12April

Eating for Easter

Michelle’s top tips for healthy eating at Easter

  1. Enjoy your favourite chocolates; it IS Easter after all! All foods can be enjoyed without guilt, particularly for special occasions. 
     
  2. While enjoying Easter eggs and hot cross buns, be mindful about how many "treat foods" you are having. To help with portion control, avoid bulk buying (indulge in your absolute favourite luxury Easter eggs instead!), go for small or hollow Easter eggs rather than big Easter chocolate bunnies, and serve out the amount you will have in one sitting so you can clearly see how much you're having. By putting the rest away where you can't see them, you're less likely to overeat simply because a food is there. 
     
  3. Remember to stock the fridge with plenty of fresh fruit and vegetables (aim for 2&5...2 serves fruit and 5 serves veggies a day) and still have a healthy balance of your core food groups (grains, meat and alternatives, dairy and alternatives, fruits and vegetables) through your day. 
     
  4. Make the most of the long weekend by doing some exercise. Half an hour a day of movement you enjoy on most days of the week keeps us fit- and helps to balance out some of the extra energy we might be consuming over Easter!

For extra tips and information, check this page out! 

By Michelle Lin 

Posted in Wellbeing, Diet, Exercise, General

07November

Caring for Ankle Sprains

The ankle joint is formed by four bones (tibia, fibula, talus and calcaneus). The stability of the joint is maintained by ligaments. Ligaments assist in guiding the normal movements of the joint and avoiding excessive movements. When an ankle is sprained, (usually caused by excessive side way bending of the ankle, for example walking on uneven surface or standing on someone’s foot) a ligament can be over stretched. This can lead to fibers of ligament and small blood vessels been torn. Then there will be symptoms like internal bleeding within the tissue, swelling and pain.

When an ankle sprain takes place, you need to immediately and within 72 hours of injury, apply RICE for management.

·       Rest – Avoiding any painful movements

·       Ice – Wrapping a wet towel around ice, then applying it on injured area for 20 minutes and repeating this process every two hours. This will help to control the amount of internal bleeding and pain.

·       Compression – Using bandage to wrap around ankle and bottom half of the leg to minimize swelling

·       Elevation – Positioning the ankle up high, above the heart level to decrease swelling

Within 48 hours post sprained ankle, it is important to avoid heat, alcohol, running and massage. This will prevent increases of swelling and will improve the healing process.

The rehabilitation process for ankle sprain can be started early on. Your physiotherapist can assist in minimizing ankle pain and movement restriction. Therefore, you can return to work and sport quickly. This process will also promote the healing of the ligament and the normal function of muscle and nerve.

Your physiotherapist will assess your sprained ankle to see which ligament is affected, how severe is the sprain and whether there is the need for x-ray. In the early stage of rehabilitation, it is mainly focusing on decreasing swelling and pain to allow ease in walking. Physiotherapist will mobilize your ankle joint to improve the mobility and to minimize joint stiffness. This will help to make walking easier and to form healthy scar tissue on the ligament. The ligament then will recover quicker and stronger.

Your physiotherapist will teach you some simple exercises to promote the strengthening of calf and ankle muscles. This will supplement the injured ligament. Muscle reaction will need to be trained as well. When the ankle position changes, muscles needs to react quickly in order to prevent re-injury of the ligament. Complete recovery of the ligament depends on the severity of the sprain. It can be few weeks up to few months. It is important to remember that pain and swelling will settle much quicker than the recovery of the muscle and ligament strength. Therefore, returning to work or sport too early can slow down the overall healing process. Your physiotherapist can teach you the use of ankle taping or brace to support your ankle to avoid further irritation while allowing you to return to normal daily routines.

The following methods can help you to minimize the chance of spraining your ankle and to minimize the severity of injury:

·       Wearing suitable shoes or applying sports tapes to provide good support at the ankle joint

·       Avoiding activities on slippery or uneven surfaces, including low light/dark locations

·       Strengthening the calf muscle to protect your ligaments

·       Practice standing on one leg to improve your balance reaction

·       Always do warm up before activities

 

If you have any questions, please contact your physiotherapist.

By Terry Kung

Posted in Wellbeing, Physiotherapy, General

24October

Nutrition in Preparation for Triathlons

It is important for triathletes to ensure meals and snacks are based around nutritious carbohydrate foods to meet daily fuel and nutrient demands. Persistent fatigue, poor recovery, illness, and unwanted weight loss are common symptoms amongst triathletes who don’t adequately meet their daily energy and nutrient requirements.

