is only in its 3rd day but interest has been amazing. I’m heartened to hear all the people who talk about the many benefits of massage. If you go to the site you’ll see a lot of info on the many benefits of massage, but I thought I would talk from a physio perspective about how I have found massage to help.

Differences between physiotherapy and massage I often get asked the difference between physio and massage. Massage is the manipulation of superficial layers of muscle and connective tissue to enhance the function and promote relaxation and well-being (wikipedia)

Physio is more about restoring abnormal movement patterns, improving posture, mobilisation of joints as well as muscles and many other forms of treatment such as electrotherapy, taping, exercise therapy, education ergonomics etc.

Massage combines very well with physiotherapy though and we are taught to do some ourselves in our course, although nowhere near as much as most trained massage therapists (when I first met my wife a trained massage therapist who had done years of study I realised how little I knew!) We also have a lot of other things we need to do in a physio session so I tell my clients if you enjoy the small massage component in my physio session to have regular massage in addition to the physio.  I do caution though great though massage is it won’t help get your strength back -you still need to do exercise, but massage can help to make the exercises easier to do)

Total Knee Replacement

http://orthoanswer.org/knee-leg/knee-replacement/definition.html

Massage after total knee replacement is one of the most effective treatments I have found to speed the recovery from what is more often than not a VERY painful experience (am not trying to scare you off here a lot of people don’t have any choice with OA knees, and just about everyone comes good eventually, it can just be very trying in the first 6 weeks particularly). Massage helps to move the fluid and get the scar tissue moving, helps decrease pain levels, and restore sensation and normal movement (particularly knee bend which we physios and doctors are so obsessed with -the magic 90 degrees you will need before leaving hospital)

CAUTION A couple of big things about massage though – 1/ In my opinion it should not cause pain. You can get an area to loosen up without pain (a little discomfort occurs sometimes but this is a lot different from pain) Listen to your body, frequent light massage works better I find than really hard massage done occassionally. This can often just cause more tightness and swelling (defeating the whole purpose of massaging!)

2/ Make sure you are medically safe to do so, and that there isn’t wound ooze or risk of infection -check with your health professional if unsure)

Besides these two things massage is generally safe TKR particularly once the wound has healed over and scar tissue (like a scab) has formed. Most of the problem getting movement and strength I find comes from the fluid and the scar tissue. This is a result of the surgery trauma -I often say to people post knee you have a good brand new knee in there its just that you are recovering from the operation! My first two patients I treated I watched their TKR being done -it was absolutely horrendous to watch and I said to them afterwards if you saw what was done to your knee you would know why you are so sore!)

It always amazes me though the number of clients I see who went through their entire hospital stay without having a massage or even being told that a massage will help the pain, swelling and scar mobility! Massage (and exercise in water, you can even do both massage and exercise in water) really helps to get things moving post knee replacement, and makes it easier to do the physio exercises to regain knee strength that are also REALLY important. I find though that those clients who have massage really seem to tolerate their exercises better, and with less pain, than those who just do exercises alone. Its common practice for people who have undergone cardiac or breast surgery to be encouraged to massage, I hope one day everyone who has a total knee replacement is given the same advice. I’ve yet to see good research on massage post TKR but I can tell you firsthand after treating many hundreds of people that it really does work!

And you don’t have to have had a knee replacement to benefit from massage. Its a great form of preventative health care and not just for those in pain. Visit www.massageproject.com for more information on benefits of massage. Our aim is to inspire more people to look after themselves and experience massage and its health benefits!

Background - As a physiotherapist I’ve been a huge believer in the therapeutic benefits of massage for years (endless studies have shown beneficial effects on sleep, depression, immune system, pain, the list goes on and on). Every day I encourage my patients to have regular massage to relieve current problems and prevent new ones developing.

The amazing thing I always find though is the reluctance for people to have massage, that it is somehow a “luxury” rather than a necessity to help maintain good health. And even those that listen and do get massage do it so infrequently that the benefits are small. I find even a lot of therapists themselves spend all their time helping others, and rarely receive massage themselves.

