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Fibromyalgia, managing the pain

Fibromyalgia International Awareness Day 2020

Chronic pain is more common than most people realise. It affects between 20 – 50% of people in the UK although most are able to carry on with daily activities.

Fibromyalgia is a rheumatic syndrome characterised by chronic widespread pain, often associated with fatigue, unrefreshed sleep and cognitive problems.

fibromyalgia-symptoms

Effective management of fibromyalgia requires a multi factorial and proactive approach to help settle pain down and allow the patient to take responsibility for self-care. There are several physiotherapy modalities which can be utilised to assist this.

Activity and exercise is helpful for chronic pain conditions but the exact type is not so important. What is important is that the exercise you do is something you enjoy, and that you are able to do regularly. If you are not sure where to start, a Physiotherapist can assess you and create an appropriate exercise programme for you to follow. It is important to get the intensity of exercise correct to avoid flaring up pain symptoms.

Flare-ups in pain are normal in conditions like Fibromyalgia. The usual symptoms you experience may change from day to day and there will be times when they increase. It is helpful to plan for these periods of flare-up so that you can manage through them and keep doing the things that are important to you. This maybe where some additional physiotherapy input maybe helpful to reduce pain (soft tissue massage, advice on exercises, acupuncture, floatation therapy) to get you back on track with your regular exercise regimes.

A 57 year old patient with Fibromyalgia says “I would encourage anyone who doesn’t do much activity to choose something they enjoy, to start slow and build up. Sometimes you feel tired and it’s the last thing you want do but the important thing is to stick with it, and you do see the benefits over time.”

At Emma James Physiotherapy we have expert Physiotherapists who are able to assess and treat Fibromyalgia and other chronic pain conditions, and help patients effectively manage their symptoms.

lisa

Lisa
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Blog post by Lisa
Senior Physiotherapist
MSc MACP MHCPC MCSP 

Emma James Physio

Radio presenter Rachel Horne on her journey to dry running with the help of physio Emma James.

Rachel Horne, newsreader and Chris Evan’s co-presenter on Virgin Radio UK. 

“My friend Jools recommended I visit Emma James Physio, a specialist pelvic floor physiotherapist at her clinic at Champneys, Tring after I announced I was going to do The London Marathon. (Rachel was cajoled live on the Virgin Radio breakfast show by Vassos, Chris and the team back in November 2019!).

I’d never attempted a long run without desperately needing the loo.

“As soon as I’d said yes to the marathon, I panicked that my weak pelvic floor wasn’t up to it and was going to stop me from running the 26 miles. I’d done the odd bit of cross country before at school and outdoor fitness boot camps but never attempted such a distance or gone for a long run without desperately needing the loo!

rachel

“In fact, I used to dread it in summer when I did the Boot Camps and would always wear an incontinence pad, tie my hoodie around my waist and take a towel to sit on in the car on the way home in case the inevitable happened.

“I had three children in just over three years; carrying them put extra pressure on my pelvic floor and then I had complicated births giving me second and third-degree tears which weakened my pelvic floor further and the reason I leak when I run. 

“I hadn’t got round to doing anything about it mainly because as one of many 30 and 40-something women who are always busy looking after other people, fixing ourselves goes right down the list of priorities.

It’s almost a badge of honour for women to say they leak.

“I think I’d also just fallen into the trap of just accepting bladder leakage was normal. It’s almost a badge of honour for women to say they leak whether that’s when they run, get on a trampoline with the kids, or sneeze. Everyone laughs about it. You see it on TV adverts where women laugh about having the condition and it’s so normalised that women think they should say nothing and just use an incontinence pad whenever we leave the house.

Emma is a force for good.

“Emma is a force for good. My first visit to her was almost like a therapy session. She took the time to ask me about myself and encouraged me to tell her my story, giving me a safe space to open up. When she said she could fix my bladder leakage I felt like a weight had been lifted off my shoulders. She was wonderful.

“She helped me to realise it’s NOT OK to leak and made me see that unless I took steps to strengthen my pelvic floor, my leakage would just get worse, particularly as I approached the perimenopause and menopause.

“Because of the challenge I was facing, training for the marathon in a little over five months, Emma suggested a multi-pronged attack although I was relieved to hear I didn’t need to have an internal exam, which I know puts many women off sorting out their bladder problems, as I don’t have a prolapse.