Timing of Meals and Snacks

As triathletes are required to train 2-3 times daily, recovery from one training session to the next is crucial. Planning their daily food intake is vital to ensure regular snacks and meals are consumed around training sessions. It’s important to have nutritious carbohydrate snacks on hand immediately after training to initiate the refuelling process. Many nutritious carbohydrate foods contain a small amount of protein which aides in the repair of regenerating proteins used in fuel metabolism and muscle damage incurred during exercise.

Carbohydrate Loading

The concept of carbohydrate loading is popular amongst triathletes prior to competition. Carbohydrate loading is more than simply eating pasta for dinner the night before competition and certainly doesn't mean gorging yourself with food for the entire week leading into a race. As training decreases leading into a race, energy (kilojoule) and carbohydrate requirements also decrease. During an easy week prior to competition it is important for athletes to taper food intake accordingly to avoid unwanted weight gain immediately prior to racing. To adequately fill muscle glycogen stores (carbohydrate stored in the muscle), athletes need to consume between 7-12g of carbohydrate per kilogram body weight for 24-48 hours prior to competition.  

For sprint and Olympic distance competitors the taper in training leading into the race in conjunction with 7-8 g of carbohydrate per kilogram body weight for 24 hours before competition is adequate to increase muscle glycogen stores. However, athletes competing in half ironman, long course and ironman races should increase their carbohydrate intake to 10-12 g of carbohydrate per kilogram body weight for 48-72 hours before race start. For further details refer to the Carbohydrate Loading fact sheet under the ‘Competition and Training’ section http://www.ausport.gov.au/ais/nutrition/factsheets/competition_and_training

Pre-Race Eating

The majority of triathlons start early in the morning so there is the temptation to miss breakfast before race start. It’s crucial to eat a pre-race meal in order to top up muscle and liver glycogen stores. A pre-race meal containing roughly 1-2 g of carbohydrate per kilogram body weight should be consumed about 1-4 hours before racing. The meal should contain familiar carbohydrate-rich foods and fluids that are low in fat and fibre. For instance two English muffins, 1½ tablespoons jam, 1 teaspoon Vegemite and 750 ml sports drink provides 2500 kJ, 125 g carbohydrate, 2 g fat, 14 g protein and only 4 g fibre. Foods like liquid meal supplements, sports bars, bananas and juice are also popular pre-race meal choices.

Eating During Training and Competition

Eating food during long training rides is essential for triathletes to help provide carbohydrate to the working muscles, meet daily energy and nutrient requirements and keep hunger at bay. Most ironman triathletes complete "brick" sessions during their preparation for an ironman triathlon. Brick sessions may consist of a 5-6 hour cycle immediately followed by 1-2 hours of running. Eating during brick sessions is not only beneficial, but essential.

During sprint and Olympic distance triathlons it is not necessary and certainly not practical to eat foods while racing. Due to the high intensity of racing, athletes competing in these events usually rely exclusively on sports drinks and sports gels to meet fuel and fluid losses. However, during ironman races where athletes are competing over several hours and consequently miss regular meals, eating food plays an important role in meeting their hourly carbohydrate requirements.

For shorter triathlon events, athletes should aim to consume 30-60g of carbohydrate an hour, whereas athletes contesting Ironman events should aim to consume 1-1½ grams of carbohydrate per kg body weight per hour.  For example, a 70kg male athlete contesting an Ironman event should aim to consume roughly 70-100g of carbohydrate an hour.  The athlete’s tolerance will ultimately dictate how much carbohydrate is consumed and should be considered when deciding on a race nutrition plan.

The cycle leg provides the best opportunity to consume adequate food and fluid, compared to the run and swim. Athletes are better able to tolerate food and fluid during the cycle compared to the run.  Athletes should take a variety of food on the bike to ensure they maintain interest in what they are eating. Sandwiches, fruit bars, sports bars, bananas, sweet biscuits, dried fruit and sports gels are all examples of foods commonly eaten by triathletes while cycling. It is good practice to have a combination of regular food items and sports foods.

The run presents many more challenges than the bike in meeting carbohydrate requirements. Most triathletes use fluids such as sports drinks and soft drink to simultaneously meet fluid and carbohydrate requirements during the run. During ironman events athletes will also use sports gels as these are far more practical to consume than food while running.

Meeting Fluid Requirements during Competition

During competition, it’s not as simple as drinking as much as tolerated or possible. Recent reports in the scientific literature have shown that some Ironman triathletes may drink in excess of hourly fluid requirements during an event.  Drinking in excess of hourly sweat losses may result in hyponatremia or low plasma sodium.  Slower athletes, particularly females contesting events in cooler conditions are most at risk of drinking in excess of hourly fluid requirements.  So how do you know how much to drink?  You need to monitor your individual fluid balance during training and competition sessions to develop a plan for subsequent exercise sessions.

