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.

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
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Blog post by Lisa
Senior Physiotherapist
MSc MACP MHCPC MCSP 
Emma James Physio

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?

Moderate 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.

Most 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?

To 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

• Physiotherapy
• Personal Training
• Pilates
• Exercise classes

Stay Healthy
Lisa

Blog post by Lisa
Senior Physiotherapist
MSc MACP MHCPC MCSP 
Emma James Physio

Types of Muscle Contraction

There are two types of muscle contraction; these are Isometric and Isotonic Contractions.
A muscle will contract upon stimulation, in an attempt to bring its attachments closer together, but this does not necessarily result in the muscle shortening. If the contraction of muscle results in the muscle creating movement of some sort, the contraction is called isotonic. If no movement results in contraction then this is called isometric.

Isometric Contraction:

An Isometric contraction occurs when a muscle increases its tension, but the length of the muscle is not changed at all. For example if you were to hold a heavy weight in the hand with the elbow held stationary and bent at 90 degrees. You will find that some of our postural muscles are consistently working in an isometric contraction, such as our calf’s which stop us from falling forwards at the ankle.

Isotonic Contraction:

It is the isotonic contractions of muscle that enable us to move about. There are two types of this contraction.

Concentric Contraction:

In concentric contractions, the muscle attachments move closer together, causing movement at the joint which causes the muscle to shorten. A good example of this is when you’re holding an object in your hand, if the biceps muscle contracts concentrically (shortening), the elbow joint will flex and the hand will move towards the shoulder.

Eccentric Contraction:

An eccentric muscle contraction is a type of muscle activation that increases tension on a muscle as it lengthens. Eccentric contractions typically occur when a muscle opposes a stronger force which causes the muscle to lengthen as it contracts. Examples of this are actions such as going down stairs, running downhill, lowering weights and the downward motion of squats, push ups or pull ups. Eccentric contractions are common to many sports in which you need controlled or resisted types of movements.

Eccentric contractions are associated with the delayed onset muscle soreness (DOMS). Eccentric muscle contractions also appear to be associated with greater muscle strengthening than when using concentric contractions.

 

How we can help

Physiotherapists have a vast medical and anatomical knowledge of massage and other manual techniques and these can be used to restore muscle length, reduce friction between structures and relieve pain and muscle spasm.  All of this allows normal function to be restored in the maximum time. To see how we can help, click the links below for further information and to book your place.

• Manual Therapy & Massage
• Sports Massage

 

Post by Emma James – April 2016

A look at sports injuries – Cycling – Iliotibial Band Syndrome (ITBS)

The most common cause of lateral knee pain is ITBS (Iliotibial Band Syndrome).

The Iliotibial Band (ITB) is a thick band of tissue on the outside of the thigh. The ITB begins at the upper hip extending down the outside of the thigh connecting with the tibia (shin bone) at just below the knee. It is crucial in stabilizing the knee during excess activities and is common in runners and cyclists in the age group of 15-50.

The ITB is aggravated and irritated through excess repeated motion causing pain and inflammation. Bony anatomical prominences located on the outside of the thigh rub against this band causing friction. Often a clicking sound can result from the tight band moving over the surfaces. ITBS is aggravated during activities such as running up hills or on slanted surfaces.

Pain is typically described as on the outside of the knee or hip, exacerbated by motion and relieved during rest. ITBS can be relatively easy to treat following correct examination, such as with stretching, strengthening, reduced strenuous activity and ice.

 

Five top ways to promote quicker healing (including services at Champneys)

By creating an optimal psychological, nutritional and physiological environment, the body is able to focus purely on the job in hand – healing the particular injury/ailment.

The services provided through the Regenerate programme at Champneys Tring in Hertfordshire can help to create this ideal environment in the following ways:

• Decrease emotional stress and distractions and ensure you are having the correct amount of rest and sleep
• Decrease environmental stress
• Ensure best and optimal circulation (acupuncture, kriotherapy)
• Optimal and appropriate nutrition (nutritionist)
• Exercising within the pain-free range and at an appropriate level for maximising healing potential (hydrotherapy, physiotherapy)

Regenerate is the UK’s leading residential medical centre based within the world class Champneys Tring Health Resort in Hertfordshire. Offering a bespoke professional service for injury rehabilitation, Regenerate provides the ultimate medical expertise and treatments required to recover physically, mentally and emotionally from all aspects of injury. Clients also benefit from using Champneys many services, as well as their luxury spa facilities and treatments.