My wife is a good example. She used to be a massage therapist, but now works tirelessly helping animals, running a horse rescue charity, writing and helping with my business. Every day she helps others, but like most of us finds it hard to help herself. She has had chronic health problems for 20 years — including fibromyalgia, insomnia, sero-negative arthritis, hypothyroidism, rheumatism, spinal degeneration (and recurrent numbness in her arms), chronic digestive issues and reflux, and recurrent wrist, knee and ankle problems. Despite these challenges she gives and gives to the world, rarely complaining about her problems.

When I first met her I tried everything I knew as a physio to help her. She has tried so many different therapies, and while she has had good short term results, little has changed for her in the long run.

I have often bought my wife massage vouchers over the years. She always feels great after a massage but she puts off getting them, often months after I’ve gotten them. Commonly she feels guilty about the money, or that she isn’t worth it. I found the only way to get her to have the massages was to just keep getting them for her until she used them!

I thought about this and came to the conclusion that the best way to help her chronic health problems, and for her to get in the regular habit of receiving massage would be something dramatic.  A massage every day for a year!

THE MASSAGE PROJECT

30 minutes massage every day for a year

Monitored by a GP to see if changes in blood levels, blood pressure etc Also quality of life outcome measures, range of motion, muscle strength, amount of sleep and medications. As far as I know this is a world first: no one has ever monitored the effects of a massage every day!

Detailed blog of experiences, and review of the different massages used (www.massageeveryday.com)

What will be the end result? Subscribe to the blog and find out!

The basic premise is something anyone who has come to treatment with me knows I believe in wholeheartedly -the body is VERY connected! Even small abnormalities in movement can cause a “chain reaction” of tightening and pain around the whole body. And small movements can in turn remove this pain. You can GAIN without PAIN to turn around a phrase I have always disliked!

I first came across Finch when my wife Jo was recommended the treatment by her doctor. I (and other physios and chiropractors) had been treating some of her connective tissue pain with a variety of methods for several years, with up and down results. I was amazed when Jo came back doing TINY little movements (so small I could barely see her moving) but the improvement she had was phenomenal. She credits most of her improvement now to Finch as well as NET (Neuro Emotional Technique, which I’ll discuss another time). I fully admit I was a bit skeptical too, despite the results. I went along myself and had some treatment from Kym Finch (the founder of the therapy) for some thoracic tightness that hadn’t resolved even with all the massage/stretching/yoga/gym/hydro I was doing. Within 2 visits all of my symptoms have gone, and they have only returned once (had been good for months, was just when I was slack doing my maintenance finch exercises! I’m human too!)

I finished the course in Finch therapy in May and have been using the therapy with EVERY one of my patients since, and the results have been sensational. It doesn’t “fix” structural problems (mostly works for postural problems) but even the structural problems I’ve found it helps with, for example taking pressure off a bulging intervertebral disc by reducing muscle strain in the region.

To find out more about how it works and some great pictures have a look www.finchtherapy.com.au

The hardest thing I find about Finch is my client’s not believing at first that such GENTLE movements could create such amazing changes in their body. But when the pain goes away, and they see their movement come back, like happened with my wife and I, the skepticism fades!

I had one patient I used to see who has spinal stenosis, that made his leg muscles very tight. I had been treating him with all the techniques I knew how when he came in with tight leg muscles that would only stretch out to 1/3 of their normal length. By the end of 30 minutes of hard work from both of us, I used to get them to 2/3 length. However he would just come back each time again back to his 1/3 length again. Very frustrating for him! After I learnt how to do Finch Therapy this year, I assessed him and found he had a lateral pelvic tilt (cause of a lot of problems I since found out!) and we improved his length to 100% within a minute of treatment JUST by doing a simple little exercise on his side.

I don’t want to overstate Finch’s benefits because it can’t help everyone, but I fully believe it will revolutionise the treatment of musculoskeletal pain in Australia. I had done physio for 11 years with great results, but Finch just took what I was doing already and improved the results immensely. I am currently the only physiotherapist to have studied this technique, but am hopeful my colleagues come on board soon, the results are amazing!

To book in for a physio session (I now do a Finch assessment with all my patients as well as my usual treatment) or find out more about Finch or anything else I do please feel free to call me directly on 0410 758 193. 

