Preheat oven to 180 degrees Celsius and line a
baking tray with baking paper. Chop cauliflower into small cubes and drizzle
with olive oil, turmeric and cumin. Slice onion into very small strips and add
cauliflower pieces to a baking tray and cook for 30 minutes until soft and
brown. Remove from heat and set aside.
In a medium-sized mixing bowl, add diced
coriander (or basil), diced garlic, white balsamic vinegar, olive oil, diced
tomato, almonds, salt and pepper. Mix together and set aside.
Bring a medium pot of water to boil and salt
slightly. Add 2 cups of quinoa and cook for 5-10 minutes until cooked. Strain
excess water and stir through olive oil mixture. Add roasted cauliflower and
serve when ready.
Preheat oven to 180 degrees Celsius and line a
baking tray with baking paper. Chop pumpkin into slices or cubes and drizzle
with olive oil.
In a medium-sized mixing bowl, add diced basil,
thyme, salt and pepper. Mix pumpkin through and allow all pieces to be coated
evenly. Coat pumpkin pieces with balsamic glaze and place on baking tray.
Bake in the oven for 40-50 minutes, depending
on the size of the pieces, turning the pumpkin halfway through. Remove from
oven and serve either as a delicious side dish.
Preheat oven to 180 degrees Celsius and line a
baking tray with baking paper. Spread dates over baking tray and drizzle with
olive oil, salt and pepper. Cook for 10 minutes.
Add almonds to the baking tray; add a crushed
clove of garlic and a sprig of rosemary. Continue baking for a further 10
minutes until almonds are toasted but not burnt.
Remove from oven and set aside to cool. Add
goat’s cheese and drizzle with lemon juice before serving.
Garnish
with rosemary and serve as a delicious starter or snack.
Place a frying pan on medium heat and add 1
Tbsp. of olive oil. Chop haloumi into thin slices and place on frying pan. Cook
for 2-3 minutes and then turn. Haloumi pieces should be lightly browned and
crispy on either side
Cut watermelon into large slices, removing skin
and seeds. Increase heat to high and add watermelon pieces to frying pan.
Drizzle watermelon pieces with balsamic vinegar and cook either side for 1-2
minutes. Remove from heat, add blueberries to pan and cook until soft.
Mix all cooked ingredients together gently in a
large mixing bowl, drain excess liquid and allow to cool.
Garnish
with mint and serve as a healthy side dish.
Bursae are small sacs of fluid found
throughout the body. These bursae produce synovial fluid and act to reduce
friction between muscles, tendons, ligaments and bones as they move over each
other. Bursae are located at strategic points, typically where there are higher
points of stress. If a bursa is injured or irritated, it can become inflamed,
painful, red and swollen and this condition is referred to as bursitis.
One commonly affected bursa is the olecranon bursa, which sits just over the hard bony process at the base of the elbow. Olecranon bursitis refers to inflammation of the bursa at this point and is a common condition, particularly in men between the ages of 30-60.
What causes it?
Olecranon bursitis has a few different causes including trauma, overuse and infection. A sharp blow to the elbow, through a fall or hit, might damage the bursa leading to bursitis. In other cases, the bursa can be infected by bacteria, which enter the body through a small skin tear. Bursitis can also develop slowly through friction of the nearby muscles that cause the bursa to become irritated and inflamed.
What are the symptoms?
The hallmark of this condition is a painful,
red, swollen elbow. Typically pain is worst when resting on the tip of the
elbow and/or with elbow movements, particularly when bending or straightening
the elbow fully. The pain often lasts a few months and may not go away on its
own. The pain may build up gradually, or come on suddenly, depending on the
cause. Bursitis caused by infection (septic bursitis) may also be associated
with general feelings of illness such as fatigue, fever and body aches.
What is the
treatment?
Because there are many different causes of this condition, accurate diagnosis is essential. Your physiotherapist is able to distinguish between olecranon bursitis and similar conditions such as rheumatoid arthritis or fibromyalgia. Septic bursitis will need to be treated by a medical professional who will determine the best course of action.
