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Article by P.XuAs we slowly start getting into the cooler seasons, many people will begin to notice sore joints waking up in the morning, or that movement has become stiff, or even headaches increasing in frequency or severity. Why is this? It turns out that cold weather can have a significant impact on your body’s tissues. Notably, the connective tissue gives our muscles and joints the ability to move as they do, called elastin. As the name suggests, elastin is one of the critical components that provide our joints and muscles with the ability to bend, stretch, and move as they need to get you through the day.
Common Stress Fracture Related Conditions
Spinal Stress Fractures
- Spondylolysis (Back Stress Fracture)
- Lumbar Stress Fractures (Cricket Fast Bowlers)
- Rib Stress Fracture
Lower Limb Stress Injuries
What is a Primary and Secondary Headache?The International Headache Society classifies headaches as Primary or Secondary. Primary headaches are not related to any other problem and include migraines, tension-type headaches and cluster headaches. Secondary headaches. Caused by an underlying problem, and can include a post-whiplash headache, neck headache, jaw headache and drug withdrawal headache. “Ice cream headache”, for example, is a secondary headache caused by extreme cold within your mouth. In other words, a secondary headache is a symptom of something else being wrong rather than the cause itself. Treatment for a secondary headache involves treating the source, e.g. loosen some stiff upper neck joints or stop eating ice cream!
Multi-Source HeadacheIt is also important to point out that many headache sufferers may suffer multi-source headaches. For example, a migraine sufferer may simultaneously experience a tension-type headache and neck headache. Treatment will vary depending upon your specific symptoms and headache source. Please consult with your healthcare practitioner for an accurate diagnosis and treatment pathway.
When Should You Be Concerned about a Headache?In a small percentage of patients, there is, unfortunately, a sinister cause of your head pain, which require investigation. We call these Red Flags because they can be vital signs of more sinister underlying conditions such as brain tumours, aneurysm, stroke, meningitis and other systemic illnesses. If you experience any of the following symptoms, please seek the urgent advice of your healthcare professional.
You MUST thoroughly investigate any Red Flags!Please check with your doctor to investigate further if your headaches have any of the following characteristics. Your headache is:
- History your worst ever headache or a different headache to your usual.
- Exertion triggers your headache (e.g. exercise, cough, sneeze or sex).
- Age is higher than 50 years.
- Despite treatment, your headache persists.
- Acute onset.
- Central nervous system findings. e.g. motor weakness, memory loss, slurred speech.
- HIV or other immune system compromise
- fEver or other systemic symptoms, e.g. weight loss, rash.
Less Urgent & Severe Headache TypesFortunately, the vast majority of headaches do not require urgent medical investigation and should respond positively to treatment depending upon an accurate diagnosis. For specific advice, please consult your doctor or headache physiotherapist.
Suffering a Headache or Migraine?If you are suffering a headache or migraine, it is appropriate that your first step is to consult your doctor. Your doctor will examine you and then determine if a neurological opinion is required and whether a CT or MRI scan of your head is necessary. Occasionally, scans can identify significant but luckily uncommon headache sources such as an aneurysm or tumour. In the vast majority of cases, your scans will be reasonable.
If Your Scan is Normal?Firstly, you should feel relieved. Scans will rule out the more sinister causes of headache or migraine.
Discovering Your Headache Source?We recommend that you should then commence a process of elimination, starting with the most commonly diagnosed and easily fixed sources. Two familiar sources of headache that can undertake an assessment and elimination are neck headache and jaw headache. A thorough examination of your neck by a skilled headache physiotherapist is your next port of call. Researchers believe that at least one in four headaches are neck origin and less than that are jaw headache. You'll have over a 25% chance that your physiotherapist will confirm and then relieve your headache at your first consultation.
How Is PhysioWorks Operating During COVID-19?
Health Departments have continued to encourage physiotherapy clinics to remain open during this period. At PhysioWorks, we have adopted some key strategies to maintain the safe provision of physiotherapy and our allied health services.
- Provide a Safe COVID-19 Free Zone for our patients and staff who are providing proximity consultations.
- Provide Safe & Effective Online Solutions. TeleHealth Online Physiotherapy
- Provide Safe GP Pre-Screened Home Visits for our high-risk patients.
- Provide Online Solutions.
What Services Are PhysioWorks Currently Providing?
PhysioWorks is continually adapting to the latest information available from the Health Departments regarding how we can safely provide our healthcare service for our beautiful clients. We understand that pain and disability do not take a rest, but we must respect the COVID-19 impact on our people (patients and staff) and understand that it is no longer business as usual.
