, and tendons generally do respond well to treatment and rehabilitation. This is where the expertise of your physio comes in – we can determine the extent/severity of your presenting tendon injury, provide any immediate treatment that is necessary, but more importantly go through the details of your training routine and carefully making adjustments to it. This ensures that we are gradually rebuilding your tendon strength properly, as well as preventing it from further irritation and breakdown. Such is the nature of tendon injuries, there is no one-size-fits-all, and each case is treated in accordance to its specific needs.

All the physios at Emma James have had the privilege to work with (and currently so) athletes at various levels, and therefore are very experienced in dealing with tendon injuries.

kelvinShould you have any doubts about your training, be sure to contact us as we would love to help. Just imagine: us making your marathon training (actually) enjoyable!

Kelvin
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Blog post by Kelvin
Senior Physiotherapist at Emma James Physio

Growing Pains in young footballers

Growing pains (Traction Apophysitis) can occur in children following a period of rapid growth and/ or increase in sporting activity. During periods of rapid skeletal growth (think teenagers suddenly almost growing overnight) the cartilage within long bones of the body is weaker and becomes more susceptible to injury.

Growing pains most commonly affect tendon attachments at these sites: the heel (Sever’s disease), below the knee cap (Osgood-Schlatter’s) and at the base of the knee cap (Sindig-Larsen-Johansson). Often these children participate in football as well as other running and jumping sports.

Onset is usually gradual with pain over the areas mentioned above. Unfortunately, often growing pains mean the child ends up resting from their sport. However, rest alone often does not solve the issue, with pain returning when the child attempts to return to activity.  Bone often grows quicker than the muscle has time to stretch and adapt causing increased tension at the tendon attachment which can cause pain to develop. We cannot control this!

However, we can have some control over other contributing factors such as;

  • Training load- how frequently/ intense training is, is it varied and balanced with good emphasis on technique and rest?
  • Poor biomechanics
  • Poor capacity of muscles to deal with rapid skeletal growth

Obtaining an early diagnosis and appropriate management plan should reduce the impact on a child’s participation in sport.  An individualised rehabilitation program should be devised with the help of your physiotherapist to address the factors outlined above. A physio will also advise on which activities to temporarily limit and which to continue with and future training strategies.

lisa

Lisa
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Blog post by Lisa
Senior Physiotherapist
MSc MACP MHCPC MCSP 

Emma James Physio

Exercises you can do at your desk!

Following my post about the benefits of Pilates, heres some useful exercises you can do at your desk!

Note: With all sitting exercises you must be sitting up tall on your sit bones. Keep your core engaged (almost feel like you are pulling your belly button in towards your spine) and shoulders relaxed and down.

desk-exercises-1

Dumb waiter

Sit with your elbows bent at 90 degrees. Keep them tucked into your waist while you open out your forearms and keep your back straight. Keep pressing your shoulders down while you repeatedly open and close your forearms.

Spine twist

Hold your hands on the back of your head. Keep elbows out to the side. Hips facing forward. Inhale through the nose and as you exhale through the mouth twist though the mid-point in your back to one side. Inhale and on exhale come back to center repeat on the other side. Do as many as you want but make sure you keep an even count.

desk-exercises-2

Spine stretch forward

Sitting nice and tall, resting your hands on your lap. Breath in through your nose as you exhale tuck your chin to your chest and start rolling down through from the top of you back, only to half way down your back. Breath in and then on the exhale use your abdominals to pull your torso back up to sitting tall. Rolling through your spine bone by bone.

Lateral/side bend

Sitting up nice and tall, arms by your side as you breath out reach your right arm down one side of your chair with out leaning forward or backwards. Repeat on the other side.

desk-exercises-3

Hip opener/Hip flexors

Cross one leg over the other (ankle on the knee) and bend forward over your legs with a flat back.

Single Leg raises

Sitting nice and tall with feet flat on the floor, extend one leg at a time focusing on activating the quadricep muscles and then slowly lower down. Alternate each leg.

Why not try a Pilates Class?