And any practitioners out there, feel free to call me or email blueribbonphysiotherapy@gmail.com to discuss it as well (I don’t have any arrangement with Kym to promote her therapy, I just believe in it wholeheartedly and feel it should be out there to more people)

As a physiotherapist I’ve heard many people tell me about how uncomfortable (and boring) most crutches are. People have often come to me with chafing, sore hands, and complain grey or wooden crutches don’t go with any of their outfits. They also feel that veryone stares at them as “that person with the crutches”. Most people hate using crutches!

I had a friend who suffers from a disability contact me and ask if I knew anywhere that sold coloured crutches in Australia. I didn’t, so went researching and couldn’t find anywhere that did other than Europe. I got in contact with the German manufacturers, Kowksy who organised for me to be their distributor in Australia. And the rest as they say is history! Our coloured crutches are now in hospitals and private residences around Australia, and available online www.standoutcrutches.com.au

We chose the name “Stand Out Crutches” because of the idea -why just stand up, when you can stand out!

Normal crutches only come in grey (metal) or wooden, not exactly possible to colour co-ordinate or express your personality! Our range of coloured crutches can be chosen in a variety of fashionable colours, or someone can design their own colour combination (from hundreds of possible combinations). They are not just stylish, they are also much more comfortable, stylish and ergonomic to use than conventional crutches.

We are also donating $20 from the purchase of every pair of pink crutches to Think Pink- the Wesley Hospital’s Kym Walters Choices program.

 So if you want to brighten up the life of someone needing to use crutches, send them along to our website www.standoutcrutches.com.au

I’m really excited by the chance to get these crutches out into the world. I look forward to the day when every ward has a bit more colour in them using coloured crutches, and grey chafing crutches are a thing of the past!

Beautiful Yarraman (from www.yarraman.net)

Blue Ribbon Physiotherapy will be starting on the 9th of April at Yarraman! We will be offering a weekly physiotherapy service from Dr Carr’s surgery at 20 Miller Street Yarraman. Every Friday we are looking forward to the chance to help people in the Yarraman/Blackbutt region who have often had to travel long distances to access physiotherapy in the past.

Our fees will be subsidised in this region because of the generous support of Dr Carr providing his rooms free of charge to help get a physiotherapy service into the region. We are grateful to Dr Carr and excited about the opportunity to work in the Yarraman area.

For those not familiar with the beautiful town of Yarraman check out

www.yarraman.net

Initially when I started my hydrotherapy training, deep water running was mainly used by athletes to either use for cross-training along with other exercise, or for keeping their fitness while rehabilitating. However I found through working at the Wesley Hydrotherapy (now closed) that it was excellent for a large number of medical conditions. These included cardiac rehabilitation patients (because of the water pressure, there is improved cardiac output in water, so the heart rate doesn’t tend to rise as quickly ie the heart pumps out more blood rather than having to go faster -very good for those who have just had a heart attack although need to be carefully supervised and medically screened). We also started using it for people who had had strokes, arthritis and for weight management. It was also very effective for lymphoedema and swelling reduction, aided by the hydrostatic pressure and the moderate-to-vigorous exercise getting the circulation going.  I had clients unable to walk 50m due to arthritic pain who could work in the pool at intensities similar to treadmill running for an hour and a half. All without as much sweating, soreness and load on the joints!

There are a number of techniques for deep water running (best determined for you by your physiotherapist -often not easy to see your own technique) I find the easiest for most people to start with that supported by either a deep water running belt, or sitting on a noodle, breastroking movement with the arms and a cycle with the legs. The spine should be straight but not too straight (around a 10 degree forward lean is usually recommended) Another style is running with alternate arms and legs, in a more traditional “running” style. This can be achieved by imagining you are dragging a piece of paper behind you with your feet pointing and your hips fully extending (very good for gluteal strengthening). Cross country skiing is the same thing except the elbows and knees stay straight throughout (propulsion is achieved via turning the hands pushing with the palm each time) This one is quite hard to master but gives some of the best resistance by creating water movement in both directions. One of my favorites is “hands up” running, which as the name implies has the hands up and just using the legs. The equivalent for the upper body is “breastroke arms” where the arms breastrokes but the legs don’t move. The legs can be either bent (easiest) or out straight in front of you (hardest)

You are really only limited by your imagination and fitness/mobility level on what you can come up with. You can run with leg or arm weights, try tethered running (where a belt is tied to the wall and you run away from it), or run without a belt or noodle at all (very hard work! You do by pushing down VERY hard like you are climbing a ladder) You can alternate your speed, do interval training, endurance work -all tailored to your individual needs.

