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6 Golden Rules for Osteoarthritis

Osteoarthritis (OA) is an incredibly common condition that can affect anyone, but is usually more prevalent in people over the age of 40, or with previous joint injuries. The joints may feel stiff, make clicking or grating noises, and can become aggravated with activity. Source: Arthritis Australia

Osteoarthritis myths

It is a condition that sparks a lot of anxiety and fear, because for eons we’ve been told scary stories about this musculoskeletal boogeyman. You’ve probably heard it’s a “wear and tear” condition, along with other scary descriptors such as “bone on bone”, “degeneration”, “bone spurs”, etc. But those descriptions are both inaccurate and inappropriate. For the majority of people living with osteoarthritis, they are able to do just that; go on living! It may seem counterintuitive, but exercise and movement is perhaps the greatest medicine available for your stiff and sore joints.

Okay, not the boogeyman, what is it?

In OA the joint space does become narrower, as the cartilage that lines the bone becomes thinner. But it isn’t load and exercise that “wear and tears” the cartilage, in fact osteoarthritis is often less common in runners! Research shows us now that rather than just mechanical load on the joint (i.e. running, skiing, tennis, basketball, etc), it is caused primarily by a biological process (involving hormones, chemicals, proteins, etc).

Why does it hurt?

knee pain

All right, I can hear what you’re saying; “who cares why it happens, it still hurts when I use it!”, so allow me to explain. Understanding your pain is the key to reintroducing exercise in a safe and helpful way. The origin of your pain isn’t the cartilage itself – it doesn’t have any of the nerve endings that sense and transmit pain. It’s not the bone either – again, no nerve endings! Pain is an incredibly tricky phenomena that is best explained to you by a health professional with knowledge of your specific circumstances, I highly recommend talking to any of the Osteopaths or Myotherapists at Peninsula Osteopathy + Allied Health. Pain doesn’t indicate the level of change within the joint. Pain does not equal damage. Have you ever had a papercut? Ouch! Stubbed your toe on the coffee table? Stepped on a runaway Lego block? You get my point… Pain is an alarm, warning you of the potential for danger, but it’s not an alarm you’d rely on daily to get out of bed.

There are three main structural origins of pain in OA. Firstly, the periosteum, a thin tissue that covers the bone like Gladwrap. Second, the synovium, the tissue that encapsulates the joint, like a balloon. And lastly, inflammation and oedema, this is the influx of chemicals and hormones designed to heal the area. All three of these can contribute to pain in varying amounts, but there are other pain factors to address with your health practitioner, such as; sleep, stress, diet, mood, activity levels, comorbidities, and more!

What can I do about it?

After an OA diagnosis, people often try to minimise the “damage” by reducing their exercise, walking less and even ceasing the leisure activities they love most. But what you’re really sacrificing is your cardiovascular health, mood, mental wellbeing, bone density, muscular strength, and increasing your risk of a variety of chronic conditions. Exercise can improve the metabolic factors associated with your condition and allow you to move more efficiently. A progressive reintroduction to exercise, guided by a health professional, can improve your osteoarthritis and reduce your risk of other conditions.

6 Golden Rules

1. Talk to a health professional
The Osteopaths and Myotherapists at Peninsula Osteopathy + Allied Health can provide a thorough assessment of your condition, function, mobility, and strength. They can accurately diagnose your condition and answer any questions you may have about it. They can help to address lifestyle factors that may be contributing to your pain. They can provide expert manual therapy to ease the aches and pains associated with your condition. And they can help guide a progressive and individualised plan to get you up and moving!

2. Reconsider your X-Rays
X-Rays, MRIs and other images are useful tools for identifying sinister conditions, however it can often be alarming to see the different changes to our body on an image. Unfortunately, findings on imaging often correlate very poorly to pain and function1. People with no pain can have drastic irregularities on their images, and others in great pain can show next to nothing! Talk to your practitioner about what your images mean for you.

