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25/Jun/2019

Vertigo or Benign Paroxysmal Positional Vertigo (BPPV) is a common disease that distresses a large number of people every year. Though, it is not life-threatening but has significantly affected their quality of life. BPPV has been defined as an inner ear disorder in which variations to the position of the head, like tilting the head backward, lead to sudden vertigo – a feeling where everything around appears to be spinning. Its intensity might range from mild to extreme and typically lasts only a few minutes.

Signs and Symptoms

BPPV may be escorted by the following signs and symptoms:

  • Dizziness
  • Lightheadedness
  • A sense of imbalance
  • Nausea
  • Vomiting

Causes of BPPV

BPPV progresses when calcium carbonate crystals, known as otoconia, move into and get trapped within the semicircular canals (one of the vestibular organs of the inner ear that regulates balance). These crystals form a normal part of the structure of the utricle, a vestibular organ next to the semicircular canals.

In the utricle, the otoconia may be released as a result of injury, infection, or age, and they end up in a sac – the utricle – where they get naturally dissolved. However, otoconia in the semicircular canals will not dissipate. As a person’s head position variates, they start to roll around and push on the tiny hair that lines the semicircular canals. Those hair act as sensors to inform the brain about balance. Vertigo develops when the hair is stimulated by the rolling otoconia.

Diagnosis and Tests

With progress in medical technology, BPPV has become easy to diagnose and treat. The diagnosis can usually be identified based on medical history and a physical exam known as the particle repositioning procedure. This process takes about 15 minutes to complete and involves a sequence of physical movements that change the position of the head and the body. These actions relocate the otoconia out of the semicircular canal and back into their proper location in the utricle.

Treating BPPV with Physiotherapy

Physical therapy is one of the most effective ways to cope up with and treat vertigo. It involves using four commonly used procedures:

  • Epley Maneuver, which is extremely effective for treating mechanical ear imbalances, such as the loose crystals that cause BPPV.
  • Semont Maneuver,  Foster Maneuver, and  Brandt-Daroff Exercise.

These are some therapeutic exercises that can reduce the intensity of your symptoms, or in some cases, eliminate them entirely. The frequency of the exercise and the general routine to follow are advised based on your individual requirements.

Every case of vertigo is different from the other. The specific physical therapy treatments will highly depend on the diagnosis of your physical therapist.

If you are struggling with vertigo and desire professional help, reach out to us at Prime Physio Plus Physiotherapy Clinic to book an appointment.


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18/Jun/2019

A rotator cuff is a group of muscles and tendons surrounding the shoulder joint, keeping the head of your upper arm bone firmly within the shallow socket of the shoulder. A rotator cuff injury can result in a blunt ache in the shoulder that often aggravates while you try to sleep on the affected side.

This type of injury is a common occurrence for those who regularly perform overhead motions in their jobs or sports, for example, painters, carpenters, shotput throwers, etc. The possibility of rotator cuff injury increases with age.

The rotator cuff treatment comprises of comprehensive physical therapy sessions in order to restore elasticity and strength of the muscles and tendons cushioning the shoulder joint.  On the other hand, an extensive rotator cuff injury may require surgical repair, transfer of alternative tendons or joint replacement. Let’s take a sneak peek at what causes the condition, how to prevent it, and its treatment options.

Causes of Rotator Cuff Injury

Rotator cuff injury may be the result of either a substantial injury to the shoulder or too advanced disintegration or wear and tear of the tendon tissue. A repeated overhead movement or heavy lifting over an extended period of time may further destruct the tendon.

Symptoms of Rotator Cuff Injury

The pain associated may display the following rotator cuff injury symptoms:

  • A dull ache deep in the shoulder,
  • Disrupted sleep cycles, especially if you lie on the affected shoulder,
  • Difficulty in performing simple activities that involve reaching behind your back, and – Weakness in the arm.

Diagnosis

During the rotator cuff injury test, your doctor will apply pressure on various parts of your shoulder and even move your arm into different positions. The strength of the muscles around your shoulder and in your arms shall be evaluated too.

