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Chronic neck pain: Physiotherapy treatments

Are you suffering from a pain in the neck? I’m not talking about your latest electricity bill, or an annoying co-worker, I’m talking good old fashioned inescapable neck pain. Over the course of a lifetime there is a 50% chance you will suffer from neck pain at one point or another.[1] This risk can be heightened by a number of factors: your age (another great part of getting older), your sex (women are more likely than men to experience neck pain[2]) and the type of work you do (I’m looking at you, computer using people). For most Australians neck pain is something that usually lasts 6-8 weeks, but for around 30% of people, neck pain can become a chronic source of pain, limiting the activities you can take part in and disrupting sleep patterns which in turn can cause other problems.[3] Neck pain is one of the most common complaints physiotherapists deal with and there are a number of scientifically proven exercises and treatments to ensure your neck pain doesn’t turn chronic.

What are common symptoms associated with neck pain?

To put it simply, the spine and neck are very complicated regions of the body and can cause a variety of symptoms and finding the right Northern Beaches physio is essential to pinpointing the cause. In all there are seven cervical vertebrae acting as building blocks of the spine in the neck and surrounding the spinal cord and canal. Within the neck, structures include the neck muscles, arteries, veins, lymph glands, thyroid gland, parathyroid glands, oesophagus, larynx, and trachea. This means that neck pain can present a wide array of related symptoms, requiring a skilled musculoskeletal physiotherapist to identify the source. Neck pain can culminate in the following symptoms:

  • Headaches
  • Numbness, weakness and tingling in the arms and fingers
  • Surrounding muscle pain, commonly the shoulders
  • Fever
  • Stiff neck
  • Sore throat
  • Even loss of bowel or bladder control

What are some of the causes of neck pain?

Neck pain just doesn’t come about for no reason, it is usually related to a specific issue with another part of the body, or begins as a direct result of an injury or overuse problem. When you first discuss neck pain with your physio they will conduct an analysis of your body in order to pinpoint the root cause in order to create the most effective program to treat it. Musculoskeletal physiotherapists and General practitioners have highlighted the following as the most common causes of neck pain[4]:

  • Degenerative disc disease
  • Neck strain
  • Osteoarthritis
  • Cervical Spondylosis
  • Poor posture
  • Pinched nerve

Is your phone being a pain in the neck?

As more people spend their days scrolling mindlessly through Facebook, the average number of hours spent on our phones is increasing rapidly, with Australians clocking up 10 hours of mobile screen time PER DAY.[5] Did you know that within 5 minutes of waking up over one third of Australians have already checked their mobile phone at least once, not even dinner time puts the brakes on mobile usage with around 70% checking their phones while eating with family and friends?[6] They are some seriously crazy numbers. We’ve even had to give it a name, text neck. Staring down at your phone causes your neck extensors to stretch unnaturally causing them to weaken over time and can add nearly 30kg of pressure to the back of the neck. This unnatural forward head posture has also been shown to inhibit breathing capacity which can lead to migraines and cause brain fog throughout the day. If you also happen to have a job that requires you to stare at a computer screen or you spend a few hours a day watching television, your risk of suffering neck pain increases.

What are the best treatments for neck pain?

Your Dee Why physio will most likely recommend a multi-modal approach to tackling your neck pain, with studies showing that a combined process is the most effective at shortening the duration and intensity of the pain.[7] A combination of strength and mobility exercises, postural and ergonomic changes, hands on treatment and dry needling have all been shown to be effective and are utilised by musculoskeletal physiotherapists around the world.

If you have been suffering from a sore neck, or any of the symptoms outlined above, you are only increasing your chances of your neck pain becoming chronic and affecting other areas of your body and daily life by not having it treated. It can be easy to shrug off neck, shoulder and back pain as a normal part of life, work and getting older, but nobody should have to put up with chronic pain. You might not be able to get rid of every pain in the neck in your life, but speaking with your Northern Beaches physio can certainly go a long way to getting rid of the actual pain.

 

[1] Hogg-Johnson S, Van der Velde S, Carroll L, Holm L, Cassidy D, Guzman J, Côté P, Haldeman S,
Ammendolia C, Carragee,14,15 Eric Hurwitz E, Nordin, M, Peloso P. The Burden and Determinants of Neck Pain in the General Population: Results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Eur Spine J. 2008 April; 17(Suppl 1): 39–51.