Current Services & Status
Based on these priorities, we are providing the current physiotherapy services:
In-Clinic consultation (face to face). Operational with some minor limitations. Read below for details, or call our clinic to discuss. You can book online for 24 hours.
Telehealth Online Physio (remote). Available for over 80% of conditions. Read on for details, visit TeleHealth Online Physio Consultation or call our clinic to discuss if your situation is suitable.
Home Visits (face to face). Only patients who have been pre-approved by their GP. Read below for details, or call our clinic to discuss.
Online Product Solutions
Our online shop is fully operational. Our suppliers are sending direct to the client where possible during this period.
If you need some home exercise equipment or some home treatment products, our online shop may be useful for you.
Qld Health has recently announced that registered massage therapists may resume clinical practice with some social distancing guidelines etc. You can book online 24/7.
Face to face in-clinic consultations is currently continuing with heightened virus transmission protocols for our staff and patients. PhysioWorks is doing everything it can to maintain COVID-19 Safe Zones within our clinics. All patients who are self-isolating, have had a known COVID-19 contact or have early symptoms will NOT be permitted to attend PhysioWorks. You should be abiding by Queensland Health instructions. TeleHealth Online Physio Consultation is the ONLY physio option available to you at the moment.
We Are Keeping Our Clinics a COVID19-Free Zone!
- PhysioWorks will NOT be seeing patients with a fever in a face-to-face consultation. Consider a TeleHealth Online Physio Appointment.
- All patients are requested to use the hand sanitiser provided in reception on arrival.
- If you have a cough, we will ask you to wear a facemask.
- In-clinic appointments will be available to healthy asymptomatic or GP-approved patients.
- Patients will be able to phone check-in and then either wait in their car or outside the clinic for their appointment. Our receptionist will call you when the previous consultation has finished avoiding unnecessary reception congregation.
- All patients are welcome to bring their towel to appointments to lay over the bed, but this is not mandatory.
TeleHealth Online Physio Information
TeleHealth Online Physio Can Assist:
- New injury assessment & assistance
- Professional advice and tips
- Exercise prescription (we will also email you your exercises via an online App or PDF)
- Post-operative or exercise upgrades
- Establish Home Exercise Programs (especially since Gyms closed)
- Online Home Workstation Setups (we've seen this increase with the transition to work from home)
- Monitor your progress
GP-Approved Home Visits
Home Visits will be increased during the COVID-19 period but only for a patient who has GP clearance for home visits. Home visit patients will be pre-screened via a phone call and advised to check with their GP if their health profile poses a risk.
There will be no call-out surcharge for high-risk >70 years or other high-risk health issues, during this COVID-19 period. Please call us if you seek a GP-approved home visit.
Keep or Start Outdoor Exercising While You Can
The winter weather is a massive bonus for Queenslanders, so get out and about to clear your head and get some feel-good exercise. The benefits of daily exercising are not just physical. The psychological side of things is equally important. That's why it has been so good to see so many people out exercising. If we keep this up, the Council will need to widen more of them!
Please Remember to SOCIAL DISTANCE!
Just remember that if your feet aren't moving and you are closer than 1.5 metres from someone who doesn't live in your home, you are breaching the social distancing rules. Keep doing the right thing, and we'll be allowed to exercise outdoors for longer.
Not Sure How To Start Your Exercise Program?
While many are out and about already, those of you who just don't know how to start an exercise program safely (e.g. exercise dose and plan) is welcome to contact one of our physio. We can even do this TeleHealth style is required. Just give us a call.
What Services Have Ceased or Altered Significantly?
Visiting Allied Health Practitioners
Please contact your specific practitioner. Most practitioners have modified their service delivery during this period. TeleHealth is available for some of these practitioners.
R U OK?
We are a "caring for people" business, and we know that anxiety, stress and other psychological factors are at play. There will be some short-term challenges ahead, but we can all help each other get through this. That's what friends and family do best. If you do need some help, please read on to see some mental health options that are now available to you.
Mental Health Support Options
Mental health issues are a serious concern in the aftermath. While our team can be a friendly listening ear, if you have serious concerns, please contact Lifeline 131114, Beyond Blue 1300 224636, or your GP.
Please Call Us If You Need A Chat
Social distancing does have a downside, with a lack of human interaction. If you need someone to chat to during this challenging period, please feel free to call one of our clinics. Our friendly reception team love a chat, and our practitioners will happily call you back between patients. We consider our patients as family and friends. If you need us, we are here.
