Monthly Archives: February 2013

resolution

Exercise is for life not just for New Years!

Now as we approach the end of February most of us are experiencing that perennial feeling of guilt that our New Years resolutions are nothing but a distant memory. It’s a well known fact that the UK’s health and fitness sector do over 80% of their business in December and January. Whether it is to loose weight or to run the London marathon most of our resolutions involve increasing our exercise levels.  So why is it so hard to keep such straight forward resolutions? Well, this is also a problem faced by physiotherapists all over the country while prescribing exercise therapy and keeping patient motivation going. Although there is no quick-fix answer to address this problem there are some factors that when considered can help.

Poor “locus of control” is a commonly quoted psychological characteristic that is associated with lack of exercise adherence. In layman’s term this means people who fail to recognise the important role they themselves play in their own health and wellbeing. No one else will make the time or do the exercise for you. The long-term prognosis of many patients I see in clinic is dependent on them taking partial responsibility for the treat of their condition/injury.

 

When exercise is prescribed by your therapist or health professional the “prescription” is just as important as the exercise itself. Just like medication, if you fail to undertake the prescribed amount then it wont have the desired effect. Conversely, if you do too much there maybe side effects such as overuse injuries and/or fatigue.

 

Adherence to an exercise plans requires firstly the acceptance that exercise is not merely an activity but it’s a life style choice. This therefore will require a time commitment to undertake. This is the point where most people fail. Even with the best will in the world, if you are working a 60+ hour week you are going to struggle to commit to exercise let alone have the energy to do any.

 

Set yourself short and long term goals. Establishing these will set you up throughout your exercise plan. They not only help you monitor progress but they also motivate you in those dark days 3 or 4 weeks in when every muscle in your body is screaming for just one week off.

 

Goals should be achievable over an appropriate period of time. Unrealistic goal setting will put you at risk of overuse injuries, which is a great excuse to stop exercising. So if you haven’t run in 20 years don’t expect to do a 4 hour marathon without at least 4 months of progressive training!! Seeing progress in your health and wellbeing is the best way to stay motivated, without short and long-term goals this is very difficult.

 

Exercise doesn’t always have to be an individual quest for “human physical perfection”. Making the move from three nights socialising in pub with your mates to three evenings on a cross-trainer can be a lonely experience. So chose something that is interesting and enjoyable. If passing out in bikram yoga, shaking your hips in zumba or letting all that stress out in body combat is your thing, exercise classes are for you. For some, finding a well run class is the ultimate answer to exercise motivation. Class benefits include social support, motivation, mastery and most importantly social “blackmail” (everyone has someone in the class they want to be like or know they should be better than).

Exercise when preformed therapeutically or recreationally can be transformative in anyone’s life. The problem is it’s often in direct conflict with our ever-shrinking spare time. Physical, psychological and lifestyle benefits are well documented. It is the health professionals’ responsibility to prescribe appropriate exercises and help formulate appropriate exercise goals. However, the ultimate responsibility is with you so don’t give up on that resolution yet!!

 

David J Bevan (MSK Physiotherapist, Physiolink)

man and lady for ED

Pre-op pelvic floor exercises help prevent erectile dysfunction following prostate surgery

One of the most common side effects of radical prostate surgery is erectile dysfunction. Depressing? But there is some good news.  Results from a small trial by researchers in Sao Paulo Brazil, show that men who have pelvic floor muscle physiotherapy with biofeedback training once weekly for three months before prostate surgery, are significantly more likely to have normal erectile function a year following surgery, than those without physiotherapy intervention.  For many men however, there will not be the luxury of a three month wait between diagnosis and surgery and so the treatment opportunity is not there. Alternatively it may not be easy to access a specialist physiotherapist in your area. But why wait? Even if you never have any prostate intervention, a strong pelvic floor can improve sexual function.  So get practicing: Squeeze and lift from your back passage as if stopping the escape of wind, then let go. Do the same thing but this time using the muscles you use to stop the flow of urine. Now try lifting from the back and front together  so that you are lifting up underneath completely. Do clusters of 10 lifts three times per day. Each cluster should comprise 10 lifts held for up to ten seconds each, with a ten second rest between each lift. You may not get the hang of it straight away but practice makes perfect as they say, so keep trying. If you want to see if you are doing the exercises correctly, stand in front of a full length mirror. As you pull up, you should see your testicles lift and draw in slightly. Not sure if it’s happening? Expert physiotherapy can help you get it right, and provide you with your own individualised exercise programme.  If you are about to undergo surgery, or have just had prostate surgery it’s not too late to seek out your nearest expert physiotherapist to get you on track. All of you out there: get lifting!

warning sign in snow

Winter whiplash injuries: don’t despair

It’s winter (and didn’t we know it earlier last month!). Here at Physiolink it’s the season when we see more whiplash injuries than any other. Why? A slide and tumble on the ice, especially one that is particularly spectacular can result in whiplash injury just as easily as a bump in the car. So for those who have taken a fall and developed whiplash symptoms, there is no need to despair. The misconception that a whiplash injury will produce pain that you are stuck with for life is unfounded (only one in five cases will produce very severe pain). This misconception is largely due to the large number of fraudulent compensation claims by folk in whom recovery is not useful. Criminal gangs are also known to deliberately crash a car in order to make a claim. Fortunately the government is currently attempting to reduce whiplash claims (1500 per day) in order to limit meteoric rises in insurance premiums.

This is not however intended to make completely light of it. The first days following a whiplash type injury can be pretty miserable. The key is to not be frightened by it, and to take on board that it will get better.  The soft tissues will be bruised and therefore will need time to settle and recover so patience is required. During this time there will not be any quick fix, but early physiotherapy intervention is recommended by experts. On a case by case basis, physiotherapists provide advice on basic exercises, the amount of rest versus activity required, optimal posture at work, daily activities and for sleeping, and other strategies to help reduce pain. Later on, rehab strategies can be instigated to restore previously painful movement.

However, the best advice of course is prevention, so make sure you have a really good grip on your walking shoes whenever ice threatens. Meanwhile, roll on Spring!