3. Aerobic exercise
This type of exercise involves raising the heart rate and is where a lot of the cardiovascular health benefits come from. Start small, doing a little more than you currently do, and gradually increasing it – under the guidance of your health professional. Walking, jogging, swimming, and cycling are great aerobic activities, but the best exercise is the one you enjoy doing. Maybe you used to play tennis, or maybe you want to get into golf, there is no shortage of ways to raise your heart rate and get moving.

4. Resistance exercise and balance
Moving your body against resistance and trying not to fall over. There are many bodyweight exercises that can achieve this, and with the addition of a few resistance bands or small weights, you’d never have to step foot in a gym if you didn’t want to. Again, speak to a health professional to learn which exercises will suit you, how to do them, and how often.

5. Diet and lifestyle
Familiarising yourself with Australia’s Dietary Guidelines can help guide you on the types of foods you should be eating on a regular basis. Diet and metabolism affects the hormonal and chemical processes that can increase joint pain and other health conditions. The odd Tim-Tam won’t hurt, you’d be shocked to see the food cupboard in the POAH tea room, but eating well as regularly as possible will go a long way to your health.

6. Don’t let pain rule you
If you wait for pain to dissipate completely before you begin exercising, you might never exercise. It is normal to feel some discomfort after increasing your activity levels, if your pain levels are tolerable and stable – within 3-4/10 – you shouldn’t fear continuing your exercise regime.

References
Guermazi, A., Niu, J., Hayashi, D., Roemer, F. W., Englund, M., Neogi, T., … & Felson, D. T. (2012). Prevalence of abnormalities in knees detected by MRI in adults without knee osteoarthritis: population based observational study (Framingham Osteoarthritis Study). Bmj, 345.

Jaw Pain? Look no further!

The letters TMJ stand for temporo-mandibular joint, the joint attaching your jaw to your head. You can feel it moving in front of your ears when you open and close your mouth.

Your jaw region contains muscles, bones, joints, ligaments and membranes which all play an important role in jaw function. Dysfunction or irritation to these structures can cause pain. Pain in the jaw can also be from distant structures, for example upper neck pain can refer to the face or even pain originating from the heart can be experienced as facial pain.

Problems with your TMJ can present as:

– Clicking or popping with jaw movement
– Locking with opening or closing of your mouth
– Pain with chewing, talking or yawning
– Tender points on muscles around the jaw
– Clenching of teeth throughout day or night

Treatment for TMJ dysfunction depends on the cause. If it is due to postural or muscular problems, osteopathic treatment can help to reduce your symptoms and relax any jaw muscle spasms you may be experiencing. Your osteopath may teach you some exercises or stretches to do after treatment, which will aim to help further reduce your discomfort. Jaw pain can be complex and may require a multi faceted approach. If symptoms persist you may require a referral to an orthodontist, or if problems are related to stress, implementation of stress management techniques may be required.

If you feel like any of the above symptoms are describing what you may be feeling, give us a call and we will do all we can to help!

3 TOP TIPS FOR YOUR HIPS

Hip Anatomy and Impingement syndrome:

The hip joint forms a solid connection between the lower limb and pelvic girdle, thus meaning it is designed for stability and weight-bearing rather than to offer a large range of mobility. The joint is a ball and socket joint formed between the thigh-bone (Femur) and the pelvis (acetabulum) and gains its stability from large supporting ligaments and muscles.

In the healthy hip joint the femoral head is able to glide smoothly within the socket of the acetabulum however this can be impaired in patients who suffer from femoral acetabula impingement syndrome (FAI). Hip impingement or FAI is a condition in which the structure of the hip joint become modified causing an impaired capability of the femoral head to move freely and smoothly within its socket. Typically this will present as stiffness or tightness of the thigh, hip or groin, poor ability to flex the hip past a right angle and pain in the groin or front of the hip when flexing the knee towards the chest, running/cycling or sitting for periods of time.