In some cases, imaging tests like X-rays, ultrasounds, and magnetic resonance imaging (MRI) will be prescribed as well to rule out any other possibility leading to the condition.

Prevention

Isometric shoulder exercises and rotator cuff exercises are a must if you are at risk of rotator cuff injuries or if you have had suffered few in the past. These include daily shoulder stretches and strengthening exercises in order to prevent future trouble.

Most patients also exercise the front muscles of the chest, shoulder and upper arm. Your doctor or a physical therapist may prescribe you a suitable exercise routine.

Physiotherapy Treatment

Conventional treatments — such as rest, ice and physical therapy — sometimes are all that is required to remedy your rotator cuff injury and assist you in recovering. Depending on the severity of your trauma, like in case of a total tear of the muscle or tendon, you might need surgery.

To reduce the pain further, steroid injections are recommended. But, physical therapy is the primary choice preferred by doctors. Exercises tailored to the exact position of your rotator cuff injury can help in restoring flexibility and strength to your shoulder. It also plays a significant role during the recovery phase after rotator cuff surgery.

If you suffer from this ailment, now is the right time to pick up your phone and book your appointment with us at Prime Physio Plus Physiotherapy Clinic.


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11/Jun/2019

The precise reason behind pelvic pain for most women can be unidentifiable, irrespective of any examinations or scans. In a few cases, the symptoms are associated with a problem that is often overlooked. Pelvic pain may arise from a pelvic floor muscle condition that can be aided by a particular form of physical therapy known as the pelvic physical therapy.

What are the Pelvic Floor Muscles?

The floor of the pelvis includes multiple layers of muscle and other tissues. These layers stretch like a hammock from the tailbone at the back to the pubic bone in the front. When your pelvic floor muscles are unable to control themselves, it is known as pelvic floor dysfunction.

What are Pelvic Floor Conditions?

The pelvic floor conditions comprise of the following:

  • Stress Incontinence,
  • Urge Incontinence,
  • Overactive bladder,
  • Ante-natal Care,
  • Post-natal Care,
  • Vaginal Collapse,
  • Pelvic Pain,
  • Fecal Incontinence, and
  • Bowel Conditions, such as Constipation.

Why Do the Pelvic Floor Muscles Weaken in Women?

The pelvic floor muscles in women can be weakened due to the following factors:

  • Pregnancy and Childbirth;
  • Persistent Constipation;
  • Repetitive Heavy Lifting;
  • A Chronic Cough (Smoker’s Cough, Acute Bronchitis, Asthma, etc.);
  • Hormonal Imbalance at;
  • Surgery (E.g. Prostate or Episiotomy); Weak Core Muscle Strength; and A Lack of General Fitness.

What is Pelvic Floor Physiotherapy?

In order to maintain the strength of pelvic floor muscles, it becomes important for both women and men of all ages to reap the benefits of pelvic floor physiotherapy and rehabilitate the weakened muscles. It can help not only with the pain but also reduce symptoms of other conditions caused by pelvic floor problems, such as urinary and fecal incontinence, painful intercourse, and sexual dysfunction. Relaxing tapered and compressed muscles can help ease pain in the pelvic floor, just as it would in other muscles in the body.

Although many women might find pelvic physical therapy unusual and offensive, it can be quite effective. The effectiveness of the therapy will always depend on the severity of the case. It can also serve as additional therapy and does not always have to be the only treatment option.

Pelvic Floor Physiotherapy Techniques

Education: A patient should be aware of his/her pelvic anatomy and how different components work alone and together. They should also have knowledge of how their habits and hygiene affect their symptoms.

Pelvic Floor Exercises: Exercises involving contraction and relaxation of pelvic floor muscles in relation to other muscles are a must. Few breathing and timing techniques that make the exercises more effective are also taught. Such exercises can assist them in stretching the constricted muscles, strengthen the weak ones, and improve flexibility.

Manual Therapy: A physical therapist may use hands-on massage or stretching to help with posture, blood circulation, and mobility.

Pelvic floor physical therapy may be part of a treatment plan involving primary care physicians, sex therapists, and mental health professionals.