Bursitis is treated initially with a RICE protocol to reduce pain and swelling (Rest, ice, compression and elevation). Mechanical causes of bursitis can require more in-depth identification of the factors that may have led to the development of this condition.
Common contributing factors are throwing technique, muscle tightness and/or weakness and training frequency. Your physiotherapist will be able to address these factors. They can also provide taping support to unload the bursa along with manual therapy and an exercise program.
In most cases, conservative or non-surgical treatment is attempted as the first line of treatment. If this is unsuccessful however, cortisone injections are often used to reduce pain and inflammation. In severe cases where the pain persists despite all other attempts at treatment, the bursa can be surgically removed in a procedure called a bursectomy. Once the pain has subsided your physiotherapist is also able to help prevent any further recurrence.
None of the information in this newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.
If you require professional advice or treatment, please see our range of treatment options, or book an appointment online. Physio Direct has many clinics located throughout New Zealand, with no GP referral required to make an appointment.
Ankle sprains are one of the most common sporting injuries
and most people have experienced one at least once in their lifetime. While
they are common, this doesn’t lessen their negative impact. Surprisingly,
having poor balance might be increasing your risk of ankle sprains. Here we
discuss a few facts about balance and what you can do to reduce your risk of
ankle injuries.
Are ankles particularly vulnerable to injuries related to poor balance?
Our ankles have to support our entire body weight when standing on one foot. To provide us with agility as well as stability, our ankles have the ability to move from side to side as well as back and forwards. There is a complicated process constantly operating to keep your foot in the correct position while supporting all this weight. This is particularly true with quick changes of direction, activities done on tiptoes, jumping and landing. If the ankle rolls excessively inwards or outwards, the ligaments on the side of the ankle can be damaged and torn, resulting in sprains. Balance is an important part of keeping the ankle in the correct alignment and not twisting too far to either side during challenging activities.
A study of high school basketball players by Timothy McGuine et al. in 2010 showed that students with poor balance were up to seven times more likely to sprain their ankle than students with good balance. Other studies have shown that balance training is an effective way of preventing falls in elderly populations.
One leg can have better balance than the other.
Most of us favour one side of our body for all activities. This is more obvious in the upper body, with most of us identifying as either left or right handed. The same is also true for our lower body, with each of us favouring one leg over the other for balance activities. This can mean that one leg has better balance and strength than the other, leaving the other leg more vulnerable to injury.
Reduced balance
can mean your body has to work harder to perform activities, with muscles
activating in a less coordinated way. Improving your balance can also improve
your body’s efficiency of movement, which can, in turn, improve your overall
performance without actually improving your muscle strength.
Balance can be trained rapidly.
Balance is one of the most overlooked dimensions of physical health
however, the good news is that it can be improved relatively quickly. Do a
quick check to see if you can stand on each leg for two minutes with your eyes
closed. If this is difficult you might find that improving your balance is a
great next step in your training program.
Your physiotherapist is able to identify any deficits in your balance is and is able to develop a training program for you to improve your balance. Come and see us for an appointment to see how we can help.
If you require professional advice or treatment, please see our range of treatment options, or book an appointment online. Physio Direct has many clinics located throughout New Zealand, with no GP referral required to make an appointment.
1. Place
a frying pan on medium heat and add 1 Tbsp. of olive oil and one clove of
crushed garlic. Add almonds, either whole or sliced and cook for 1-2 minutes.
Add broccolini and cook for 2-3 minutes, turning regularly. Finally add
blueberries and cover pan, cook for a further 2 minutes then remove from heat.
2. Whisk
together remaining olive oil, lemon juice, white balsamic vinegar and salt and
pepper to create a dressing. Cover
broccolini with dressing and move to a serving plate, add parmesan flakes.
Garnish
with hummus and serve as a healthy side dish.