FAI commonly arises from high impact sports or exercises that involve a large amount of jumping, changing direction and recurrent movement of the hip joint outside its normal range (such as football, dancing and golf) placing excessive and abnormal load through the hip joint. The stress of ongoing excessive load can lead to either a thickening of the femoral neck (CAM lesion) or deepening of the hip socket (PINCER lesion), or a combination of both which over time can result in damage to the cartilage of the hip joint.

In other cases FAI can be present from birth and be largely asymptomatic until later in life.

What are my treatment options?

In some cases surgical intervention may be required for successful treatment of FAI however there are many conservative measures that can be taken to improve hip functionality and reduce symptoms associated with FAI.
Osteopathic treatment may be able to assist in reducing symptoms of FAI. It is not uncommon with FAI for the muscles of the hip, pelvis and lower back to become tight acting on further limiting the range of motion available at the hip joint. Treatment of soft tissue massage and muscle stretching techniques can be used to help relax and lengthen these muscles, assist in reducing inflammation and ultimately reducing pain.

Exercise based rehab focused around promoting hip mobility may also assist in the ongoing management and reduction of symptoms – Here we have provided you with 3 of our favorite at home stretches and exercises to give a try!

1. Kneeling hip flexor stretch

2. Pelvic bridges

3. Hip adduction stretch (Frog stretch)

If you are currently suffering from hip or groin pain and would like further personalised advice on treatment and management options feel free to contact the clinic today to discuss whether Osteopathy or Exercise Physiology may be able to get you back into what you love doing!

Say good bye to headaches and get on with your day!

Headaches describe any pain to the head or face and are one of the most common conditions amongst Australians, with 20-25% of adults suffering from chronic tensions type headaches.
Headaches can occur at any age and seriously weigh you down and interfere with your day-to-day life.
The good news is headaches are generally not serious, and can be easily treated. However, we recommend you consult with your doctor if you are suffering from any of the following:
• New type of headache that appears suddenly and is getting worse
• Symptoms of slurred speech, confusion, weakness in your limbs and drowsiness
• Headache that comes on suddenly when coughing, sneezing, laughing or movement
• Headache following serious trauma to the head or neck

Why do I have it?

If you have recently started a new medication or been involved in a traumatic incident resulting in a bump or knock to the head, it is likely that your headache has occurred as a secondary response to this. It is important to consult with your doctor in these circumstances.
Quiet often it may seem as though your headache has come on for no apparent reason and you can’t seem to figure out why, but there are a number of things that can lead to headaches. Typically when the muscles and joints of the neck become tight and aggravated this causes inflammation and stress that may manifest as a head ache and will often feel like tension or a pulsating feeling in the front, side or base of the head.
Common reasons that cause the neck to become aggravated and cause headaches include poor posture – particularly with desk based jobs and students, stress, poor/lack of sleep and eye strain/squinting.
Other causes of headaches include dehydration, skipping meals/poor nutrition, caffeine withdrawal and hormonal imbalances.

How long until I get better?

The time it will take for your headache to get better will depend on the cause of your headache. Once we determine the cause of your headache, it is easier to estimate how long till you will get better. With appropriate management and advice you can often say goodbye to your headaches within 2-4 weeks.

How do I get better?

Increase your fluid uptake. When you first feel a headache coming on drink plenty of water! Often a headache is our body’s way of telling us that we need to drink more water.
Rest – Getting plenty of rest is beneficial for both your physical and mental health and so can contribute to reducing your headaches. Allowing time to get adequate sleep and rest may help to reduce physical symptoms of headaches as it allows our body to recover. It may also assist in reducing stress within the body that may be resulting in maintaining persistent headaches.
Heat helps to encourage nutrient flow to tissues of the body and promotes muscle recovery. Therefor applying heat to the base of the skull at the end of a busy day can have lasting benefits in the treatment of headache disorders.
If you are still finding it difficult to shake those headaches, Osteopathic treatment may be beneficial. An Osteopath may be able to use a range of techniques including soft tissue massage, joint stretching and movement to address and correct postural imbalances that may contributing to your headaches. An osteopath may also be able to provide you with advice on correct desk set up, stretches and exercises to have you back on the road to recovery and on your way to a headache free life. Typically it may take 2-4 weekly treatments to get on top of your headaches, followed by 2-3 fortnightly – monthly reviews.
If you require more specific advice relating to your headaches or aren’t having success with the above consult with your health care professional.