No Reported COVID-19
Our sympathies and support go out to the families and friends who have contracted COVID-19. To our knowledge, we have no known cases that affect a member of our staff or patient community. We'd also like to keep it that way, so thank you for minimising virus transmission actions, which is your current priority.
Keep Safe & Healthy Yourself.
While we understand that COVID-19 does require everyone's vigilance, we can safely get through this period if we all do the right thing.
All of our staff have undertaken the latest COVID-19 Infection Control Training. While this free online training is for healthcare workers, the information is excellent, and we recommend for all patients.
Protecting Our Staff & You
All practitioners and administration staff are now working only in one clinic or remotely. We apologise to all patients who may be inconvenienced by this decision. However, we have made this call to serve the majority of our patients best and for staff safety.
If one clinic does close to face-to-face patients, we will prioritise their time to TeleHealth appointments.
Staff are working in non-adjacent regions within the clinic and not congregating to keep social distancing at the forefront.
Staff hours have altered to decrease potential cross-contamination periods.
We aim to keep all of our PhysioWorks clinics a COVID-19 Safe Zone.
Principally we have established high-end infection control policies to keep our clinics a "COVID-19 Safe Zone" for the safety of our people (staff and patients).
- We have refreshed our infection control protocols for all staff to maintain impeccable hygiene practices.
- We will be requesting the same infection-control practices from any persons (patients and others) who enter a PhysioWorks clinic.
- Staff and patients will continue to adhere to strict hand washing and sanitising protocols.
- Equipment and surfaces cleaned regularly.
- Personal Protective Equipment (PPE) is available.
COVID-19 Symptoms? What To Do?
Here is a quick synopsis of COVID-19 symptoms and what actions you should take.
- All staff or patients who have a fever, shortness of breath, dry cough, sore throat, or feel fatigued should self-isolate until your GP clears you. Self-isolation includes NOT attending PhysioWorks or other face-to-face locations.
- Shortness of breath? You should be phoning 000 for advice. The combination of fever and shortness of breath appears to be the most likely symptoms that differentiate between COVID-19 and the flu.
- Fever is something you can measure at home with a thermometer. It is associated with COVID-19, the flu and other infections. Temperature is not generally associated with the common cold. If you have a fever, contact your GP. PhysioWorks will not be seeing patients with a fever in a face-to-face consultation. Even if you don't have COVID-19 or Influenza, you are fighting an infection and should be resting at home. Consider our TeleHealth Online Physio Appointment Option.
- Fatigue typically means your health is under stress. Please call your GP.
- Cough or sore throat? GPs have informed us that over 99% of coughs and sore throats are related to the seasonal increase in common cold. If associated with a fever, or if in doubt, please call your GP.
The good news is that the vast majority of you will not have COVID-19. Less than 1% of currently COVID-19 tested Australians have tested positive. However, now is a time to be cautious. If you have any symptoms, you should be calling your GP for advice and only attend face-to-face appointments if cleared by them.
Apply the current recommendations of self-isolation, social distancing and good hygiene.
The Health Department has informed us that the most reliable source of information will be at health.gov.au.
Keep Safe & Healthy
Finally, we wish you and your family the best of health during this challenging period. We are all in this together, and PhysioWorks is happy to play our part in minimising the virus transmission, keeping our staff and patients healthy while assisting them during this "business as UNusual" period.
If you have any questions, please do not hesitate to call us. And remember, if you simply need a chat, please call us.
Many thanks and best wishes through this challenging period.
The PhysioWorks Team
Sports Injury Management
You probably already know that a sports injury can affect not only your performance but also your lifestyle. The latest research continues to change sports injury management considerably. Our challenge is to keep up to date with the latest research and put them to work for you.
How we treated you last year could vary significantly to how we treat you this year. The good news is that you can benefit considerably from our knowledge.
What Should You Do When You Suffer a Sports Injury?
Rest from painful exercise or a movement is essential in the early injury stage. "No pain. No gain." does not apply in most cases. The rule of thumb is - don't do anything that reproduces your pain for the initial two or three days. After that, you need to get it moving, or other problems will develop.
Ice or Heat?
We usually recommend avoiding heat (and heat rubs) in the first 48 hours of injury. The heat encourages bleeding, which could be detrimental if used too early. In traumatic injuries, such as ligament sprains, muscle tears or bruising, ice should help reduce your pain and swelling.
Once the "heat" has come out of your injury, you can use heat packs. We recommend 20-minute applications a few times a day to increase the blood flow and hasten your healing rate. The heat will also help your muscles relax and ease your pain. If you're not sure what to do, please call us to discuss your situation specifically.
Should You Use a Compressive Bandage?
