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A Physiotherapist’s Truth Bombs

I have literally treated hundreds of bodies with a multitude of conditions over the years of being a Physiotherapist in Umhlanga. A few basic truths/rules/advice seems to pop up for every person and I’m going to share these with you. They have great value and could certainly help you prevent experiencing pain or at the very least, help you recover faster.

Movement is always your best friend

Physiotherapist move

As a physiotherapist, a simple rule I apply to life is…move. If you have been sitting for an hour, get up and move for a minute or two. If you have been turning your neck to one side for the last 10 minutes talking to someone, stop, turn the other way a few times and then continue. Lying on the couch watching tv? Place the remote control on the other side of the room so that you must get up to change anything. When you lie down, try lying on the other side.

Even when you injure yourself (unless it is a broken bone), movement is still your best friend. Gently (emphasis on gently) try to do a few movements that don’t hurt too much. Start with small movements and gradually your body will allow you to do more. Being sedentary almost always makes pain worse if it isn’t balanced out with a bit of movement in between. Never force a movement, always start gently.

Quality always trumps quantity

Physiotherapist quality

It is my job as a physiotherapist to teach people about movement quality. Quality is becoming aware of your body, your posture (the body’s position in relation to its environment) and what it feels like to do movement or exercises. Which muscles are you engaging? Are you starting in a good posture and maintaining it throughout the practice of the movement or exercise? Does it hurt to do a specific movement? Think about what you are doing.

If you are simply trying to reach a certain number of reps or beat the guy next to you without being aware of your body, your chances of injury are much higher. Being aware, engages your brain during exercise and makes sure that there is neuromuscular control, connection and growth also taking place. Never be in a rush. If you have time constraints, rather do fewer reps. Your body will thank you.

Warm up is essential

Physiotherapist warm up

Before attempting any complex movement activity, prepare the muscles and the joints by slowly moving them through a routine to warm them up. This could be prior to sport or in the case of someone that has an injury, prior to doing a simple task like standing up.

A warm up is simply breaking down the movement you will require to do into its components and actively doing those simpler movements repetively. E.g. When you have a calf injury, standing up requires the calf to engage and may be painful. Doing a few seated calf raises prior to standing up will reduce calf pain and stiffness.

Exercise is 90% of your recovery

Physiotherapist exercise
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Contrary to popular belief, that simple little exercise programme that your physiotherapist introduced to you, is how you are going to recover from your injury. Remember the first point I made? Movement is your best friend. We are designed for movement and that is where your healing starts. Movement helps the brain to switch off the pain centre and see that everything is going to be okay. Exercise also helps you to see and believe that you can get better.

Yes, the hands-on treatment is helpful but without the exercise programme adherence, the chances of recovery become much less. Exercise and in particular strength training has also been shown to be the one thing that helps prevent pain and injuries. Exercise and not therapy is what helps to make arthritic knee pain tolerable. Exercise is what reduces pain in tendinopathies.

X-rays, ultrasound and MRI’s can be deceiving

Physiotherapist x ray

X-rays can be very helpful in diagnosing an injury, especially a bone fracture. They can tell a physiotherapist where in the lungs you have bronchitis and indicate if you have arthritis in a joint. Then how can they be deceptive? The simple answer is that often the pain someone experiences and the findings on the x-ray don’t match up.

The same goes for ultrasound and MRI. In the case of acute pain like from a ligament or tendon that tore, it helps to diagnose the level or type of injury. However, as with x-rays, when the pain is of a chronic nature or related to the back it can be deceptive. The pain and the radiological finding often don’t match up.

Why am I telling you this? I don’t want people to look at their radiological findings and then catastrophise their pain. The brain is a complex machine. The centre for pain interpretation. But we don’t know why some people feel pain with certain pathology and why others don’t. Therefore, don’t get caught up in the results and believe it is the end of the world. Belief in the ability of your body to overcome is way more powerful than the result of the x-ray/MRI.

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