[2] Ostergren PO, Hanson BS, Balogh I, Ektor-Andersen J, Isacsson A, Orbaek P, Winkel J, Isacsson SO; Incidence of shoulder and neck pain in a working population: effect modification between mechanical and psychosocial exposures at work? Results from a one year follow up of the Malmö shoulder and neck study cohort. Malmö Shoulder Neck Study Group. J Epidemiol Community Health. 2005 Sep; 59(9):721-8.

[3] Mehanical Neck Pain and Cervicogenic Headache. Neurosurgery 2007: 60:S1-21–S1-27

[4] Bot SD, Van der waal JM, Terwee CB, et al. Incidence and prevalence of complaints of the neck and upper extremity in general practice. Ann Rheum Dis 2005:64(1):118–23.

[5] Australian consumers spending more than 10 hours of every day on their digital devices’, 2016, Ernst & Young, www.ey.com

[6] Mobile Consumer Survey 2017: The Australian Cut, Deloitte, https://www2.deloitte.com/au/mobile-consumer-survey

[7] William J. Hanney WJ, Kolber MJ, Schack-Dugre J, Negrete R, Pabian P, The Influence of Education and Exercise on Neck 
Pain. Am J Lifestyle Med. 2010;4(2):166-175.

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Why you should choose a Titled Physiotherapist

With literally thousands of physiotherapists now at your fingertips and an infinite number of Google options to choose from, how do you know if the Dee Why physio you choose is appropriately qualified to treat your specific condition? Anyone who can legally call themselves a physiotherapist has studied for 4 years at university, covering multiple areas of practice including: Musculoskeletal injuries and conditions (joints, muscles, bones, tendons and ligaments,) Neurology (spinal cord and brain injuries) Cardio-respiratory conditions (heart and lungs) Paediatric issues (children). Fresh out of uni you could say a physio is a jack of all trades, but a master of none. It is after admission as a fully fledged physiotherapist that we can really delve into the more specific and advanced areas of practice and hone our skills to become experts in our field.

What is a Titled Physiotherapist?

If you think of a regular physiotherapist as a General Practitioner, a Titled Physiotherapist is the equivalent of a specialist. The Australian Physiotherapy Association (APA) defines a Titled Physio as “highly qualified physiotherapist with expert knowledge and skills”. That’s putting it pretty lightly. To be eligible to call yourself a “Titled Musculoskeletal Physiotherapist” you need to do your 4 years Bachelor of Applied Science (Physiotherapy), complete a 2 year Masters of Musculoskeletal Physiotherapy (making a substantial contribution to the field academically) followed by a minimum of 2 years full time clinical experience dealing primarily with musculoskeletal conditions. That’s nearly a decade of study right there.

What are the common areas of Titled Physiotherapy?

  • Sports medicine
  • Paediatrics
  • Animal physiotherapy
  • Musculoskeletal physiotherapy
  • Neurological physiotherapy
  • Gerontological physiotherapy
  • Cardio respiratory physiotherapy
  • Occupational Health and Safety
  • Continence and Women’s Health

What does a musculoskeletal physio specialise in?

Musculoskeletal Physiotherapists have expertise in the treatment of muscular and joint conditions. These rockstars have a comprehensive knowledge of anatomy, physiology, pathology, injury assessment and utilise up to date evidence based approaches to treating spinal and joint injuries. Musculoskeletal Physiotherapists are the experts in assessing the structures, contributing factors and mechanics causing your pain. Think of them as the pain doctors.

How musculoskeletal physiotherapy can help you.

  • Completely relieving or reducing your pain
  • Helping you to avoid future injury recurrences
  • Providing you with ongoing strategies and support to manage your injury or condition
  • Improving your flexibility, muscle strength, quality of movement and co-ordination
  • Enabling a quicker recovery and allowing you to your normal activities sooner
  • Assisting you to achieve your exercise or functional goals
  • Improving your fitness by structuring a personalised injury management training program
  • Prescribing exercises to do at home or in the gym to enhance your recovery

How common are Titled Musculoskeletal Physiotherapists?

Not quite as rare as hen’s teeth, but not far off. Did you know that less than 5% of physiotherapists attain the level of Titled Musculoskeletal Physiotherapist? Your local Dee Why physiotherapist, Damien Glover combines an expert understanding of anatomy and human biomechanics, the latest scientific methods and years of practical experience in the field to provide a multi-pronged program designed to combat a number of common musculoskeletal issues.

The multifactorial approach of a musculoskeletal physiotherapist to your examination allows us to accurately diagnose your condition or injury and highlight further influencing factors of what is happening with you. This deep dive into your physical health allows your Northern Beaches physio to design a bespoke rehabilitation program with short, medium and long term outcomes to ensure success and a pain free future.