Regenerate provides the highest standards and employs leading professionals in the medical fields under the Directorate of Champneys Medical Director, Dr Michael Curtin MB ChB Dip Med Ac. MF HOM. Regenerates multidisciplinary team includes: Doctor, Acupuncturists, Physiotherapists, Exercise Physiologists, Movement Therapists, Nutritionists, Personal Trainers, and Motivational and Mental Skills Coaches. They will conduct comprehensive examinations and diagnostic testing, and provide appropriate treatment which may include physiotherapy, acupuncture, clinical pilates, kriotherapy, nutritional therapy, exercise and rehabilitation programmes, sports massage, vibrogym therapy and altitude training, amongst others.

More Information

• How to book your place
• Sports Injuries
• Sports Massage
• Sports Specific Rehabilitation

Blog Post by Emma James March 2016

A look at sports injuries – Basketball (Jumpers Knee)

Patella tendinopathy or ‘jumpers knee’ is one of the more common tendinopathies affecting skeletally mature athletes, occurring in as many as 20% of jumping athletes. Jumper’s knee is believed to be caused by repetitive stress placed on the patella tendon during jumping, and therefore is specific to athletes participating in jumping sports such as basketball.

 

Description of condition in laymans terms

The patella tendon is a structure that attaches the quadriceps muscle group to the tibia (shin bone) via the patella. This tendon comes under a large amount of stress with repeated jumping movements. With repeated strain, micro-tears as well as collagen degeneration may occur in the tendon, causing pain and dysfunction. The main symptoms of ‘jumpers knee’ are: pain at the bottom and front of the kneecap, especially on palpation; aching and stiffness after exertion; pain when you contract the quadriceps muscle; and the affected tendon may appear thickened in comparison to the unaffected side. The key to fully recovering from Patellar Tendinopathy is in trying to elicit a healing response without overloading the tendon.

 

Five top ways to promote quicker healing (including services at Champneys)

By creating an optimal psychological, nutritional and physiological environment, the body is able to focus purely on the job in hand – healing the particular injury/ailment.

The services provided through the Regenerate programme at Champneys Tring in Hertfordshire can help to create this ideal environment in the following ways:

• Decrease emotional stress and distractions and ensure you are having the correct amount of rest and sleep
• Decrease environmental stress
• Ensure best and optimal circulation (acupuncture, kriotherapy)
• Optimal and appropriate nutrition (nutritionist)
• Exercising within the pain-free range and at an appropriate level for maximising healing potential (hydrotherapy, physiotherapy)

Regenerate is the UK’s leading residential medical centre based within the world class Champneys Tring Health Resort in Hertfordshire. Offering a bespoke professional service for injury rehabilitation, Regenerate provides the ultimate medical expertise and treatments required to recover physically, mentally and emotionally from all aspects of injury. Clients also benefit from using Champneys many services, as well as their luxury spa facilities and treatments.

Regenerate provides the highest standards and employs leading professionals in the medical fields under the Directorate of Champneys Medical Director, Dr Michael Curtin MB ChB Dip Med Ac. MF HOM. Regenerates multidisciplinary team includes: Doctor, Acupuncturists, Physiotherapists, Exercise Physiologists, Movement Therapists, Nutritionists, Personal Trainers, and Motivational and Mental Skills Coaches. They will conduct comprehensive examinations and diagnostic testing, and provide appropriate treatment which may include physiotherapy, acupuncture, clinical pilates, kriotherapy, nutritional therapy, exercise and rehabilitation programmes, sports massage, vibrogym therapy and altitude training, amongst others.

More Information

• How to book your place
• Sports Injuries

Blog Post by Emma James Feb 2016

Back Pain

Back Pain

Back pain is a very common musculoskeletal complaint affecting 80% of adults at some point in their lifetime, although the symptoms and severity will vary greatly. Many factors may contribute to your condition including injury and diseases, but for some cases there is no specific cause and clinicians refer to this type of pain as ‘non-specific’ or ‘mechanical low back pain’.
There are some signs and symptoms that must not be ignored. You should always seek urgent medical advice if you have back pain and:

• A loss of control of your bladder or bowel
• Numbness around your genitals, buttocks or surrounding area
• Chest pain
• Unexplained weight loss

 

How can I lower my risk of developing back pain?

• Carrying extra weight, especially around your belly, puts added stress on the muscles in the lower back and can affect your posture and position of your pelvis; in turn leading to lower back pain
• Weak muscles and abdominals are unable to support your posture and trunk when you move, which can lead to overloading the small muscles in the back which are not designed to do this job and lead to injury
• Your occupation could also affect your back. Those with manual jobs are at risk due to heavy lifting and repetitive bending, whilst those with sedentary jobs are at risk due to the amount of time they sit, particularly if they tend to slouch

 

How can I treat my back pain?

