Milltown Physiotherapy are delighted to introduce new Neurological Physiotherapy service led by Chartered Physiotheraist Una Cusack who has expertise as a Neurological Physiotherapist with extensive clinical experience in adult and paediatric Neurological rehabilitation as well as having completed a Masters in Clinical Neuroscience from Kings College London.
Congratulations to our chartered physiotherapist Gráinne Wall who completed the Dublin Marathon on Sunday. Despite hitting the wall on mile 22, she finished in a great time. With her first marathon now under her belt she says she can’t wait to sign up again for next year. Registration for the 2018 Dublin marathon opens up tomorrow!
The Spirit Motor Group Twilight Team Challenge took place in Sandyford yesterday evening for the 4th year running. This team event has become a focal point of the year in the workplaces of south Dublin. Over 600 runners, joggers and walkers signed for this late evening race under street lights. The night race under street lights certainly added to a great atmosphere. This race was hosted by DSD AC who provided runners with a great night of entertainment and fun running. The title sponsors Spirit Motor Group provided a fabulous HQ where participants were very well looked after with catering and refreshments.
Helen, Eimear, Frank and Tara represented Milltown Physiotherapy and managed to survive the thundering wind and a few steep hills to come out in 10th place out of nearly 40 teams. It was a great event, and extremely enjoyable.
If you are looking to get involved in running, or are just starting out we would recommend speaking to a physiotherapist – the movement specialist to help you avoid common running injuries.
A great timed event held in parks across the country for free is the 5km parkrun. You can find further details on www.parkrun.ie on how to register. The event caters for walkers, joggers and runners. Get out there!
Women with uncomplicated pregnancies should be encouraged to engage in aerobic and strength-conditioning exercises before, during, and after pregnancy. Regular physical activity helps with weight management, reduces the risk of gestational diabetes in obese women, and enhances psychological well-being. An exercise program that leads to an eventual goal of moderate-intensity exercise for at least 20–30 minutes per day on most or all days of the week should be developed and adjusted as medically indicated.
Here at Milltown Physiotherapy we offer ante and post natal Pilates classes for women from 16 weeks pregnant and from 6-8 weeks post natal. Women can enjoy Pilates in comfort and safety, knowing they are exercising correctly under the care of a Chartered Physiotherapist with experience in Women’s Health. Click here for further information on our classes
Swimming, walking, modified Yoga, stationary bike and low impact aerobics are all safe exercises in pregnancy. Some Yoga positions should be avoided later in pregnancy. Avoid Hot Yoga.
If you were lifting weights before you got pregnant, keep going as long as you go easy. Avoid heavy weights or routines where you have to lie flat on your back.
High intensity sports: If you regularly run or play tennis, you don’t need to stop. As you get closer to your due date, run on flat, groomed surfaces to reduce impact and avoid falls.
Risky Sports are the contact sports such as basketball, hockey, and soccer and activities that increase your risk of falling, such as off road cycling, roller-skating, downhill skiing, and horseback riding.
In consultation with your doctor running, jogging, racquet sports and strength training may be safe for pregnant women who participated in these activities regularly before pregnancy (ACOG 2015).
Engage your core i.e. your abdominals pelvic floor with impact or you might leak, get pelvic girdle pain or low back pain. If you are not sure how to do this find a Chartered Physiotherapist in your area.
When to slow down: As long as you can talk comfortably and aren’t short of breath while exercising, you’re moving at a good pace. Don’t exert yourself to the point of heavy sweating. Drink plenty of fluids. If you have any of the following symptoms, stop exercising and call your doctor right away:
Calf pain or swelling
Less movement by the baby
Fluid leaking from the vagina
The American College of Obstetricians and Gynecologists, Womens’s Health Care Physicians Number 650 • December 2015
Congratulations to our physiotherapist Noreen Dockery and the Irish masters hockey team on their victory in the Home Nations tournament last weekend. Noreen was vice-captain, and helped lead the Irish team to three wins from three, beating Wales, Scotland and England.
Noreen will now travel to Amsterdam in August representing Ireland in the European Championships.
Well done Noreen and the team, we’re very proud of her achievements and wish her all the best in the Europeans.
Antenatal digital perineal massage reduces the likelihood of perineal trauma (mainly episiotomies) and the reporting of ongoing perineal pain. Women should be made aware of the likely benefit of perineal massage and provided with information on how to massage (Beckmann & Stock 2013).