High-five-mum

Junior AFL is beneficial for children in more ways than one

In previous blogs we’ve looked at some of the physical, psychological and social benefits that playing a team sport can have on children. Today we’re going to be looking specifically at Australian Rules Football (we’ll just call it AFL for ease of reading from here on in!) and some of the great effects it can have on kids’ physical and social development. As AFL continues to grow in NSW, so does physiotherapists’, Doctors’, psychologists’ and education expert’s knowledge of how AFL and other ball sports positively affect children and their development into young adults. Unfortunately my love of AFL can only be channelled through being able to support the physical needs of players and unashamedly cheering on the GWS Giants from the stands. Us sports physiotherapists aren’t much help to others when we’re injured, and I seem to be a target for big hits and big injuries (ask me any time about the number of surgeries I’ve been through).

This year I am going to be sponsoring the Balgowlah Suns Junior AFL Club and helping kids and parents to get a sports physiotherapists view of the biomechanics, preparation and recovery that go into every game. When prepared for properly, AFL is one of the safest sports children can play, with less physical contact than rugby league, more hand to eye co-ordination skills and more aerobic fitness. Getting kids into safe and fun sports is essential in combating childhood obesity and improving social development skills.

What are the physical benefits of AFL and programs like Auskick?

Children learn a variety of fundamental and advanced gross motor skills from kicking, handballing, catching, running, jumping and evading that will benefit them for future physical development and sports participation. Through regular training, children are also learning the basics of fitness conditioning and the basic principles and importance of health and nutrition.

  • Improved physical fitness
  • Increased hand-eye coordination
  • Better aerobic capacity
  • Strengthening muscles and bones

How does AFL improve psychological and social skills?

Children who play physically active team sports are more attentive, have a more efficient memory, enhanced creativity, better learning adaptability and problem solving and attitude regulations abilities.[1] AFL Juniors have to make rapid and complex decisions during the game while remembering certain structures of play and achieving pre-defined goals. This allows children to adapt to a variety of situations off the field more efficiently with the neuroplasticity of the brain creating new neural pathways at an astonishing speed in young kid’s brains. Yes, you read that correctly, football gameplay learning makes kids more adaptable. There’s more good news though.

Children who participate in team sports develop important social skills, a sense of belonging and camaraderie much faster than kids who don’t. The President of the International Council for Sport Science and Physical Education, Professor Margaret Talbot once stated ‘Sports and other challenging physical activities are distinctively powerful ways of helping young people learn to ‘be themselves’.[2] These benefits flow positively through children’s lives and the broader community is better for it too.

  • Better communication skills
  • Fosters a sense of self belief
  • Improves concentration and cognitive function
  • Increases teamwork skills
  • Builds a sense of mateship/belonging
  • Make a ton of new friends

Good preparation and recovery is vital

Preparation and recovery is much more than hitting the carbs the night before and a bottle of powerade in the morning (more on why you shouldn’t dose your kids with powerade in a following article). It is important to stay hydrated leading up to and on the day of the game and eating a balanced, nutritional diet is going to help keep kids fuelled up for the big game. Complete a warm up and cool down including stretching, slow jogging and running activities, with and without the football to minimise the risk of muscular and joint injuries.

Get a musculoskeletal screening test

Wouldn’t it be cool to be able to see into the future and prevent an injury before it happened? Musculoskeletal screening tests aren’t quite looking into a crystal ball, but they are becoming increasingly backed up by numbers and science. Do you think the pros step out onto the pitch and just hope that their body has it in it that day? They have an entire team of physiotherapists, sports scientists and strength and conditioning experts monitoring every step that they take. Musculoskeletal physiotherapists test a range of movements and take measurements to create a physical profile that will identify areas that may be more susceptible to an injury. Musculoskeletal screening tests have been shown to be an accurate and reliable indicator of specific injuries in AFL players.[3] Finding a Dee Why sports physiotherapy expert is crucial to ensuring any musculoskeletal screening tests are comprehensive and accurate, otherwise you may actually be putting yourself or your child at risk of suffering an injury.

AFL is an all round awesome sport for children to help grow and adapt so many skills that are going to benefit them in later life, not to mention they get a real kick out of it! If you have any questions about all sports physiotherapy or musculoskeletal screening tests for AFL or other sports, get in touch with The Beaches Sports Physio on the Northern Beaches at info@thebeachessportsphysio.com


[1] Erwin H, Fedewa A, Beighle A, Ahn S. A Quantitative Review of Physical Activity, Health, and Learning Outcomes Associated With Classroom-Based Physical Activity Interventions. Journal of Applied School Psychology. 2012;28(1):14–36.