“Through Emma’s clinic, I’ve used a combination of pelvic floor strengthening exercises, tried pelvic floor trainer Pelviva, had sessions on the PelviPower chair, and used Secret Whispers and my bladder leakage has dramatically reduced.

Leaking has definitely improved my general wellbeing.

“After just six weeks of support, I was dry after the first mile which was never the case before as I always leaked just after I started to run. Recently, I managed 5km (3.5 miles) over hilly terrain and was completely dry at the end of the run which felt like such a massive, massive achievement. Leaking less has definitely improved my general wellbeing too as I feel more like myself again. I now no longer need to wear a pad EVERY SINGLE DAY and only keep one on for exercise in the unlikely case I might leak. 

I no longer need to wear a pad every day.

“Now due to the Coronavirus, The London Marathon is rightly postponed but I do hope to run it later in the year. Once I’ve done that, I don’t think I’ll ever do another marathon ever again! However, I’m planning to continue running between 5 and 10km on a regular basis to get that time to think, feel energised, enjoy the fresh air, and release those endorphins and will be able to do so without always leaking which is just amazing!”

rachelhair

 

 

Featured post

Why we should Exercise

Adults should do some type of physical activity every day. Any type of activity is good for you. The more you do the better. The following advice is from NHS England.

Adults should:

  • aim to be physically active every day. Any activity is better than none, and more is better still
  • do strengthening activities that work all the major muscles (legs, hips, back, abdomen, chest, shoulders and arms) on at least 2 days a week
  • do at least 150 minutes of moderate intensity activity a week or 75 minutes of vigorous intensity activity a week
  • reduce time spent sitting or lying down and break up long periods of not moving with some activity

What counts as moderate aerobic activity?

exercisingModerate activity will raise your heart rate, and make you breathe faster and feel warmer. One way to tell if you’re working at a moderate intensity level is if you can still talk, but not sing. Examples of moderate intensity activities include brisk walking, water aerobics, riding a bike, dancing, doubles tennis, pushing a lawn mower, hiking.

What counts as vigorous activity?

Vigorous intensity activity makes you breathe hard and fast. If you’re working at this level, you will not be able to say more than a few words without pausing for breath. In general, 75 minutes of vigorous intensity activity can give similar health benefits to 150 minutes of moderate intensity activity.

riding-a-bikeMost moderate activities can become vigorous if you increase your effort.

Examples of vigorous activities include jogging or running, swimming fast, riding a bike fast or on hills, sports, skipping, aerobics, martial arts.

 

What activities strengthen muscles?

muscle-trainingTo get health benefits from strength exercises, you should do them to the point where you need a short rest before repeating the activity. It is best to get a chartered physiotherapist or qualified personal trainer to advice you on this.

There are many ways you can strengthen your muscles, whether you’re at home or in a gym and this includes lifting weights, using resistance bands and body weight exercises (such as press ups).

Always gain advice from a qualified professional before starting a new exercise programme or if there is a change in your health status.

How we can help

lisa
Stay Healthy
Lisa

Blog post by Lisa
Senior Physiotherapist
MSc MACP MHCPC MCSP 

Emma James Physio

Pilates for Men

It is 2020, and we know people now realise that Pilates isn’t just for women. You can almost hear the collective sigh of relief from us physios – partly because we can finally (almost) move on from the long-overplayed “so you think Pilates is a girls’ thing? well then let me tell you about Joseph Pilates…” rhetoric, but mainly because we are finally seeing the benefits of Pilates being recognised by the wider public and how it is becoming increasingly common across different demographics.

While Pilates is hardly a gender-specific/focused exercise routine, it is worthwhile mentioning how its application can benefit men nonetheless. From the amateur weekend warrior to professional athletes, principles of Pilates have been firmly incorporated in their weekly schedules, training, and recovery sessions; here are some of the reasons why.

kelvin-on-reformerFlexibility

Reformer Pilates involves various three dimensional movements, working the length and elasticity of your muscles and encourages your joints to be able to move through the biggest possible range, thus reducing your likeliness of injury.

Improving Posture

The origin of most aches and pains is bad posture. Every Pilates exercise you do will have a postural benefit due to the combination of challenging your strength and flexibility. Pilates will develop muscular balance in your joints which will improve your posture.