Fibromyalgia is a
chronic condition characterised by widespread pain throughout the body along
with fatigue, memory problems, sleep and mood disorders. Sufferers of
fibromyalgia often spend years trying to find a diagnosis that fits their many symptoms
and fluctuate between periods of having high energy and ‘crashes’ of fatigue
and pain. In severe cases, fibromyalgia can cause significant lifestyle
disruptions, including reduced activity, unemployment and depression.
The underlying
mechanism that creates the symptoms of fibromyalgia has been shown to be
increased pain amplification by the central nervous system and reduced
activation of the sympathetic nervous system. Essentially this means that small
pain signals in the body are processed as large pain signals by the central
nervous system.
What causes it?
Fibromyalgia is a complicated condition that is poorly understood. This can be very frustrating for sufferers, who often find themselves being shuffled between health practitioners looking for answers and long term relief. While the pain generally feels muscular, usually little to no muscular damage or injury can be found on physical assessment. The symptoms can also mimic those of an infectious illness, or other chronic diseases. Often a diagnosis of fibromyalgia is reached after other diseases and causes have been ruled out.
The cause of
fibromyalgia is as yet unknown, it was thought that the depression and reduced
activity that are often associated with fibromyalgia could be causative,
however it has been show that these are symptoms of fibromyalgia rather than
causes. Other significant signs of fibromyalgia are a lack of REM sleep in
sufferers and a positive result of more than 11 out of 18 muscular trigger
points.
What is the treatment?
Following a diagnosis of fibromyalgia, patients primary strategy is to understand and manage their symptoms. This can involve pacing activities and balancing exercise so as to reduce ‘crashes’ and unhelpful pain cycles that lead to frustration. Identifying activities, employment and a routine that don’t exacerbate symptoms can have a significant impact on quality of life for someone with fibromyalgia.
Having psychological support can also be very important to
help patients deal with the emotional distress of a complex chronic condition
that has no outward physical signs.
Treatments that have been shown to help reduce symptoms are
TENS (electrical stimulation) which produces an endorphin response and can
reduce pain. Certain medications may be helpful when prescribed by a doctor.
Education and understanding of this condition can have the largest impact for
sufferers, helping them to manage and maintain some control over their
symptoms. Physiotherapists can have a large role in education and helping
patients find a routine and activity level that helps them manage their
condition as best as possible.
None of the information in this newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.
If you require professional advice or treatment, please see our range of treatment options, or book an appointment online. Physio Direct has many clinics located throughout New Zealand, with no GP referral required to make an appointment.
If you are experiencing regular neck pain that just won’t go away, it’s possible that parts of your daily routine are contributing without you realising. Here are a few common everyday activities that might be making your neck pain worse.
1. Your sleeping position
It’s easy to underestimate the impact your sleeping position has. However, spending hours in one position will undoubtedly have an effect on your body. In fact, poor sleeping posture is commonly among causes of neck pain. Pillows that are too high or too flat can mean your cervical joints are sitting at the end of their range in too much flexion or extension. Similarly, sleeping on your stomach often means your thoracic spine is locked into extension and your neck is fully rotated. In simpler terms, this means your joints are under more stress than necessary. Ideal sleeping posture allows your spine to maintain it’s natural curves.
2. Your daily commute
Many of us make
sure our work stations are ergonomically set up to reduce stress and strain
throughout the day. Few of us take the same consideration when it comes to
driving. In fact, the set up of your car can be just as important as your
work-desk, particularly if you are driving more than 30 minutes everyday. The
correct setup in your car can mean you use less effort to drive and turn your
head less often to check traffic.
Ensuring that your steering wheel, seat and mirrors are set up correctly could make a difference to your posture and even perhaps reduce neck pain and headaches. If you find that driving is still affecting your pain after making these changes, try catching public transport or riding a bike on alternative days.
3. Your downtime
Many of us unwind by watching TV or our laptops
at the end of the day. Your position during this time can be something you give
little thought to however, looking up to view a screen mounted on a wall or
looking down at a small screen or laptop can put pressure on the upper
structures of the neck. Take a few minutes to consider what posture you’re
sitting in before settling down to binge watch a series and see if you can
either lower the height of your screen or raise it slightly so your neck can be
in a more neutral position.