If you wish to undergo pelvic physical therapy, then we at Prime Physio Plus Physiotherapy Clinic are just a call away!


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04/Jun/2019

Misinterpreted as well as mismanaged, lower back pain is a significant cause of agony and distress for many across the world. Though common and recurrent in nature, it is definitely not very severe. Before we learn about how physiotherapy aids in treating back pain, here’s the up-to-date knowledge on the ailment.

What Causes Lower Back Pain?

Strain

Strenuous physical activity can result in stretching or tearing of muscles and ligaments in the lower back. It is usually characterized by pain and soreness in the affected area, and even, muscle cramps.

Disc Injury

As we age, the risk for the discs in the back to get injured, increase. Some frequent disc injuries include a herniated disc and compression of the nerve root. They occur unexpectedly after lifting something or twisting the back. The pain can usually span across for more than 72 hours.

Sciatica

Sciatica generally follows when the herniated disc presses on the sciatic nerve. Since the sciatic nerve links the spine to the legs, this ailment can cause shooting pain in the legs as well.

Spinal Stenosis

This condition is identified by narrowing of the spinal column that applies pressure on the spinal cord and spinal nerves. Spinal Stenosis is a common development of degeneration of the discs between the vertebrae. Its symptoms tend to worsen while standing or walking.

Abnormal Spine Curvatures

Scoliosis, kyphosis, and lordosis result in abnormal curvatures in the spine. These ingrained conditions are first diagnosed when patients are children or teenagers. The curvature puts pressure on the muscles, tendons, ligaments, and vertebrae causing pain and feeble postures.

Other Factors

Conditions like arthritis, fibromyalgia, spondylitis, osteoporosis, and spondylosis comprise factors that generate lower back pain symptoms.

Symptoms of Lower Back Pain

One of the major symptoms is an ache in the lower side of the back that sometimes even travels to the buttocks and legs. The pain usually goes away without any medical treatment, but if it is persistent with the following symptoms, you need to see a doctor:

  • Weight loss,
  • Fever,
  • Inflammation or swelling on the back,
  • Continuous back pain, where lying down or resting does not help,
  • Pain down the legs,
  • A recent injury, blow or trauma to the lower back,
  • Difficulty in Urination,
  • Loss of control over bowel movements,
  • Numbness around the genitals, and
  • Sore buttocks and anus

How Can You Prevent Lower Back Pain?

To lower the risk of developing back pain include the following factors:

  • Establish an exercise routine.
  • Quit smoking!
  • Maintain your body weight as per the BMI.
  • Perfect your posture alignment, while both, standing and sitting.
  • Use the correct lifting techniques.
  • Do not lift and twist at the same time.
  • Wear flat shoes to avoid straining the lower back. Ensure back support while driving.

How Does Physiotherapy Treat Lower Back Pain?

Early treatment that focuses on exercise, mechanics, and posture is the key to reducing your pain and returning to an active lifestyle. To relieve your lower back pain, a physical therapist will design a treatment plan pertaining to your explicit problem, based on a systematic investigation. The sooner you visit the physiotherapist, the more effective will be the treatment. Based on your examination, the best treatment for lower back pain shall revolve around the following:

  • Manual Therapy (Mobilization of the Joints in Your Back): Physiotherapists accomplished in manual therapy customize accurate hands-on procedures to relieve stiffness and improve the affected spine joints and muscles by initiating movement.
  • Movement Exercises: In order to reinstate the lost motion and lessen the prickling pain, most physiotherapists prescribe these exercises, using a protocol called the McKenzie method. If your pain is enduring, physiotherapy is a must for you. Along with the first two options, chronic low back pain is best managed with progressive strengthening exercises.
  • Progressive Strengthening Exercises: These usually highlight stability and endurance. A comprehensive assessment analyzing the kind of pain, how it occurred, how to better it and what makes it worse will let the physiotherapist prescribe the right treatment option for you.

If you are undergoing lower back pain, then book an appointment with us at Prime Physio Plus Physiotherapy Clinic without any further delay.