Core Strength

Your core is the combination of muscles that support your spine and torso, forming the foundation for all movements. A weak core causes instability and reliance on dominant muscles, which over time inhibits flexibility, reduce range of movement and ultimately cause injury. Pilates promotes core activation and engages all of your postural muscles leading to more stable and powerful movements. Consider a tennis player who has to return a powerful serve while moving and contorting their bodies: for them to be able to generate the adequate force on their return they must have good core strength.

Addressing Muscular Imbalances

Some of your muscles, like those that dominate your daily movements, are stronger than others, and a huge emphasis of Pilates is focusing on those muscles that don’t typically get a lot of attention. Pilates requires you to consciously move in certain ways to challenge muscles that you don’t hit while lifting heavy weights in the gym, running or in your daily life.

Awareness, Concentration and Focus

mens-health-pilatesPilates forces you to pay attention to your body, you’ve got to focus on your breath while working through each movement and concentrating on proper form and activating the correct muscles. This significantly enhances your body control and awareness (Thus improving your balance as well) which are both fundamental skills to maintaining sporting performance.

The reason that Pilates is fundamentally such an all-encompassing, well-rounded approach to exercise and body movement is precisely the reason why it could – and should – be incorporated in most people’s routine. Its minimal requirement of equipment and space makes it a very versatile option for a quick, mobile workout, and the gains from Pilates almost always translate across to other aspects of one’s wellbeing as well. More and more men are slowly realising its benefit and the conversations with their physios are certainly a lot different to what it was a few years ago.

It is 2020. It is no longer a misunderstanding, and it is no longer just a trend.

kelvinKelvin

Blog post by Kelvin
Senior Physiotherapist at Emma James Physio

More Information:

Top 10 lower back pain Myths!

Lower back pain and the unhelpful beliefs that could negatively impact your behaviours

 

Most of us will have inevitably suffered from some form of lower back pain in our lives, to varying degrees of severity and volumes; but it’s almost certain to have affected us somewhere along the way! That opening statement in its itself is a perfect example of how beliefs and experiences around back pain can negatively impact our behaviours, fortunately I am going to now expand on it and point you in the direction of some fantastic editorial research that has recently been published for the benefit of the general public.

back-painLower back pain (LBP) is the leading cause of disability worldwide, but the way we as health care professionals and you as patients understand the pathology may differ. In an ever-progressing world of research; there are even gaps of knowledge within sub-groups of practitioners that negatively impact the way LBP is perceived and treated. We hear about it through all media channels and we have an understanding of the ways pain management is prescribed and how we are instructed as patients to manage LBP. Common beliefs and understanding on these factors can influence the way individuals perceive and understand LBP and ultimately the affect it can have on the way you live your life.

In this blog I will review the aforementioned article and address the fact’s from my own point of view and experience;

Ten unhelpful LBP beliefs;

Unhelpful LBP beliefs are common, culturally endorsed and not supported by evidence.

Myth 1:  LBP is usually a serious medical condition

You can feel debilitated or in an amount of pain that indicates a serious pathology; but the facts are the vast majority of LBP cases are not life-threatening pathologies that cause permanent disability.

Myth 2: LBP will become persistent and deteriorate in later life

There is no strong research to support an association with age and deterioration in LBP; age is not a risk factor – we are all subject to the same level of risk; of which there are very well supported methods of managing LBP.

Myth 3: Persistent LBP is always related to tissue damage

Having a reoccurrence of the same type of LBP doesn’t mean the same structures are being damaged to an increasing degree each time – it may feel that way because the pain can get worse but the soft tissue structure that are involved in LBP will heal within a normal time frame. There are a multitude or internal and external factors that relate to pain replication which can be managed and overcome.

Myth 4: Scans are always needed to detect the cause of LBP.

Scans are unlikely to tell us anything different to what we already know. There can be the same scan presentation in a person with and without LBP; again, it’s the multi-faceted level of factors contributing to our pain which are more important than scan results.

Myth 5: Pain related to exercise and movement is always a warning that harm is being done to the spine and a signal to stop or modify activity

There are really clear and accurate ways to monitor painful responses during exercise; most of the time – pain is acceptable during exercise/rehab and is more likely to be beneficial than harmful. Increasing your exposure to painful movement/tasks is one of the more effective way to reduce your sensitivity to these painful triggers.

sitting-at-desk-pain

Myth 6: LBP is caused by poor posture when sitting, standing and lifting

A really common one; posture does not cause pain, plain and simple. Stress, anxiety, sleep deprivation, periods of persistent working/inactivity are more likely to be the cause of posture related pain rather than the position its self. Get up, move, meditate, talk to your peers and share experiences; it will make a difference.