 

By Jana Mellor
Senior Dietitan

Source:  AIS Sports Nutrition, last updated April 2009. © Australian Sports Commission.

Posted in Wellbeing, Diet, Exercise, General

10October

Cupping

 

What is cupping?

Cupping is the use of glass, plastic or silicone cups or containers to create suction over an area of skin or muscle. In Traditional Asian Medicine this form of therapy has been used for thousands of years to help alleviate problems from coughs and colds to muscle trauma caused by stagnation.

When the cups are applied they lift and separate the layers of tissue below the cup (skin from the fascia, the fascia from the muscle, and the muscle from the bone), allowing a release of any stagnant blood or toxins that have built up in the area. The purple marks you can end up with are a result of that stagnant product being drawn up to the skin where it can be eliminated from your body through your lymphatic system.

 

What use is cupping for athletes?

Cupping is particularly beneficial for anyone, like athletes, who do lots of repetitive and intense actions and training. The act of intense exercise and repetitive actions causes not only tightness in the muscles and tendons, but also a buildup of lactic acid and other toxins. This tightness and build up can decrease your body's ability to properly oxygenate and repair the muscle tissue that is being continually damaged leading to prolonged recovery time, increased risk of injury and reduced performance.

The act of cupping can help relieve this build up in the muscles and tendons and encourage the flow of blood and oxygen to area allowing it to loosen and repair. This in turn can decrease your recovery time and injury risk while at the same time improving your performance by assisting your muscles to operate at their maximum capacity.

By Simon Strudwick

Posted in Wellbeing, Exercise, Acupuncture, General

19April

Achieving Better Health Through Routine

 
We all know that in terms of health, prevention is better than cure, but how do we prevent disease and maintain good health? We do this by developing good habits and avoiding bad habits.
 
How do we promote good habits? We do this by living in harmony with nature. In Chinese philosophical language we might call this ‘living in accordance with the Dao’ or ‘being in harmony with yin and yang’.
 
Nature works in regular cycles and our bodies are no different. Our bodies love routine. This is called circadian rhythm (1). There is a proper time to sleep, a proper time to wake and a proper time to eat. Every morning, dawn is the birth of yang. This is not the best time for sleeping. This is time to wake up and get moving – a good time to warm up the body with exercise and a good time to focus and sharpen our sleepy mind with meditative practice. After this we should be awake, fresh and ready for a good breakfast to fuel a productive day ahead.
 
As the sun goes down in the evening, this is the decline of yang and the birth of yin. As we come to the later hours, this is the time for us to wind down and relax and prepare ourselves for a good restorative sleep. If we find ourselves lying in bed with mind racing, thinking about 10,000 things, then we need to work on improving our evening routine. Sometimes it is a good idea to set an alarm to remind ourselves when bed time is approaching.
 
This is an especially good idea for the workaholics and internet addicts among us, allowing us time to break away from the activities that we are engrossed in and prepare ourselves for sleep. There are various different bedtime rituals which can be great to help us transition into a good night’s sleep – maybe taking a shower, doing some stretches or some quiet meditation before bed. My best general suggestion for people without a good bedtime ritual is to google ‘sleep hygiene’ and do some research of your own. You’ll be glad you did!
 
 
In the modern world, everybody has their own unique needs and their own unique set of challenges. Not everybody can live by the same ‘perfect’ routine but at least we all should have a routine. 
 
Without routine, life is just chaotic and good health can’t be sustained from chaos!
 
 
 
 
(1) Sleep Drive and Your Body Clock, https://sleepfoundation.org/sleep-topics/sleep-drive-and-
your-body-clock
 
 

Posted in Wellbeing, Exercise, Acupuncture, General

01March

Why you should love your dairy

Milk bottles

 

It seems dairy has gotten a bad rap lately. It could be due to the paleo hype going around at the moment (which excludes dairy from the diet)…I guess they have their reasons.

I have two big reasons for loving my dairy…

1. It’s high in calcium and is a great source of protein. Calcium is vital for building and maintaining strong bones and teeth and is also required for normal neuromuscular and cardiac function; where protein is important for the growth and maintenance of our muscles. Which makes sense because our bones and muscles work hand in hand - whether we’re going about our days or pumping out some exercise.

2. The second reason I’m a massive supporter of dairy, particularly for women, is because once we hit menopause our bone density decreases 2-3% per year which increases our chance of developing osteoporosis. By the time we’re 30, our bone density physically cannot increase more than it is already is, which is why it’s so important to maintain whatever our density is at that stage, for later in life.