We offer a wide range of Pilates and Yoga Classes at our Hemel Hempstead Clinic, with our experienced and qualified instructors.

pippaPippa
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Blog Post by Pippa
FCO Gym Manager & Personal Trainer
Emma James Physio

 

Pilates – gain a balanced body and mind

Pilates practice can help you gain a balanced body and mind. … A balanced body is one in which each part of the body works with one another to create and maintain a stable person. A balanced body is one that is mentally, emotionally, and physically stable.
The beauty of Pilates is that anyone, at any age can get started. Through the controlled and progressive movements, you can totally reshape your body.

Improved posture

By strengthening your core and improving your alignment of your spine.
Desk jobs encourage bad posture which can lead to kyphosis (rounding of the upper back) by working on muscular imbalances this can be reversed. Most Pilate moves help with scapula, shoulder and spine stability.

Improve flexibility

flexibilityWith longer hours of sitting we get tight hip flexors and generally stiff. Pilates encourages you to lengthen and expand your muscles.

Strengthen core

All Pilate moves require you to hold your core. Core muscles are not just your abdominals but the deep muscles running from the bottom of your head to your pelvis. They help support the trunk. Having a strong core will help support your back, which will help with pain and injury prevention.

Improve your balance

As you get older your balance becomes worse over time, this can then cause falls and injury. Pilates exercises require a more holistic approach and require activation and coordination of several muscle groups at the same time, which in turn improves your balance reducing the risk of falls.

Mental Health

pilates-classes

In Pilates you are told to regulate your breathing. Breathing is one of Joseph Pilates key principals. Pilates breathing directs your focus inward for the duration of the class, focusing on the present, feeling the muscles work and reconnecting with your body.

Exercising even if low impact helps produce endorphins in the body, which are also known as the happy hormones. It is natural drug to help boost your mood.

 

Pilates Classes

We offer a wide range of Pilates and Yoga Classes at our Hemel Hempstead Clinic, with our experienced and qualified instructors.

Look out for my next pilates post coming soon!
pippaPippa
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Blog Post by Pippa
FCO Gym Manager & Personal Trainer
Emma James Physio

 

Football injuries in kids

Playing football has many benefits, however, as with all sports there is some risk of injury. According to research (Faude et al, 2013) this risk tends to increase with age throughout the age groups.

Research suggests Between 60 and 90 % of all football injuries were traumatic and about 10-40 % were overuse injuries. Most injuries (60-90 %) were located in the lower extremities with the ankle, knee and thigh being most affected.

The most common injury types were strains, sprains, and contusions (bruises).

The injuries we see the most in clinic among young footballers include:

  • Ankle sprains
  • Hamstring strains
  • Groin strains
  • Knee injuries (from bruises to cartilage and ligament injuries)
  • Quadricep (thigh) bruises and strains
  • ‘Growing pains’

Research suggests about half of all football incurred injuries led to an absence from sport of less than 1 week, one third resulted in an absence between 1 and 4 weeks, and 10 to 15 % of all injuries were severe (including, at the extreme, an anterior cruciate ligament tear which can lead to over 9 months out of football).

football-injuriesIt is important to see an experienced and Chartered Sports Physio as soon as possible after an injury to ensure:

  1. Correct diagnosis, treatment and management
  2. That the injury correctly repairs and does not return when the child resumes playing football and/ or give long term issues

 

Treatment for most acute injuries sustained during playing football includes:

  • PRICE – protect, rest, ice, compression, elevation
  • Rehabilitation – range of movement exercises and strengthening
  • Advice on gradual return to play
  • Analysis of training amount and type, addition of regular strength training if needed, modifying training amount to ensure full recovery and limit risk of future issues.

The timing and exact nature of these interventions depends on the injury sustained and the individual player and, as such, we would recommend you always consult a Sports Physio.

Treatment of overuse injuries (often referred to as ‘growing pains’) is similar but may also include more analysis of the child’s biomechanics, strength and training routine to try to identify why the issue has occurred and what can be done to resolve things and get the child back to playing football.

More Information:

lisa

Lisa
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Blog post by Lisa
Senior Physiotherapist
MSc MACP MHCPC MCSP 

Emma James Physio

Physiotherapy & Cancer Treatment

Changes in the delivery of cancer care to include physiotherapy:

  • 2 million people in the UK are living with or after cancer
  • 60% have unmet physical or psychological needs following treatment
  • 1.6 million cancer survivors are not active at levels recommended by the UK’s Chief Medical Officer

A key message in guidance recently published by the Royal College of Anaesthetists, Macmillan Cancer Support and the National Institute for Health Research Cancer & Nutrition collaboration was that providing people with a cancer prehabilitation programme (an exercise programme delivered before treatment) improved their outcomes, raised their quality of life and reduced the risk of the disease progressing.