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12/May/2019

Read These Three Tips For Long Car Rides

It’s no secret that car rides can be hard on your lower back—especially if you have to travel for an extended period of time.

The key to finding relief is to make a plan before you set off on your trip, and these 3 little-known tips can help you do exactly that:

1. Schedule regular stops for exercise

Sitting in one position for an extended period of time can tighten your back muscles, which in turn can lead to pain and even muscle spasms. So then, it’s a good idea to schedule stops every 30 to 60 minutes so you can walk around and stretch your lower back. This activity loosens your muscles and encourages blood circulation, bringing nutrients and oxygen to your lower back.

In addition to scheduling regular stops, try adjusting the position of your seat every 15 to 20 minutes. You can also pump your ankles to stimulate blood flow and to provide a slight hamstring stretch. Basically, any movement that’s safe to perform while driving can contribute to the relief of your back pain.

2. Bring a cold pack to relieve your lower back pain

More often than not, back pain is accompanied by inflammation. Applying a cold pack for 15 to 20 minutes can reduce this inflammation and numb sore tissues, both of which can relieve your pain.

Of course, finding relief through cold therapy on a road trip requires advanced planning. Here are a few simple options you can consider:

  • Before you leave on your trip, fill a cooler with reusable ice packs. You can also make your own customizable ice packs at home and toss them in the cooler.
  • Purchase instant ice packs at a pharmacy or general merchandise store. You can store these instant packs in the glove compartment of your car.
  • If you’re in a pinch, you can purchase ice and plastic bags on your trip—just make sure the bags are leak-free.

Regardless of which option you choose, remember to place a protective barrier between your skin and the cold pack to avoid ice burn.

3. Break up your trip into manageable stages

It seems counterintuitive, but sitting places more pressure on your spine than standing. So if your lower back pain is severe, consider breaking up your road trip into manageable stages. For example, rather than traveling 12 hours in one day, try 2 travel days instead. This strategy can help reduce the pressure on your spine—and it may encourage you to seek out unique tourist destinations.

Of course, breaking up your trip may cost you additional time and money—but it’s worth it if you can avoid lower back discomfort.

I hope all of the above advice will help keep your lower back happy and healthy during your next road trip.


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08/May/2019

By Eric Wong

Precision Movement

So, you’ve got lower back pain from squats, do you?

Damn, that sucks.

Fortunately for you, in this article we’re going to go through:

  • 3 characteristics that are common amongst people who hurt their lower back squats,
  • 3 things to address to prevent this annoying problem, and
  • A short routine you can do right now for some instant pain relief

Trust me, I know the kind of pain you’re feeling, seeing as this is the back that I personally squat (and deadlift) with.

The surgery and resulting big scar has significantly impacted my tissues, alignment and movement patterns, so I’ve had to learn a lot just to keep myself healthy.
And before we continue, one thing you can be thankful for is the fact that this didn’t happen to you:
We can always find gratitude if we look for it.
Now that we’re in a positive frame of mind, let’s dive in, starting with the 3 most common reasons people get lower back pain from squats.

3 Common Characteristics of People Who Get Lower Back Pain From Squats

When people hurt their back doing squats they typically have one, two or all three of the following characteristics:

  1. Male
  2. 28-50 years old
  3. Poor Squat Movement Pattern

Let’s go into each one separately so we can understand where these problems are coming from and find some solutions, shall we?

Males

It’s true – guys hurt their backs doing squats way more often than girls do, and there are two main reasons for this…

First, us guys typically walk around with either a neutral or posterior pelvic tilt, whereas most females have either a neutral or anterior posterior tilt.
We’re going to break this down when we talk about the movement pattern itself.
Which brings us to the second point…
Guys have BIG egos.

These gargantuan egos – let’s call them our inner bros – are in competition with other inner bros, and cause us males to either try to out do each other at any opportunity we get or impress any females that might have a sightline to you and your squats – and guys I can tell you’re getting a little defensive right about now, don’t worry that’s just your inner bro talking.

Our inner bro is what makes us stuff socks in their pants (or so I’ve heard), buy expensive sports cars when we reach 40-50 years old, do pushups and bicep curls before going to a bar or club and yes, squat more weight than we’re capable of.