4. Your exercise routine
Any activity that
requires sustained positions or repetitive neck movements can contribute to
neck pain. Cyclists can be stuck in neck extension while looking ahead and
breast stroke swimmers can also have excess neck extension. Freestyle swimmers
with reduced thoracic or neck rotation can have difficulty achieving rotation
when breathing which can cause pain and discomfort over time.
Your physiotherapist is able to identify any daily habits or activities that might be causes of neck pain. Come and see us for an appointment to see how we can help.
If you require professional advice or treatment, please see our range of treatment options, or book an appointment online. Physio Direct has many clinics located throughout New Zealand, with no GP referral required to make an appointment.
A ring of flexible,
fibrous connective tissue, known as the glenohumeral labrum, surrounds the
shoulder joint. This labrum increases the stability of the shoulder while
allowing for the required flexibility of one of the bodies’ most sophisticated
joints. One well-known muscle of the arm, the biceps, has an attachment
directly into the labrum and is a common site of injury. A tear of the labrum
can occur in many locations, however the most common is at the point where the
biceps tendon attaches to the labrum. Usually, this tear follows a typical
pattern and is referred to as a superior labrum tear, anterior to posterior
(SLAP tear).
What causes it?
SLAP/labral tears can be caused by trauma such as a fall onto an outstretched hand or a dislocated shoulder. Tears can also develop over time with repeated throwing actions or overhead activities as the labrum is weakened and eventually injured. Traumatic tears are more likely to be symptomatic than tears that develop slowly.
What are the symptoms?
As mentioned, SLAP tears can occur suddenly, through
trauma or develop slowly through repeated stress. Often if the injury develops over
time, patients can be unaware they have sustained a tear and the injury doesn’t
have a significant impact on their pain or function. Preexisting SLAP tears can
however, place more tension on the long head of biceps tendon, leading to
overuse disorders as a secondary complication.
When the tear occurs through a sudden action or
trauma, symptoms can be more marked. Sufferers often notice pain deep in the shoulder
joint with overhead shoulder movements, a feeling of weakness, loss of power
and/or accuracy with throwing activities. Some people may notice a popping or
clicking sensation and occasionally the shoulder may give way. In severe tears,
the shoulder might feel unstable and even be at increased risk of dislocation.
How can physiotherapy help?
Your physiotherapist is able to help diagnose a suspected
SLAP tear and send you for further imaging if needed. SLAP tears are often graded
by severity from I to IV as a way to guide treatment. Physiotherapy is usually
recommended as a trial for all tears before considering surgical repair and in
many cases can effectively help patients return to their previous activities,
symptom-free.
If physiotherapy is unsuccessful, surgical repair with a
full rehabilitation program is recommended. Surgery will usually either repair
the tear or reattach the biceps tendon to the humerus (tenodesis). Following
surgery, a period of rest in a sling is required before rehabilitation can
begin.
None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.
If you require professional advice or treatment, please see our range of treatment options, or book an appointment online. Physio Direct has many clinics located throughout New Zealand, with no GP referral required to make an appointment.
Your posture is one of the first
things other people notice about you and can affect so much more in your life
than just spinal health. Healthy posture has been linked to better respiratory
health and has even been shown to affect your confidence. In this article, we
explore a few other surprising facts about posture.
Ideal posture doesn’t mean having a straight back.
Many people think
having good posture means standing as straight as possible with your shoulders
pulled back. This is actually a relatively unnatural posture and requires a lot
of energy to maintain. Ideal posture, where the spine rests in it’s most
comfortable and strongest position, is where the neck has a gentle curve
backwards, the thoracic is curved gently forwards and the lower back curves
back again. These curves create an elongated ‘S’ shape and can be seen when
viewing a person from side on.
There
are four common postural patterns other than ‘ideal posture’.