Let’s veer away from dairy as a whole and look more closely at yoghurt (my fave - yum). This beautiful food is my savior for all things ‘gut-focused’. I recently had to take a dose of antibiotics that would apparently strip my gut of both good and bad bacteria and I was recommended to take Inner Health Plus for 1 WHOLE MONTH. While I’ve got nothing wrong with Inner Health Plus (by all means there are some people out there that do need it), I’m a young, healthy and fit person and strongly believed that my immune system would do just fine if feeding it the right food.

The reason yoghurt comes into this is because it’s full of probiotics - friendly little bacteria that are superb for our digestive system. There’s been so much new research coming out recently that suggests that an imbalance of good and bad gut bacteria may strongly influence food allergies, inflammatory bowel disease (IBD) and obesity.

My tips for keeping your digestive system happy and healthy:

  • Have at least 200g yoghurt per day!
  • Have lots of high fibre foods which improve your balance of good bacteria (lentils, beans, bran, nuts & wholegrains etc)
  • Avoid overusing antibiotics!!! A US study looking at antibiotic use in children under three found that those who’d had three or more courses of antibiotics were twice as likely to develop a food allergy because of the change in gut microbiota. Not to mention that our bodies are incredibly adaptive - the more drugs to give it, the more immune it becomes.

 

By Sophie Aardoom

Bachelor of Health Science (Nutrition & Dietetics), Provisional Accredited Practicing Dietician, Accredited Nutritionist

 

Posted in Wellbeing, Diet, General

01March

Headaches

Headaches are one of the most common symptoms experienced by humans, and we all know how much of an interruption they can be to your day!  

Why some people frequently experience headaches, while others may never, is still unknown. Very occasionally headaches can be the result of a more serious disease however they are usually harmless.

The brain itself is insensitive to pain, whereas its covering membranes, larger blood vessels and other structures within the head and upper neck (e.g., eyes, ears, sinuses, skin, muscle and joints) are richly supplied by nerve fibres capable of transmitting the experience of pain. 

One common source triggering a headache is upper neck joint dysfunction.  This is where irritation in the upper neck from mechanical, chemical or inflammatory mechanisms triggers pain sensitive nerve fibres to send a ‘pain’ message to the brain.

Once the pain signals get to the brain, it needs to decide from where the pain signals arise. Since the nerves that supply the upper neck also supply the skin overlying the head, forehead, jaw line, back of the eyes and ears, the brain may decided that the signal is coming from the head, therefore you feel a headache rather than having neck pain. This is also known as a cervicogenic headache.

Although cervicogenic headaches can occur at any age, it is commonly seen in patients between the ages of twenty and sixty.

All our physiotherapists are well trained to treat upper neck joint dysfunction to ease your headache. Come and visit us to see how we can help you regain control of your headaches!

 

By Amy Baum 
- B.Phty (hons)

Posted in Wellbeing, Physiotherapy, General

01March

Ankle Sprains

A sprained ankle is one of the most common injuries presenting to physiotherapy clinics on a daily basis.

The lateral ligament complex (outside of the ankle) is frequently the injured structure, this consist of three ligaments; 1) Anterior talofibular ligament  2) Posterior talofibular ligament and the 3) Calcaneofibular ligament.

Ankle Sprain

These ligaments are overstretched or torn with an inversion mechanism (rolling the ankle in) as the outside of the joint is opened. The inside of the joint is compressed with this mechanism and can be a cause for ongoing medial ankle pain. 

Grades of Ligament sprains:

·Grade 1 -  up to 20% of the ligament tearing 

·Grade 2 - (partial tear) up to 50% ligament tearing

·Grade 3 - over 80% tearing of the ligament fibres.

Grade 1 sprains generally recover with 1-2 weeks and respond well to physiotherapy. The patient can often weight bear immediately after the injury and there is often mild swelling which settles quickly. A grade 2 sprain or partial tear is a more severe injury characterised by inability to weight bear, moderate to severe swelling and more significant pain. These patients often require crutches to walk and may take up to six weeks to fully recover. A grade 3 rupture can take up to 3 months to rehabilitate and in some cases may require surgery to repair the ligament.

Initial treatment for ankle sprains should follow the RICE principle; rest,compression, ice and elevation. Ice buckets work well initially to reduce swelling. Once the patient is able to weight bear rehabilitation commences with active range of motion, calf strengthening, balance re-training and sports specific training. Most patients who sprain an ankle will be back to full functioning within six weeks, however, there is a small group of patients who will have ongoing pain and swelling which may require further investigations such as an MRI.