This is based on a review including four studies (2497 women) comparing digital perineal massage with control. Antenatal digital perineal massage was associated with an overall reduction in the incidence of trauma requiring suturing and women practicing perineal massage were less likely to have an episiotomy. These findings were significant for women without previous vaginal birth only.
No differences were seen in the incidence of first- or second-degree perineal tears or third- or fourth-degree perineal trauma. There was a reduction in the incidence of pain at three months postpartum in women who had previously given birth vaginally. No significant differences were observed in the incidence of instrumental deliveries, sexual satisfaction, or any type of incontinence for women who practiced perineal massage compared with those who did not massage.
The basic perineal massage technique is the woman or partner performs daily 5-10 minute perineal massage from 34 weeks. One to two fingers are introduced 3-4 cm in vagina, applying alternating downward and sideward pressure using sweet almond oil (Labreque 1994). Other descriptions are to perform massage for 4 minutes 3-4 times per week from 34 weeks, 5cms into the vagina and sweeping downward from 3 o clock to 9 o clock (Shipman 1997).
The Epi-No® has been designed to assist women with antenatal perineal release and it is recommended to use it from 37 weeks. It is recommended to insert the balloon 2/3rds into the vagina and to contract and relax the muscles against the balloon, which provides resistance. It should then slowly be inflated to the point of stretching and comfort each day and the muscles are stretched more. After the stretching phase the pelvic floor muscles are relaxed to allow the inflated balloon to be gently expelled from the vagina. A randomized controlled trial on this product showed that antenatal use of the Epi-No® device is unlikely to be clinically beneficial in the prevention of intrapartum levator ani damage or anal sphincter and perineal trauma as diagnosed with ultrasound imaging (Atan et al. 2016).
It has been shown that almost 60% of women who have never given birth report some pelvic floor symptoms (Durnea et al 2014) and clinically it can be observed that many women present with high tone and sometimes painful pelvic floor at this stage. At www.milltownphysiotherapy.com we teach breathing release for the pelvic floor from 34 weeks gestation and gradually increase to include perineal massage, connective tissue manipulation of the external perineum and extend to manual therapy of the deep pelvic floor muscles. We recommend 3-4 sessions as needed with a chartered physiotherapist with a special interest in women’s health depending on the resting position and tension of the pelvic floor. We teach a home exercise program for daily practice.
A recent study by Enda King and Dr. Éanna Falvey the next head of the British and Irish Lions medical team, and published in the British Journal of Sports Medicine (BJSM) compared the research on physiotherapy versus surgery on return to play for Athletic groin pain.
Athletic groin pain has been shown to be quite prevalent among players involved in gaelic football.
They divided the groin injury up into pubic related, adductor related and abdominal related groin pain.
The review suggested better results and quicker return to play with physiotherapy rehabilitation over surgery for pubic-related groin pain.
They also found no difference between surgery and physiotherapy rehabilitation for the adductor and abdominal groups.
You can see why the groin comes under some strain with all the side stepping seen in Gaelic football, rugby, hurling and soccer. With Colm Cooper today retiring from Gaelic football I thought I would share some of the side steps, points and goals throughout his career.
Is your child complaining of recurrent heel or knee pain with no specific cause and it gets worse with activity?
Aisling Dolan, one of our physiotherapists here at Milltown Physiotherapy, has a special interest in treating and managing such injuries, having done a recent thesis on this topic as part of her Masters.
According to her review of recent research, the rise in children participating in organised sports has brought about an overall increase in over-use injuries. With this increased participation rate, there is also a growing pressure on children to perform at high levels and this can lead to inappropriate levels of training intensity, frequency and duration.
“Calcaneal apophysits”, (more commonly known as “Sever’s disease”) is the lead cause of heel pain in children. This condition causes intermittent pain where the Achilles tendon joins the heel bone at the growth plate. When the load at this junction has exceeded its tolerance level, it can cause an inflammatory response. Other common symptoms can include tenderness on palpation of the back of the heel, swelling and pain provoked by activities such as jumping and running.
The growth plates can be weak links and prone to this injury due to an increase in muscle tightness which occurs during growth spurts and increased levels of sport and activity. Aisling’s research reported that physiotherapy modalities are commonly used to manage these types of overuse conditions. Successful physiotherapy management includes activity modification, manual therapy and a home stretching programme specific to each child’s needs.
Preventative strategies for these type of injuries include monitoring growth spurts, muscle tightness and ensuring that sport participation is managed appropriately with these variables.