Physio Plus, Physiotherapy, Massage Therapy, Pilates, Christchurch, New Zealand

To view our range of archived newsletters click on the links below:

Welcome to our second newsletter of the year. I think with the current weather conditions we have to finally admit that winter is well and truly on its way, if not upon us already!

Despite the weather our PhysioPlus Fitness classes continue to run on a Friday morning, transferring to our Ferry Rd clinic should the weather not be suitable. With the radio turned up to get you moving, and the heat pump on to keep everyone warm, there is certainly no excuse for not attending. Further information on PhysioPlus Fitness and a promotion that we are running through the months of June and July can be found later in this newsletter.

Also in this newsletter Ebony discusses how physiotherapy can assist in alleviating the symptoms of cervicogenic headaches. Nikki looks at thoracic outlet syndrome and the benefits of massage therapy in association with this condition, while Nick writes about sciatica. Tess then follows on from her article in our last newsletter (Upper Cross Syndrome) by talking about Lower Cross Syndrome and the benefits of massage therapy.

Please feel free to contact any of us at any stage if you have any feedback or require any further information.

Nicola Judkins

Principal

PhysioPlus

nic@physioplus.net.nz

Where is that Headache Coming From?

Stress, hunger, dehydration, strained eyesight, sinus problems and tight muscles are all causes of headaches. The one that physiotherapists are most interested in, however, is when the pain originates in the cervical spine, neck and upper shoulders. These headaches are often referred to as a cervicogenic headache and can be a by-product of whiplash, neck injury, muscle trauma, or due to poor prolonged posture or severe stress.

A cervicogenic headache is clinically defined as pain that is present in the head but which originates in the cervical spine.

The most common symptoms of cervicogenic headache include one-sided head and neck pain made worse or initiated by head or neck movements; a steady, non-throbbing pain at the back and base of the skull, sometimes extending down to the neck and between the shoulder blades. The pain can also be located behind the brows and forehead. On examination sufferers tend to have a reduction in neck range of motion; sore and tender neck muscles; and reduced joint mobility with poor motor control of the deep neck flexors (stabilising endurance muscles).

According to the Cervicogenic International Study Group additional symptoms have been reported that include patient nausea, vomiting, dizziness, blurred vision, photosensivity, phonosensitivity and feeling of pain down one or both arms.

It has been found that fatigue, interrupted sleep, cervical disc issues, current or prior injuries, poor posture and stress on the muscles can increase the severity or the frequency of cervicogenic headaches.

The most commonly reported initial treatment for a cervicogenic headache is pain relief medication. Although it is often difficult to diagnose the exact source of a headache, physiotherapy treatment for a headache that appears cervicogenic in nature should be considered. It is important that sufferers are assessed by a physiotherapist to differentiate if the headache is of a cervicogenic nature, and therefore easily treatable by physiotherapy, or is actually another form of headache such as a migraine.

Physiotherapy intervention has been found to be successful in treating cervicogenic headaches and includes postural correction, joint mobilisation, massage, stretches, exercise programmes and self-management.

If a client presents with a headache and reports the above signs and symptoms why not consider a physiotherapy assessment – their neck will thank you for it!

Ebony Hornibrook

Physiotherapist

PhysioPlus Ferry Rd

ebony@physioplus.net.nz

Thoracic Outlet Syndrome & Benefits of Massage Therapy

The thoracic outlet is the area of the shoulder/neck where the nerves (brachial plexus) and subclavian blood vessels pass from the cervical area toward the axilla (armpit area). Thoracic Outlet Syndrome (TOS) is a set of symptoms that result due to compression and/or irritation of these vessels and nerves. There is much controversy amongst physicians, making diagnosis of this syndrome very difficult. It is often confused with carpel tunnel syndrome, brachial plexus syndrome, rotator cuff syndrome and bursitis.

Signs and Symptoms

Vascular Symptoms include:

Swelling or puffiness in the arm or hand.
Bluish discoloration of the hand.
Feeling of heaviness in the arm or hand.
Pulsating lump above the clavicle.
Deep, toothache-like pain in the neck and shoulder region.
Easily fatigued arms and hands.
Superficial vein distension in the hand.

Neurologic Symptoms include:

Paraesthesia along the inside forearm and the palm.
Muscles weakness and atrophy of the gripping muscles and small muscles of the hands.
Difficulty with fine motor tasks of the hand.
Cramps of the muscles on the inner forearm.
Pain in the arm and hand.
Tingling and numbness in the neck, shoulder region, arm and hand.

TOS has been described as occurring in a diverse population. It is most often the result of poor or strenuous posture but can also result from trauma or constant muscle tension in the shoulder girdle.

Static postures often result in a drooping shoulder and forward head posture. This position of the shoulders and head also indicates poor upper body posture. Middle aged and elderly women who suffer from osteoporosis often display this type of posture as a result of increased thoracic spinal kyphosis.

Carrying heavy loads, briefcases and shoulder bags can also lead to neurovascular compression. Humans are not well adapted to carrying heavy loads. Weight hung from the shoulders and arms can stress the supporting structures of the shoulder girdle which is basically suspended by the clavicle and al the component ligaments and muscles.

Occupations which require repetitive over-head movements can also produce symptoms of compression. Swimmers, volleyball players, tennis players and softball pitchers may suffer compression of the neurovascular structures as well. Compression of these structures, however, may also be caused by stretching or micro trauma (small tears in muscle tissue) to the muscles which support the scapula.

How Can Massage Therapy Help ?