All MyCare Health Professional Physiotherapists have received extra training in the assessment and management of ankle sprains. We will perform an accurate assessment giving you a diagnosis with a rehabilitation program to follow so you are back on the sporting arena ASAP.  Our integrated team of Acupuncturists, Massage Therapists, Exercise Physiologists, Dietitian and Psychologist can further support your total care.

 

Solomon Cheng

Musculoskeletal & Principal Physiotherapist

Posted in Physiotherapy, General

01March

Identifying & Managing Sciatica

The sciatic nerve is the longest nerve in your body. It runs from pelvis through your buttock and hip area and down the back of each leg. It controls many of the muscles in your lower legs and provides feeling to your thighs, legs and feet.

Sciatica refers to pain that radiates along the path of the sciatic nerve, from your back into your buttock and leg. You may feel the discomfort almost anywhere along the nerve pathway, but it is most likely to follow a path from your lower back to buttock and the back of thigh and calf. The pain can vary widely, from a mild ache to a sharp, burning sensation or excruciating discomfort. Sometimes it may feel like an electric shock. Sciatic pain often starts gradually and intensifies over time. It may be worse when you cough or sneeze, and prolonged sitting or walking can also aggravate symptoms. Usually only one lower extremity is affected

Sciatica frequently occurs when a nerve root is compressed in your lower spine, mostly as a result of a herniated disc in the lower back. Disks are pads of cartilage that separate the vertebrae in your spine. They keep the spine flexible and act as shock absorbers to cushion the vertebrae when you move. As you grow older, the discs may start to deteriorate, becoming drier, flatter and more brittle. Eventually, the tough fibrous outer covering of the disc may develop tiny tears, causing the jelly-like substance in the disc’s centre to seep out. The herniated disc may then press on a nerve root, causing pain in your back, leg or both. Other conditions can also put pressure on the sciatic nerve, including, spondylolisthesis, trauma, sciatic nerve tumor and spinal tumors.

Mild sciatica usually goes away given a little time and patience. Call your doctor or physiotherapist if self-care measure fail to ease your symptoms or if your pain lasts longer than six weeks, and the pain is severe or becomes progressively worse.

Risk factors for sciatica are health problems, lifestyle choices and inherent qualities, such as age or race. They include:

  • Age – Age related changed in the spine are the most common cause of sciatica. You are likely to have some degeneration in the discs in your back by the age of 30. Most people, who develop herniated discs, are in their 30s and 40s.
  • Occupation – A job that requires you to twist your back, carry heavy loads or drive a motor vehicle for long periods makes you more prone to develop sciatica.
  • Physical activity – Although walking and jogging have been associated with an increased risk of sciatica, exercise in general has not. In fact, people who sit for prolonged periods or have a sedentary lifestyle are more likely to develop sciatica than active people are.
  • Genetic factors – Researchers have identified two genes that may predispose some people to disc problem.
  • Diabetes – This condition affects the way your body uses blood sugar and increases the risk of nerve damage.

For most people, sciatica responds well to self management. You will heal more quickly if you continue with your usual activities, but avoid what may have triggered the pain in the first place. Although resting for a day or two may provide some relief, prolonged bed rest is not a good idea. In the long run, inactivity will make your symptoms worse.

Other measures good for sciatica include using cold packs to reduce inflammation and relieve discomfort, applying hot pack and massaging to help relieve muscle spasm and stretching the lower back to feel better and may help relieve nerve root compression. Some over-the-counter medications can help to reduce pain and inflammation, but make sure you consult with the pharmacist or your doctor.

Physiotherapy and acupuncture play a vital role to help with relieving sciatica discomfort. Rehabilitation typically includes exercises to help correct your posture, strengthen the muscles supporting your back and improve your flexibility. The exercise physiologist can design a rehabilitation program to help prevent recurrent injuries. These treatment programs then should become part of your daily routine at home or at gym permanently.

When conservative managements do not alleviate your pain and the pain gets progressively worse, then surgery might be the last choice of management. Surgery is most often performed to remove a portion of a herniated disc that is pressing on a nerve. You may experience immediate results from disc surgery, but it does not stop degenerative changes and your pain may recur in time.

Preventing sciatica is not always possible. However, it is still very important to do so through exercising regularly, maintaining proper posture when you sit and stand, and using good body mechanics. Poor posture stresses the back, leading to fatigue and stress on joints and nerves. Before you lift something heavy, decide where you will place it and how you will get there. Bend at your knees, not your back, so that you legs do the lifting. Carry objects close to your body at about waist level. Don’t twist at your waist, but turn by stepping around.

If you have any further concerns, please contact us at Mycare Health Professionals.

 

By Terry Kung

B.Phty (UQ)

Posted in Physiotherapy