Try to keep mobile. It may be tempting to remain on bed rest until the pain subsides however evidence suggests that remaining mobile may actually help reduce the intensity and duration of your back pain as well as prevent it from returning. Start off with low impact exercise first such as walking or swimming

Take pain relief. People often worry that taking painkillers will make the symptoms worse by masking the pain, however by taking painkillers while you are in pain it will allow usually you to continue with your daily routine which in turn will often speed up your recovery

Try physiotherapy. A physiotherapist can help identify the root cause of your back pain and use a variety of techniques including massage, acupuncture and home exercises to reduce your pain and prevent it recurring

Pilates. There is lots of evidence to support the idea that a weakened core puts pressure on the little muscles and supporting structures in the lower back. Therefore by strengthening the muscles which support our trunk and core, it will minimise your risk of developing back pain as well as help to ease the pain if you are already suffering.

 

What is Pilates?
Pilates is a low impact form of exercise aimed at strengthening the whole body, especially the core. Whether a beginner or an elite athlete and regardless of age and gender, Pilates could be beneficial for you. Practioners argue there is a wide array of benefits to practicing Pilates including improving muscles strength, balance, joint mobility and even stress relief.
Here at Emma James Physio, we offer a range of different classes including Clinical Pilates which are led by highly qualified instructors. View our Pilates timetable here >>>

Where can I go for help?

If you have back pain and would like to see how we can help, please call us 01442 870686 or visit our website www.ejphysio.co.uk

The Winter Ski and Snowboard season is here!

With the snow season here and mountain holidays approaching we want to ensure you enjoy your time on the slopes with some top tips and information.

Skiing and snowboarding are physically demanding, and so undertaking a variety of appropriate exercises in advance will enhance your performance on the slopes and allow your snow sports holiday to be more fun, efficient and safe.

STRETCHING

• Key to activate your muscles before use
• Lengthen, help them recover and increase flexibility post snow slope

MUSCLES

• Calves, quads, back and hip flexors

CARDIO

• Interval training improves your sustained and shorter high energy activities
• Cycling/Running/X-trainer

STRENGTH

Compound movements targeting multi-joints and then practiced plyometrically to increase power.

Quads:

• Power muscles for the snow, hold you position and protect your knee during movements
• Squats and lunges help react to changes in extension, are good for thick snow and changing terrains
• Split squats and single leg dips help single leg strengthening ensures no weakness

Gluts:

• Usually underactive due to over reliance on quads
• Clams, step-ups, squat with theraband around your thighs
• Sideway jumps replicate fast movements on steep, narrow slopes

Calves/Hamstrings:

• Maintain your position of bent knees and promote stability along with your hamstrings
• Calf raises, hamstring curls

BALANCE AND CORE STABILITY

• Essential for posture on the slope and un-easy terrain
• Russian twists, Swiss ball crunch

PROPRIOCEPTION

• Important for being aware of your body in poor conditions and in preventing injury
• Single leg balance with your eyes closed and adding in movements

 

COMMON SKI INJURIES:

Usually lower extremity injuries and knee ligament damage 

Causes

• Twisting movements of the upper leg, while the lower leg rotates the opposite way
• Valgus forces from direction changes during falls

Upper extremity injuries to the thumb

Causes

• Ski pole being caught in snow in un-easy terrain or during a fall

COMMON SNOWBOARD INJURIES:

Usually upper-extremity injuries causing wrist fractures/sprains, elbow dislocations/contusion.  Or broken collar bones and rotator cuff injuries.

Causes

• Landing on outstretched hands with force after a fall
• Direct impact to the clavicle or shoulder

Lower extremity injuries to the knee ligaments and ankle

Causes

• Valgus forces associated with one footed chair dismounts and falls
• Compressive forces landing a jump/fall

STRATEGIES TO PREVENT INJURIES

1. Have good fitness, muscle strength and flexibility
2. Have good quality, well fitted equipment
3. Seek advice for biomechanical deformities
4. Complete a warm up and cool down
5. Adhere to ski slope rules, safety rules, stay on marked trails and ski with partners
6. Book lessons to improve you standard, knowledge and technique with a qualified instructor
7. Snowboard to your own ability and on appropriate terrain for your level
8. Ensure good conditions e.g. visibility, terrain, weather, snow quality
9. Invest in safety gear e.g. wrist/elbow guards/knee pads/impact shorts/helmet

PHYSIOTHERAPY

1. Helps with injury, illness or disability.
2. Physio also assesses the body as a whole using a variety of techniques including: personal training, sports massage, acupuncture, gait scanning and pilates.
3. These improve health, aid relaxation, prevent injury, provide education, encourage health promotion, improve biomechanical deficits and provides expert knowledge and exercises for specific sports; perfect to enhance your time on the slopes.

If you’re interested, ring us and book an appointment to find out more or visit our website for details.