For those who don’t have ideal posture, four common variations are seen. These are:
kyphosis (excessive curve of the thoracic region)
lordosis (excessive curve of the lower back)
flat back (loss of the normal spinal curves)
sway back (where the pelvis is pushed in front of your centre of gravity and the upper body leans back to compensate).
Each of these postures is often accompanied by
a typical pattern of joint and muscle stiffness that can lead to pain and
injury. Your physiotherapist is able to assess your posture and identify any
ways this may be contributing to your pain. They can also help you to change
your posture with strategies to increase spinal mobility and strength.
Regular
movement is just as important as your posture.
While ideal posture has been shown to reduce
the amount of stress and tension found in the spinal muscles, holding yourself
rigidly in one position is also not healthy. Ideally, our spines will be
flexible and able to move through their full range without pain or stiffness.
Regular movement is the key to healthy joints, including the spine. If you
finding yourself sitting or standing for long periods, try to find time to
stretch as well as working on your posture.
Personality type has been linked to postural patterns.
A study by S. Guimond and others in 2014 showed a surprising link between personality type and posture. They found that extroverted personalities were much more likely have an ‘ideal posture’ or excessive spinal curves than introverted personalities and introverted personalities were more likely to have ‘flat’ or ‘sway back’ postures. However, they were unable to determine if personality influenced posture or vice versa. There may have also been a hidden third factor, such as pain.
Always see a medical professional for advice on your individual injury or issue.
If you require professional advice or treatment, please see our range of treatment options, or book an appointment online. Physio Direct has many clinics located throughout New Zealand, with no GP referral required to make an appointment.
Preheat your oven to 180 degrees, Lightly grease and line your brownie tray with baking paper. Place the beetroot into a saucepan with cold water and bring to the boil Simmer for 20-25 minutes until tender. Soak the dates in enough boiling water to cover them until softened (about 10 mins), then drain water.
Tip the cooked beetroot into a sieve, drain off any excess liquid, then put into a high-speed food processor with softened dates until smooth.
Then add the cacao powder, eggs, coconut oil, maple syrup and blend to combine. Then add almond meal, nut milk, baking powder, vanilla, baking soda and blend until smooth.
Pour your mixture into the prepared tray and bake for 25-30 minutes until firm and a skewer comes out clean when inserted into the centre.
Boil water in a medium saucepan and add lentils. Simmer while covered for 30 minutes or until soft. Remove from heat and strain excess water away. Peel sweet potatoes and chop into small pieces.
Coat a large frying pan with 1 Tbsp. of olive oil and cook mushrooms, sweet potato and garlic on medium heat for 6-8 minutes, while stirring frequently. Cook until sweet potato is soft and remove from heat and allow to cool. Blend the sweet potato mixture, paprika, rocket, salt and pepper and soy sauce in a food processor for one minute. Then gently mix these ingredients with the cooked lentils.
Shape mixture into four round patties and coat each side lightly with plain flour. Add 1 Tbsp. of Olive Oil to a frying pan, cook patties on medium heat for ten minutes, turning once.
Makes four patties, serve in burger buns or with a side salad.
Most tissues in the body have
healed completely in six to 12 weeks following an injury, however, many people
have severe pain that lasts much longer than this. We know that the intensity
of the pain you feel is not always associated with a similar amount of damage.
In some cases, there can be a severe amount of pain with almost no detectable
damage. With this in mind, we explore some reasons why your pain might not be
getting better, long after the tissues have healed.
You’re
afraid of the pain.
Pain can mean many different things, for some
of us pain can affect our ability to work or can be a symptom of a serious
disease. What you believe about your pain can either amplify or reduce the
symptoms you experience. If you feel that every time you experience pain you
are causing more damage, you will naturally pay more attention to this and your
nervous system will amplify the signals in an attempt to keep you safe.
If you understand the cause of your pain and
know that while there is discomfort, you are not in danger of causing more
damage, often the pain will feel less severe. This is one of the benefits of
seeing a physiotherapist after your injury as they can help you to understand
your pain, giving you more control over your recovery.