Yes. A compressive bandage will help to control swelling and bleeding in the first few days. In most cases, the compressive dressing will also help support the injury as you lay down the new scar tissue. This early healing should help to reduce your pain. Some injuries will benefit from more rigid support such as a brace or strapping tape. Please ask us if you are uncertain about what to do next.
Gravity will encourage swelling to settle at the lowest point. Elevation of an injury in the first few days is beneficial, especially for ankle or hand injuries. Think where your damage is and where your heart is. Try to rest your injury above your heart.
What Medication Should You Use?
Your Doctor or Pharmacist may recommend pain killers or an anti-inflammatory drug. It is best to seek their professional advice as certain medications can interfere with other health conditions, especially asthmatics.
When Should You Commence Physio?
In most cases, "the early bird gets the worm". Researchers have found that the intervention of physiotherapy treatment within a few days has many benefits. These include:
- Relieving your pain quicker via joint mobility techniques, massage and electrotherapy
- Improving your scar tissue using techniques to guide the direction it forms
- Getting you back to sport or work quicker through faster healing rates
- Loosening or strengthening of your injured region with individually prescribed exercises
- Improving your performance when you return to sport - we'll detect and help you correct any biomechanical faults that may affect your technique or predispose you to injury.
What If You Do Nothing?
Research tells us that injuries left untreated take longer to heal and have lingering pain. They are also more likely to recur and leave you with either joint stiffness or muscle weakness. It's important to remember that symptoms lasting longer than three months become habitual and are much harder to solve. The sooner you get on top of your symptoms, the better your outcome.
What About Arthritis?
Previously injured joints can prematurely become arthritic through neglect. Generally, there are four main reasons why you develop arthritis:
- An inappropriately treated previous injury (e.g. old joint or ligament sprains)
- Poor joint positioning (biomechanical faults)
- Stiff joints (lack of movement diminishes joint nutrition)
- Loose joints (excessive sloppiness causes joint damage through poor control)
What About Your Return to Sport?
Your physiotherapist will guide you safely back to the level of sport at which you wish to participate. If you need guidance, ask us.
What If You Need Surgery or X-rays?
Not only will your physio diagnose your sports injury and give you the "peace of mind" associated, but they'll also refer you elsewhere if that's what's best for you. Think about it. You could be suffering needlessly from a sports injury. Please use our advice to guide you out of pain quicker. And for a lot longer.
If you have any questions regarding your sports injury (or any other condition), please contact your physiotherapist to discuss. You'll find our friendly staff happy to point you in the right direction.
Acute Sports Injury Clinic
How to Best Care for Your Sports Injury?
There is never an excellent time for an injury. But we do know that most sports injuries occur over the weekend! That's why at PhysioWorks, we have established an Acute Sports Injury Clinic at a selection of our clinics on a Monday and Tuesday.
The acute sports injury consultation fee is significantly lower than a routine assessment and treatment consultation. In most cases, your private health will cover the full cost of your full acute injury physio assessment fee.
Why Use an Acute Sports Injury Clinic?
Your Acute Sports Injury Assessment Consultation allows us to provide you with:
- A quick and accurate diagnosis. One of our Sports Physiotherapist's or an experienced sports injury-focused Physiotherapist will confidently guide your new injury management.
- Early acute sports injury care, professional advice and education. What to do this week?
- Fast referral for X-rays, ultrasound or MRI scans to confirm your diagnosis.
- Prompt referral to Sports Physicians, GPs or Surgeons with whom we work if required.
- Immediate supply of walking boots, braces and rental crutches if needed.
- Low-cost professional service.
For more friendly advice or guidance, please call your nearest clinic to discuss your specific needs.
Why Should You Enjoy the PhysioWorks Difference?
Friendly & Caring Service
One thing that you'll notice about the PhysioWorks team is that they are very friendly and caring health professionals. We know that sometimes pain or injury can make you a little less tolerant, so we've trained our healthcare team always to greet and treat you like they would a family member or best friend.
Thorough & Unrushed
Everyone should be entitled to individualised professional care. That's why we book longer initial appointments to ensure that your unhurried first visit will include a thorough and individualised assessment of your injury or problem. This extra time allows us to discuss your short, medium and long-term goals and treatment options before commencing your rehabilitation.
You'll find that your PhysioWorks healthcare practitioner is not only a great listener but also an excellent treatment planner to focus on your efficient and effective treatment outcome. After all, that's why you have chosen to see us in the first place.
What is the Aim of Your Initial Consultation?