What can I do to stop it coming back?

There are a number of at home stretches and exercises that you can perform to reduce your likelihood of experiencing headaches we have outlined a few below for you to try.
Taking regular breaks whilst sitting at a desk for work and/or study is essential in maintaining and preventing your headaches. Taking 30 seconds to stretch out the muscles in your neck will help to keep the muscles in a healthy state and contribute to overall neck mobility.
Whilst sitting at your desk for work or study try to pull your shoulder blades back and down towards the ground to assist in achieving optimal posture.
Keeping mobility through the mid back and neck assists with keeping joints healthy, and may decrease your headaches. A simple exercise to maintain mobility in these regions is the cat and camel exercise. This is performed on all fours and involves alternating between drawing the spine to the ceiling to form a “hump” (like a camel), and drawing the spine towards the ground and looking up to the roof (like a happy cat).
As most of us spend majority of our time at our work stations, having an independent assessor come in to evaluate your desk/station set up to ensure it is in a way the best benefits your health. An optimal work-station set up will limit extension through your neck and therefore decrease strain through the muscles at the back of the neck. This can easily be achieved by altering computer screen height, desk and chair height. A workplace ergonomic assessment can be organised with assistance from a healthcare professional.

The osteopaths at Peninsula Osteopathy + Allied Health are all qualified to assess the cause of your headache, and can offer treatment and management advice! Call us on 5253 2345 or book online today!

Is your low back holding you back? Here’s how to manage it!

Managing your low back pain

Most of us have had some sort of low back pain before. From a minor ache and tightness that resolves in a couple of days to more intense, sharp pain that can take a little bit longer and be much more intimidating and frightening!

Regardless of the severity and the duration, there are a few things you can do to make sure that the pain doesn’t linger and affect your life anymore than it has to.

These are some tips we end up saying to the majority of people who present to us with various types of low back pain.

But of course, if there are more serious symptoms like pins and needles, numbness and weakness in your legs then it is important you seek a healthcare professionals opinion.

Keep moving and stay at work

This is probably the most important thing that you can do. Movement is the best medicine for any episode of low back pain. Go for gentle walks and do some gentle stretches. Keep that back moving. Also returning to work and if needed, returning with modified duties improves your chance of recovery and decreases how long your low back pain will hang around for. Some activities may need to be modified to make them easier for you to do and your healthcare professional can help you with this.

Use heat, not ice

A lot of confusion about whether to use heat or ice exists in the community. Of course it depends on the type of your back injury, but generally in acute back injuries or in back injuries that have lasted a long time there is unlikely to be much inflammation, so icing the affected area is unlikely to help. Using heat instead can help relax and decrease the tension in those tight back muscles and help you feel and move better.

Hands-on treatment can help

Your healthcare professional (osteopath etc.) can give you information on what is happening, why you are in pain, recognise if something more sinister is going on and educate you on what you should and shouldn’t do. They can also help relieve some of those aches and pains and give you stretches and exercises to help keep you moving.

Some medications may help, but try conservative treatment first

A great adjunct to movement and hands-on treatment is the addition of certain medications. Speak to your doctor or pharmacist about what may be suitable for you, dependent on your past medical history and complaints. This may not be a long-term option so it is important that medication is used in conjunction with some of the other strategies we have mentioned above.

Stay positive

Above all else, stay positive. Most episodes of more acute low back pain settle within a few weeks and rarely have a longer lasting impact on your quality of life. Keep moving, modify a few things and let the body do its job. Our bodies are amazing at healing themselves and some things just take time.

For personalised advice regarding your low back pain come in and see one of the PO+AH team to help you on your recovery.