 If you have your legs too far out behind you though you will find it hard to stay straight and you will lean forward excessively (and this is why deep water running not great idea initially for those who aren’t that confident in the water because you need to be able to get yourself up off your tummy and either swim to the side or right yourself)

Pool noodles also known as "woggles"

The cheapest way to do deep water running is to just sit on a noodle (can get from many discount stores for around $3) These are fine for most people. When you start getting better at deep water running, or if you need additional back support, the deep water running belts are best. You will sit lower in the water than you do with the noodle, and there is also more of a tendency to lean forward, so you will also work harder than if you are on the noodle.

Features of our AquaJogger running belts

Aqua Jogger deep water running belt

COST - $65 See our equipment page on how to order

Low Profile pillow

Pillows are a very individual thing. People often try lots of pillows before finding the right one for them. The trouble with cheaper pillows is that they are too flexible and our neck can get into all sorts of bad positions during the night as we move around.

Contour Pillows are designed to mold your neck into a neutral (neither looking up or down) position (see the pictures and have a look at how the spine strays straight on the pillow) This can be very effective in helping neck and back pain (since the spine is very connected poor position of the neck can influence the lower back as well). And changing your pillow is a much cheaper idea than changing your mattress! It is recommended to change your pillow every 1-2 years.

http://www.healthpress.us/4-key-benefits-of-contour-pillows/

Low profile -With optional neck support heights of the front and back edge rolls, this “Low Profile” pillow is overall 2.5cms (1″) lower than the companion “High Profile” pillow.

This lower contour should best suit smaller framed people who sleep on their side, or most people who sleep on their back. With your head in the contour and your neck positioned on the raised edge roll you are provided with the best therapeutic support and with the ideal posture for correct spinal alignment

High Profile – This higher profile is best suited for medium or larger framed people who sleep on their side. (Back sleepers should be on a lower pillow). With your head in the contour and your neck positioned on the raised edge roll you are provided with the best therapeutic support and with the ideal posture for correct spinal alignment.

NOTE -There is no guarantee that a contour pillow will improve your neck/back pain. However it is worth a try if you wake with a stiff/painful neck in particular. I have found over the years that the Denton brand works for the majority of those with neck/back pain, but as I said at the start, pillows are a very individual thing.

Cost -$77 See our equipment page for details

Pic by Franklin Dattein

In response to many enquiries about equipment sales, and the difficulty of our patients sourcing equipment themselves from Brisbane, we are pleased to announce that we will soon be selling physiotherapy equipment from our website. We plan to start with TENS machines, leg weights, theratube, and back and posture braces, as well as exercise balls. Stay tuned for more details.

Based in south-east Queensland, Australia, Charlie’s Angels not-for-profit organisation rescues and rehomes horses that have been abused, neglected abandoned or are homeless. In particular, they strive to rescue horses from “dogger” sales (horses bound for slaughter to be either pet food or horse meat exported to the likes of Europe and Japan).

Blue Ribbon Physiotherapy offers all financial members of Charlie’s Angels Horse Rescue a 20% discount on services. Members should present their membership card to claim your discount.

Go to the Charlie’s Angels website to read all about the benefits of becoming a member of this worthy cause.

It’s not as easy to answer as you think. What does ‘hard’ mean? What does ‘easy’ mean? These are all relative terms. One person might find doing twenty minutes of walking ‘hard’ while another might find climbing a mountain ‘hard’.

In part 1 we looked at heart rates as a way of measuring how ‘hard’ you should exercise.

Part 2 is much simpler. No maths or calculators required! It’s The Talk Test. Simply put when you finish your exercise you should still be able to talk without gasping or straining. That’s it. Simple