Because we do spend more time than most physiotherapists thoroughly assessing, by the completion of your initial consultation, we should be able to determine and inform you:
- What exactly is your problem
- Why you are experiencing pain or dysfunction etc
- What you can be doing to correct it
- How long it will most likely take to recover
- How to prevent a future recurrence
Your Tailored Treatment Plan
Your physiotherapist will design a specific treatment program specifically for you based upon your examination. Your treatment may include hands-on treatment, such as joint manipulation, mobilisation or massage. It will probably also include lots of helpful advice and home exercises. We'll also use other technology or treatment tools depending upon your needs.
Your treatment will vary depending upon your age, sex, sport, work requirements or lifestyle, so generic therapies tend to be effective than specifically targeted treatment plans.
As highly-trained exercise prescribers, your physiotherapist will usually instruct you on specific exercises and stretches to undertake at home to assist in your rapid recovery. We'll also offer you helpful advice to help ease your pain, such as the appropriate resting positions or whether to use heat or ice and precisely for how long.
The result is prompt pain reduction, quicker natural healing and your successful return to full activity, whether it be work or sport, as soon as possible.
How Long is Your Physiotherapy Appointment?
Allow at least one hour for your initial physiotherapy session. Subsequent treatments are usually 30 to 60 minutes in duration. Your physiotherapist will inform you if additional or less time is required. Complex or multiple regions may require a longer consultation. Our receptionist will happily book an appropriate appointment for your clinical needs.
Do You Need a Referral to Consult a Physiotherapist?
A doctor's referral is not required to see a physiotherapist in private practice unless you claim a work injury (e.g. Workcover), or some other insurance claims. Department of Veterans Affairs patients will require a doctor referral. If you have been involved in a motor vehicle accident or plan for your treatment to be funded by an insurance company, it is good practice to consult your GP for a referral.
What About Private Health Insurance?
A proportion of treatment costs is rebatable under all higher table private health insurance schemes. The private health insurance rebates do vary considerably depending upon your specific coverage.
What is HICAPS?
PhysioWorks is linked to the HICAPS electronic health fund system so you can instantly claim your rebate at the time of treatment. You'll need to present your health insurance card to our receptionist.
Acute Injury SignsAcute Injury Management. Here are some warning signs that you have an injury. While some injuries are immediately evident, others can creep up slowly and progressively get worse. If you don't pay attention to both types of injuries, chronic problems can develop. For detailed information on specific injuries, check out the injury by body part section.
Don't Ignore these Injury Warning Signs
Joint PainJoint pain, particularly in the joints of the knee, ankle, elbow and wrist, should never be ignored. Because these joints are not covered by muscle, pain here is rarely of muscular origin. Joint pain that lasts more than 48 hours requires a professional diagnosis.
TendernessIf you can elicit pain at a specific point in a bone, muscle or joint, by pressing your finger into it, you may have a significant injury. If the same spot on the other side of the body does not produce the same pain, you should probably see your health professional.
SwellingNearly all sports or musculoskeletal injuries cause swelling. Swelling is usually quite obvious and can be seen, but occasionally you may just feel as though something is swollen or "full" even though it looks normal. Swelling usually goes along with pain, redness and heat.
Reduced Range of MotionIf the swelling isn't obvious, you can usually find it by checking for a reduced range of motion in a joint. If there is significant swelling within a joint, you will lose range of motion. Compare one side of the body with the other to identify major differences. If there are any, you probably have an injury that needs attention.
WeaknessCompare sides for weakness by performing the same task. One way to tell is to lift the same weight with the right and left side and look at the result. Or try to place body weight on one leg and then the other. A difference in your ability to support your weight is another suggestion of an injury that requires attention.
Immediate Injury Treatment: Step-by-Step Guidelines
- Stop the activity immediately.
- Wrap the injured part in a compression bandage.
- Apply ice to the injured part (use a bag of crushed ice or a bag of frozen vegetables).
- Elevate the injured part to reduce swelling.
- Consult your health practitioner for a proper diagnosis of any serious injury.
- Rehabilitate your injury under professional guidance.
- Seek a second opinion if you are not improving.
Acute Injury Treatments
- Early Injury Treatment
- Acupuncture and Dry Needling
- Gait Analysis
- Biomechanical Analysis
- Proprioception & Balance Exercises
- Real Time Ultrasound Physiotherapy
- Soft Tissue Massage
- Dry Needling
- Electrotherapy & Local Modalities
- Heat Packs
- Joint Mobilisation Techniques
- Kinesiology Tape
- Physiotherapy Instrument Mobilisation (PIM)
- Running Analysis
- Stretching Exercises
- Supportive Taping & Strapping
- TENS Machine
- Video Analysis