You started
moving differently after the injury.
Immediately after an injury, it’s natural to change the way you move to avoid painful movements. After a
while, these changed movement patterns can become maladaptive and actually
begin to cause pain and discomfort on their own due to the altered stress patterns
placed on your body.
Correcting these
adaptive movement patterns can often go a long way in reducing pain after an
injury. You might not have noticed these changes and might need a
physiotherapist to identify and help you to return to your usual movement
pattern.
You have lost muscle strength since the injury.
While a certain
amount of rest following an injury is always helpful, if we stop moving
altogether, our muscles can lose strength. This can mean that our posture
changes, we fatigue easier during our usual activities and that we are more
susceptible to further injury. Less movement also means we actually focus on the
pain more when it does happen. Physiotherapists are able to advise you on the
right types and amounts of excercise for you in the period following your
injury.
The pain has affected your lifestyle.
When pain affects
your ability to sleep, work and even concentrate, it’s not surprising that this
can have a negative affect on your overall wellbeing and mental health. This
can create a negative cycle of anxitey and depression that perpetuates and
increases the experience of pain. If your pain is really getting you down, speaking
to a mental health professional can actually be a valuable part of your
physical recovery.
Our
knees are complex hinge joints, designed to provide stability from side to side
and smooth movement forwards and back as you walk, kick and run. The patella,
or kneecap, is a small bone embedded in the tendon of the quadriceps muscle
that protects the knee and also provides extra leverage to the quadriceps,
amplifying their strength. The patella moves up and down in a groove at the
front of the knee as the knee bends and straightens. Usually this movement is
smooth, with little friction, however, if something causes the patella to move
in a dysfunctional way, the soft tissue between the kneecap and the knee can
become irritated, causing pain in a typical pattern. This condition is often
referred to as ‘runner’s knee’, PFJ Syndrome or patellofemoral pain syndrome
(PFPS).
What causes it?
The patella usually sits in a balanced
position in the shallow groove at the front of the knee and moves easily
without friction. The patella is attached to the quadriceps muscle at the top
and connected to the lower leg via the patella tendon at the bottom. When the
quadriceps contracts, this pulls on the patella and acts to straighten the
knee. If one side of the quadriceps is stronger or tighter than the other, it
can cause the kneecap to pull to one side and over time become irritated.
There can be many factors that cause a
muscle imbalance or weakness on one side of the quadriceps. In most people, the
outer aspect of the quadriceps tends to be stronger and tighter than the inner muscle.
Certain postures and leg positions require
the outer muscles to work harder and the inside muscles to become less active.
Lack of arch support in your feet or simply a physical abnormality of the knee
can also place stress on the movement of the patella.
What are the symptoms?
This condition is characterized by pain
felt on the inside or behind of the patella with activities that require
repetitive bending of the knee. There may be a sensation of crepitus, clicking
or grinding and some people report that their knee suddenly gives way. The pain
is commonly felt when running, going up and down stairs or when doing squats
and is relieved with rest. The pain may start as a small niggle and gradually
become worse over time.
How can physiotherapy help?
The first step in effective treatment is
to exclude any other conditions and have a physiotherapist confirm the
diagnosis. Your physiotherapist is able to determine which factors are
contributing to this condition, which could include poor posture, a lack of
arch support in your feet or poor running technique.
Once these factors have been identified, you will be provided with a specific treatment program to best approach your condition. Runner’s knee usually responds quite well to biomechanical analysis and correction of any muscular weakness and imbalance. Having the correct shoes and orthotics can also make a huge difference. There are some short-term treatments, such as patella taping, dry needling, trigger point therapy and ultrasound, which may help alleviate symptoms quickly and keep you active while you address the other factors contributing to your pain.
None of the information in this newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.
If you require professional advice or treatment, please see our range of treatment options, or book an appointment online. Physio Direct has many clinics located throughout New Zealand, with no GP referral required to make an appointment.