There are many ways that massage therapy and body work can be used to treat TOS. The massage therapist will employ a number of techniques to relieve the condition. For example, the massage therapist may use techniques to eliminate myofascial trigger points in the scalene muscles and other muscles of the front of the neck. The massage therapist could also use Myofascial Release techniques or Deep Tissue Massage techniques to release fascial adhesions in the area of the thoracic outlet and surrounding tissues while also using techniques to gently lengthen the scalene muscles and other affected neck, chest and shoulder muscles. TOS also responds well to positional release therapies. In addition to working on the scalene muscles and pectoralis minor muscle it may be necessary to provide therapy for other muscles adjacent to, or opposing the scalene or pectoralis minor to improve muscular balance. Treatment for postural issues may also be needed. Comprehensive treatment with massage and bodywork, in conjunction with a home programme of stretching and exercise, usually helps to completely resolve the TOS.

If you feel you may be suffering from some or all of the symptoms listed in this article then please do feel free to contact us here at PhysioPlus. An initial assessment with one of our experienced physiotherapists would be the ideal place to start and, working closely with our physiotherapists I, as the massage therapist, can help to alleviate these symptoms for you.

Nikki Hudson

Senior Massage Therapist

PhysioPlus Ferry Rd

massage@physioplus.net.nz

Sciatica

Although sciatica is a relatively common form of low back pain and leg pain, the true meaning of the term is often misunderstood. Sciatica is a set of symptoms rather than a diagnosis for what is irritating the root of the nerve, causing the pain.

Most causes relate to compression of the nerve. This could include:

Disc herniation (otherwise known as prolapsed or ‘slipped disc’).
Spinal stenosis (disc, bone spurs, vertebral slips causing nerve space narrowing).
Piriformis Syndrome (where the muscles in the buttock compress the nerve).
Trigger Points (‘knots’ in the back and/or gluts referring pain down the leg).
Pregnancy (uterus onto nerve or increased muscle tension from the extra weight).
Tumours (in spine compressing).
Habits (self-inflicted, such as sitting on a wallet).

In terms of treatment typically pain relief and anti-inflammatory medication is often prescribed, along with physiotherapy and massage therapy to diagnose the cause , which as stated is very important in creating the right treatment and management for each individual to get back onto the right path, relieve pain and symptoms, and prevent surgery.

Nick Hovenden

Senior Physiotherapist

PhysioPlus Ferry Rd

physio@physioplus.net.nz

Lower Cross Syndrome

So! Last time we talked about Upper Cross Syndrome and now for the lower body equivalent – Lower Cross Syndrome.

This accounts, in massage, for a large majority of lower back pain, knee pain and hamstring strains. The posture involves an anterior tilt of the pelvis (as shown in the picture), resulting in stretched gluteal muscles and tight hip flexors and lower back muscles. It is made more obvious by a curved lower back and a stomach that protrudes slightly, and can in turn cause tight calf muscles as they have to hold on for dear life as the hips come forward and the upper body sways backwards in order to compensate. Notice the neck position and see if you can understand how this ties in with Upper Cross Syndrome.

When the gluteal muscles are stretches like this for long periods of time they cease to function properly, causing the lower back and hamstrings to take up the excess. Similarly the abdominal muscles weaken leaving the hip flexors to work harder. This is why, in this position, lower back pain can occur and hamstrings can be overworked and become prone to strain.

The cause of this posture can be long periods of sitting, cycling, inactivity, pregnancy or injures that have not been resolved. Remember that pain or discomfort is your body’s indicator that something is wrong, and that it can not compensate any more. So get up, stretch out your hip flexors, lock your abdominals on, and we will see you in the clinic for your next massage!

Tess O’Toole

Senior Massage Therapist

PhysioPlus City

tess@physioplus.net.nz

PhysioPlus Fitness

PhysioPlus Fitness is a group fitness session held at Radley Park on a Friday morning at 10.00am. Each session is only $10.00. The sessions are run by Ebony Hornibrook, who is also a qualified fitness instructor. Anyone is able to attend as all exercises are graded for each individual’s ability. PhysioPlus Fitness is brilliant for anyone of any age and fitness level, and is of benefit to anyone who is carrying an injury that wishes to return to physical activity or for people who have medical conditions that would be helped by physical exercise.

For the months of June and July any new participants to the programme can attend their first session for free, so bring along a friend and take the plunge and give it a try.

Also during the month of June and July, for every three friends you bring along to the sessions you go into the draw to win a free half hour massage at PhysioPlus.

For further information on PhysioPlus Fitness please call Ebony on 389 9350 or email her at ebony@physioplus.net.nz .

Pink Pilates

On May the 15 ^thLou James, the founder of the Pink Pilates Trust, and two Auckland women who had been through the Pink Pilates Programme ran the Great Wall of China marathon and half marathons to raise money for the Pink Pilates programme. This was a tremendous effort by all three women. In support PhysioPlus held a Zumba Dance Class fundraiser on the same day. This was a great success with everyone having a great time swinging their hips and dancing away to a great cause.

Thank you to everyone who helped promote and run the event, as well as to everyone who turned up and showed their support for what is a great programme.

Your Chance to Win a Free Massage!

Simply email your contact details to admin@physioplus.net.nz with the words PhysioPlus Massage in the subject line and you will go into the draw to win a free 45 minute massage with PhysioPlus. This is a monthly competition but you are only able to enter once in each calendar month. The monthly winner is drawn at the end of each month and will be notified by phone.

Words of Wisdom

Don’t let what you cannot do interfere with what you can do.

John Wooden