[2] http://www.icsspe.org/

[3] Reliability of common lower extremity musculoskeletal screening tests Belinda J. Gabbea, Bennellb, Wajswelnerc, Finch. Physical Therapy in Sport 5 (2004) 90–97

Photo: High five mum by Mike Hauser (2008) https://flickr.com/photos/35314767
Attribution (http://creativecommons.org/licenses/by/2.0/)
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7 easy ways to find an expert Dee Why physio

Searching for and finding the right physio for your needs online can feel like searching for a needle in a haystack. You could spend hours searching through Google for the right sports physio, musculoskeletal physiotherapist; even narrowing down your search to Northern Beaches physios is likely to give yourself an extra headache! So how do you find the best physio for your condition? Like many other health professions, physiotherapists have a vast array of areas of expertise.  All practitioners have to be highly educated and officially registered to practice with the governing body, adhering to strict standards of service.  Working out which physiotherapist can treat your specific condition requires more than simply typing in to Google. Luckily there are a number of hints and tricks to finding the right local physio for your needs, by following these tips below you will go a long way to finding that special someone.

Check for what areas the physiotherapist specialises in

Physiotherapists cover a huge range of areas of practice and not all physios are experts in the type of pain or condition you are suffering from. You wouldn’t go to a podiatrist to get an eye test, so why visit a physio who doesn’t specialise in the area of pain you are experiencing? For example, when it comes to musculoskeletal physiotherapy, did you know that only 5% of practicing physiotherapists attain the rank of “Titled Musculoskeletal Physiotherapist”? The Australian Physiotherapy Association (APA) defines a Titled Physio as “highly qualified physiotherapists with expert knowledge and skills. They undergo a rigorous selection process to ensure that they achieve and maintain exceptional standards of clinical experience and knowledge. The APA Title serves as a professional mark of distinction.” For issues like Back and neck pain, Nerve pain (especially sciatica, carpal tunnel), Chronic injuries, Arthritis/osteoarthritis and other aging related pain, postural dysfunctions including scoliosis, kyphosis (hunched back) and flat feet – don’t sell yourself short by visiting a physio not ranked in that top 5%.

Ask your doctor for their advice

Many Northern Beaches doctors work hand in hand with highly trained physiotherapists to treat long term and immediate physical pain for their patients. They are some of the best people to give advice on who to see in the local area with the skills and specialisation to help you recover faster.

Phone a friend

There aren’t many better ways to finding the right physio than getting a referral from a friend. Getting confirmation from a friend on the skills of a physio will give you much more insight than Googling away aimlessly for hours. They’ll be able to give you firsthand knowledge of their expertise, bedside manner and obviously on whether or not they were able to help their own issues.

Check on the Australian Physiotherapy  Association

Not checking to see whether a physiotherapist is registered with the Australian Physiotherapy Association is like playing Russian roulette with your musculoskeletal system. If they aren’t registered on there, you might as well go and see Doctor Nick from the Simpsons.

Consult Facebook and have a look at relevant groups on social media

It’s become increasingly common today for Facebook groups related to sports and health and fitness to share stories about their injuries and post reviews of their tips and experiences with various sports or injury related professionals. If you’re uncertain, put a post up along the lines of “Does anybody know an awesome physio that specialises in lower back pain in Dee Why” and you’re bound to get a few bites. Always check and verify their advice with other methods though!

Consult Doctor Google

Once you’ve narrowed your search scope down, it is important to check Google reviews and other community reviewed websites to check what the word on the street about the physio is. Keep in mind again, Google reviews aren’t the be all and end all, but they do play an important part in finding a reputable and skilled physio for your needs.

Ask for a referral from your local sporting club

If you play in a team or individual sport, it is likely that your club has knowledge of physiotherapists that are reputable and skilled in specific areas of the body. Sporting clubs don’t just recommend any old physio either, because they are made up of trained and skilled individuals themselves, the last thing they’d be doing is recommending a physio with a Kelloggs Cornflakes degree.

Finding the right Dee Why physio can be a daunting task if you don’t know where to start. By following those tips and verifying claims and data between a number of different sources and referral points, you are much more likely to find a physio who is capable of looking after your pain or injury in the most professional and up to date way possible