So guys, be aware of your inner bro and make sure he’s not the one in charge of putting the weight on the bar when you squat.

28-50 Years of Age

This means that you were born somewhere between 1967 and 1989. Yep, I’m psychic. I can also guess your weight – TOO MUCH! j/k 😉

Another thing I can guess about you is that you’re probably extremely focused on your career and/or your family right now, and you probably find it difficult to set time aside to look after your body.

Have you ever taken time off from your workouts, because you were so busy with life, and tried to go back to the gym with the same intensity you had in your last session (which could have been months or years prior)?

Did you think you were a magician because you were able to make 20lbs feel like 100lbs?

This magic trick isn’t like Jesus turning water in to wine, my friend.

Going back to the gym after taking a long time off and thinking you’re the same person you were before is a prescription for pain and injury.

So if you are hitting the weights after a break, start easy and ramp up slowly over time. Your body will thank you.

Poor Squat Movement Pattern

To understand what’s going wrong with your movement pattern, let’s break down each variable that creates the squat movement pattern to shed some light on the subject.

These variables include:

  • Hip Mobility
  • Core Stability
  • Technique

Before we address these 3 areas, we need to take a look at the common postural defects caused by each of these faults, which are lumbar flexion and posterior pelvic tilt.

Lumbar Flexion and Posterior Pelvic Tilt

An assault to the intervertebral disc is the most common occurrence when people hurt their lower back squatting; with muscle strain a distant second.

The reason why the disc gets assaulted (not necessarily damaged) is because the lumbar spine flexes or pelvis tilts posteriorly, even if only for a brief moment.

Posterior pelvic tilting, or butt wink, occurs for many people when they lower in to the bottom of the squat. This butt wink isn’t exactly a major issue in everyday activity, but under heavily loaded exercises, like back squats, excess lumbar flexion and a pronounced posterior pelvic tilt can really launch that assault on the discs.

Check out the different pelvic tilts in these images.

Pay close attention to the curves of the lower back.

The image on the left illustrates an ideal squatting posture maintaining the natural lordotic curvature of the lumbar spine [1], while the image on the right illustrates how the pelvis looks in the butt wink.

When the back has not been properly conditioned for lumbar flexion the tissues and ligaments aren’t prepared to handle the stress and cause extreme posterior stress, which can cause prolapsing, or herniation of the discs when heavy loads are applied over time.

Take a look at the image below.

Notice how lumbar flexion in the image on the right is compressing the anterior of the disc, causing the nucleus to be squeezed out against the posterior annulus wall.

If you’ve ever had a Fedex delivery arrive at your home, you’d know the satisfying feeling of popping those little plastic bubbles in between your fingers

As satisfying as this feeling is, it’s excruciating when it happens to your discs.

A Lack of Sufficient Hip Mobility

If you spend most of your day sitting in front of the computer, watching television or driving in your car, I’m afraid to say that chances are you have shitty hip mobility.

This is a big problem because your body is designed to move, and sitting down for too long weakens important muscles like the glutes, hip flexors and hamstrings.

These muscles just aren’t being activated if you’re sitting on your ass all day.

When you add heavy weight to the squat, your body looks to the extensor and stabilizing muscles of the glutes and hips to help support a neutral spinal position. [3]

Think of the way the elastic band in your underwear supports the hold around your waist. Over time the waistband loses its elasticity and become weak and useless. The weaker your glues are, the more useless they are at stabilizing your pelvis.

And when these muscles are weak, your lower back wants to step in to take over.

The key idea you need to take away from this is if you don’t use it, you lose it, so you’ve got to ensure you’re constantly training your core to undo all the damage sitting does.