Evidence shows that exercise reduces the risk of cancer recurrence and mortality. Mortality can be reduced by 50 per cent, 40 per cent and 30 per cent in bowel, breast and prostate cancer respectively. In addition to this, disease progression was reduced by 57 per cent in men with prostate cancer who engaged in three hours a week of moderate intensity exercise.

Exercise can improve quality of life for cancer patients, regardless of the type and stage of their disease. Inclusion of physio-led exercise within cancer pathways can reduce and prevent disability and also alleviate distressing symptoms such as lymphoedema and fatigue, which debilitates 75-95 per cent of all cancer patients.

Excessive weight gain and loss and reduced bone density due to treatment can be a problem for many patients. Specialist physios can advise patients on how to maintain a healthy weight, prevent muscle-wasting and limit bone density loss. Specialist Physio can also alleviate distressing symptoms such as lymphoedema and fatigue, which debilitates 75-95 per cent of all cancer patients.

Many patients with cancer present with Pain. Pain can lead to a vicious cycle of fear, inactivity and further disability as a consequence. Physios are experts in helping patients manage pain.

It is recommended that every person with cancer receives a personalised rehabilitation care plan, which they co-develop with a multidisciplinary team which should include a physio.

For more information please see:

Cancer Rehabilitation at Emma James Physio

pinc-ejphysio

We offer Cancer rehabilitation treatment and management of a cancer diagnosis and throughout the cancer journey. Practioners of the PINC Cancer Rehab Physiotherapists Program. More information can be found on our Website – Cancer Rehabilitation.

 

lisa

Lisa
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Blog post by Lisa
Senior Physiotherapist
MSc MACP MHCPC MCSP 

Emma James Physio

Sports Massage – Not just for Athletes!

Sports massage is regularly advertised as a treatment modality for only highly skilled athletic performers. The fact is, sports massage can be beneficial to ANYONE regardless of sporting ability or exercise participation.

What is Sports Massage?

Sports massage refers to a range of massage techniques that are applied in a rhythmic, deep and manipulative fashion. Yes, sports massage can be used to prepare athletes prior to an event or to reduce the effects of delayed onset of muscle soreness (DOMS) following an event. BUT sports massage can also be used on a weekly basis to maintain muscular health, reduce pain and muscular tension and improve flexibility and range of movement.

Is massage right for me?

office-workersIf you are an office worker and suffer from regular tension type headaches or pain in your neck, shoulders or back, then sports massage can benefit you just as much as an athlete. Sitting at an office desk for 8+ hours can place great strain on your muscles, similar to the strain experienced by an athlete when training for an hour. During such circumstances, a gradual build up in muscular tension occurs which includes an increase in the presence of scar tissue and active trigger points.

The science behind a massage…

Massage generates heat, allowing tissues to become more pliable. As a result, there is an increase in circulation, improving the exchange of fluids to tissues. Different massage techniques stretch muscles transversely as well as lengthways, which allows scar tissue, adhesions and fascia surrounding muscles to loosen or break down – this can both help in muscle repair as well as releasing muscle tension. Massage can also be beneficial as a natural remedy to pain by reducing nerve compression.

What are the benefits?

  • pain-free

    Reduced pain

  • Relieved muscular tension
  • Increased flexibility
  • Increased range of movement
  • Reduced stress
  • Improved posture
  • Reduced tension type headaches
  • Relaxation
  • Soothe mental anxieties and depression
  • Improve your sleep
  • Relieve headaches
  • Improve sporting performance

50% off!

We are offering 50% off Sports Massage and Initial Assessments throughout September & October 2019 at our Hemel Hempstead Clinic, so book today! Come along to our lovely Hemel Hemstead practice to see how we can help. Don’t forget… Sports Massage is not just for Athletes!

india-waylandBye for now 😉
India
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Blog Post by India
Sports Therapist at Emma James Physio

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