Myth 7: LBP is caused by weak ‘core’ muscles and and having a strong core protects against future LBP

Our ‘core muscles’ control spinal movement; so, it makes sense that weakness increases our injury risk, right? Wrong. Varying the degree and quality of movement in our lower back; along with the able to transfer weight through our trunk gives us more dynamic movements; but weak muscles do not cause pain.

heavy-lifting

Myth 8: Repeated spinal loading results in ‘wear and tear’ and tissue damage

Heavy lifting and forward bending do not wear out the spinal discs, it actually lubricates them and some studies have found evidence to support increasing strength of discs with increased loads, just make sure these movements are familiar and build them up.

Myth 9: Pain flare-ups are a sign of tissue damage and require rest

Similar to Myth 5; there are a number of factors that can cause pain replication, sensitivity related to previous movements, tasks, scenarios and intrinsic factors are most likely to be the causes of pain; and your practitioner should talk you through understanding this and how to manage it before you refer back for re-assessment (if needed at all).

Myth 10: Treatments such as strong medications, injections and surgery are effective, and necessary, to treat LBP

These interventions are invasion, have varying success rates, complication risks and secondary symptoms; the long-term benefits are not guaranteed. Of course, there are pathologies and examples where these treatments are more likely to be necessary; but for the majority of LBP patients; they just aren’t needed.

 

adamSo that’s it, also check out this useful infographic about Back Facts
Keep your eyes peeled for more on this subject!
Adam 😊

Blog post by Adam
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

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

 

Benefits of working with a Personal Trainer

There are many reasons why having a Personal Trainer (PT) can benefit you, people of all ages and abilities. See better results by living a happier more active lifestyle.

A Personal Trainer will help build a unique training plan for each individual, which can easily be adapted and adjusted. Exercises can be regressed or progressed depending on the level of fitness, injury, results driven, time and if having an ‘off day’.

Top 5 Benefits

1. Faster and Better results

person-training-1Having a Personal Trainer will make sure you stick to your programme and push you to your limits during a workout session. Often when you work out solo you can become distracted and don’t push yourself as much. Time is always an excuse as not to work out but having a PT can adjust programs so they are just as affective no matter what the length of time you have available.
By pushing your boundaries, you will see faster results, this could be weight loss, toning up, cardio/fitness level or strength.

2. Fat loss and Muscle Gain
This is not everyone’s main goal but for 80% off people hitting the gym it is. Having a Personal Trainer, they know the right exercise each individual should be doing to achieve their goals. A mixture of weight training to gain muscles and become stronger and cardio to get fitter and leaner

3. Reduce chance of injury
A Personal Trainer will teach proper form and technique, which will prevent injury. Injuries can easily occur from not warming up properly or doing exercises incorrectly.

4. Establish a lifestyle habit and routine
A Personal Trainer can help motivate and encourage to create new habits. Once a routine is established it is easier to stick to, making it part of your lifestyle will make it easier to achieve results. Exercise and diet are all about consistency if you want to see those results.

5. They fit into your schedule
We all have busy lives and lots going on the beauty of a Personal Trainer is that they will adapt their time to fit in with you. So if you need an early morning or late evening workout a PT will be there.

person-training-outside6. Flexibility on Location
Many do not like working out in a gym as it can be crowded and over whelming. A Personal Trainer can change the location of any workout from either the gym, a home work out or even outside.

7. They can help with specific goals – an Event
As well helping set realistic goals a Personal Trainer can help set a training plan and train for specific event whether this be a run, triathlon, swim or a sporting event etc. With events you need to reach a certain level of fitness to be able to compete and stay injury free.

8. Mentor / Mental Health
Exercise realises endorphins which are ‘happy hormones’ they can help make you feel good physically and mentally. A Personal Trainer can help motivate you when you are suffering from mental health issues, they can help keep you on course to release the greatest number of endorphins. This in turn helps with a person’s overall wellbeing. A PT cares about how stressed you are, they will listen to you, they want to give you the best results which can be impacted on how you are feeling.

If this sounds interesting and you need that extra push why not call or email Emma James Physio to find out more….
reception@ejphysio.co.uk
01442 870686pippa

Pippa
x

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

 

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