Weak Core Muscles

Stabilizing the spine is the main function of your core, thus, weakness in these muscles results in an unstable spine, which will result in low back pain. [4]

The different muscles that make up your core and support your spine include:

  • The Multifidus
  • The Transverse Abdominis
  • The Rectus Abdominis
  • The Internal/External Obliques
  • The Latissimus Dorsi

Each of these muscles are important for stability in all 3D movements:

  • The Sagittal Plane – Bending down to pick up your child
  • The Transverse Plane – Throwing a ball or torso rotation when running
  • The Frontal Plane – Doing cartwheels in the park or side-bending to scratch the outside of your knee

Squatting with heavy weight demands a higher degree of core activation than lighter weight or bodyweight squats do. [5]

The heavier the weight, the more strength and stabilization you need in your core.

If you lack strength in any of the core muscles listed above, you’re playing a dangerous game going ass to grass with heavy weight.

Because of this, it’s important you develop core strength first, before making maximal strength gains the focus of your workouts.

Lack of Proper Technique

Finally, the last area you need to address is your technique.

The squat is one of the most fundamental human movements. It’s so fundamental that even toddlers can drop down for the perfect squat without cues or coaching.

The problem is there are so many conflicting pieces of information and opinions dished out by bro science professors about the right way to squat.

Want to know the real truth?

There’s no “RIGHT” way to Squat!

The better question would be, “Which is the right way for me?”

The best technique for you really depends on:

  • What your goals are
  • The unique structure of your hips
  • Your weapon of choice – i.e. kettlebells, barbells, dumbbells, etc.

For example, powerlifters will go for a low bar placement across the posterior deltoids and stand with a much wider stance compared to Olympic weightlifters, who go for high bar placement, using the traps like a shelf for the bar, and a shoulder width stance.

Why?

For powerlifters it’s all about weight; the more they squat the better. Adopting a wider stance and a low bar placement is the best way to load more weight onto their squat.

For Olympic weightlifters, the squat is more dynamic and the technique they use is geared towards exploding out of the squat and getting under the bar to achieve an overhead position.

So, you’re probably wondering which technique would be best for you, the powerlifter or the Olympic weightlifter?

Before you decide, just ask yourself, “Am I a powerlifter or an Olympic weightlifter?”

If the answer is no, and I bet it is, neither of these is the ideal fit for you.

To the stance that works best for you, try this method that has worked well for many of my clients in the past:

  1. Take 2 or 3 small vertical jumps in the air and wherever your feet land naturally is the stance your going to test first
  2. Turn your toes out slightly if you want, up to 30° is fine
  3. Try squatting and see how it feels, if it feels natural you’re good
  4. If the squat feel unnatural in any way, adjust your stance and try again until it feels natural

Now that you’ve found your stance it’s time to go over a few pointers for the basic squat.

Basic Squat Technique

  1. Maintain neutral spine position with your shoulders back and chest tall
  2. Ensure your femur (thigh) tracks inline with your feet by pushing your knees out as you squat down
  3. Inhale on the descent and exhale on your way up
  4. To help maintain spinal alignment, look forward as you move through the squat and avoid looking up, which can break neutral position of your cervical spine (neck)

How to Relieve Your Lower Back Pain

If you’re reading this article, it’s no doubt you’re currently suffering lower back pain from doing squats.

Addressing the problems we’ve already talked about will help you reduce the risk of developing further lower back pain in the future.

But for those of you in need of pain relief, and need it now, try running through my Damage Control Routine in the video below.

This routine is great for easing the tweaks and strains that you may have in your lower back from squatting and has been successful in helping many of my clients out in the past.

Ok, that’s it for today.

We’ve covered a lot of information about lower back pain, including:

  • The 3 common characteristics of people who get lower back pain from squats
  • 3 areas leading to lower back pain from squats
  • A simple yet effective routine for quickly relieving lower back pain

I hope you’ve enjoyed this article and can take something useful from it that you can use in your own life. Whether you have lower back pain or not, knowing this information is essential for safe and pain free squatting now and in the future.


About Us

We aim to remove your pain and develop personalized treatments while maintaining up-to date practices provided by our qualified experts. It is through dedication and a cohesive team of energetic and educated individuals that we will continue to uphold this vision.

Initial assessment

We will start with identifying the cause of the problem, not only the symptoms. We can then design a tailor-made treatment plan that will help you recover in the shortest period of time, so you can get back to enjoying your life to the fullest.

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