Prophysiotherapy Information and Blog - latest physiotherapy treatments in Wimbledon and Earlsfield

November 25, 2009

Reflexology in pregnancy

Filed under: Treatments — admin @ 4:46 am

We recently had a question from a patient who asked if reflexology was safe in pregnancy.

The answer is yes it is safe. For an interesting read try:

http://www.gentlebirthmethod.com/birth_prep_body3.php?lnkis=reflexology

Our reflexologist has found that different techniques at different stages of the pregnancy help. It can be used throughout the three trimesters although most people are more familar with it during the birthing process. At that point, it can help with labour and pain relief.

I hope that answers the question!

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Are you fit for skiing this winter?

Filed under: News, ProPhysiotherapy — admin @ 4:30 am

We at ProPhysiotherapy have purchased an amazing bit of equipment – the Skier’s Edge. There’s not many around as they are mainly used by national ski teams as they specifically train the muscles you need for skiing. There is no other off-piste way of replicating the movements needed for skiing. Most gym equipment and ski classes consists of squats and forward/backward exercises – the Skiers Edge trains you in that lateral side to side movement that skiers need as they carve their way down the slopes.

We have specialist physiotherapists who have worked with ski medical teams in Val d’isere. They can check your ligaments, strength and look at your ski technique to optimise your performance. You’ll learn alot about the body and the effect altitude has on the body too.

The Prices?

1:1 Skiers Edge Assessment :30 mins £30
1:1 Full MOT technique assessment, joint check and muscle testing: 60 min £50
Ski fit class: £15/session; £12.50 if block booking
* NOTE: you must be checked on the Skiers Edge as a pre-requisite to the class*
Unlimited use Skiers Edge 6 months (just call and book ahead) £50

Just call and book 020 8 879 1555

Looking forward to seeing you soon.

The Team

ProPhysiotherapy
www.prophysiotherapy.co.uk

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November 6, 2009

November Clinical Update

Filed under: Treatments — admin @ 5:33 am

Every month we update the GPs in the local area with the latest research. Here is a sample of the articles we have reviewed and passed on.

MEDIAL TIBIAL STRESS SYNDROME – HOW TO PREDICT IT?

Sports Med. 2009;39(7):523-46

Medial tibial stress syndrome (shin splints) is common in athletes and military personnel and is characterized by tenderness of greater than 5cm on palpation of the medial tibia. It is caused by periostitis as a result of adverse traction of anterior muscle groups on the bone. In this study they have reviewed the available literature and suggested some risk factors that may predispose to the condition. Intrinsic factors such as increased foot pronation were highly indicative of symptoms occurring, as was to a lesser extent, higher BMI, increased external and internal hip rotation and calf girth. A previous history of the condition also indicated resorptive changes in the bony cortex as a maladaptive change to poor biomechanics. It is a useful article in terms of it covers the basic physiology and conservative management of the condition.

WHIPLASH – THE LATEST STUDY.

Patient Saf Surg. 2009 Jan 16;3(1):2.

The latest German study looking at the best approach to manage WAD2 symptoms post-RTA, assessed active and passive modalities in conservative management. They compared these groups against an ‘act as usual’ group and measured range of motion and pain scores up to 2 months post-incident. The active rehabilitation group had the biggest reduction in pain and seemed to shorten the post-injury disability phase significantly. The authors called for more access to rehabilitation services as long term costs for treatment increases substantially as pain continues.

CHRONIC COMPARTMENT SYNDROME – TO BE CONSIDERED WITH OVER-TRAINED ATHLETES. Scand J Med Sci Sports. 2009 Oct 4

Rehabilitation researchers have turned their focus on the vascular effects of exercising hypertrophied muscle within their fascial compartments. Chronic exertional compartment syndrome (CECS) is now an accepted phenomenon at the higher levels of sport. This latest study looked at normal, ‘matched’ individuals compared to those who had CECS and followed them post-fasciotomy. They found that CECS patients had lower capillary density than the normal subjects. One year post-surgery, there was evidence of developing myosin chains but no increase in capillary capacity. The pathogenesis of CECS is still poorly understood as fasciotomy seemed to trigger a regenerative response in the muscle but not the capillary bed. Further studies are planned.

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October 29, 2009

Pilates: the latest for the good folk of SW17,SW18 and SW19!

Filed under: Treatments — admin @ 3:16 am

A recent study this year looked at Pilates and an Eastern system of martial arts training and found significant improvements on perceived self-effacacy, sleep quality and mood. Strength and balnce were equally improved across both disciplines. (Source:Journal of Bodywork and Movement Therapies, Volume 13, Issue 2, Pages 155-163
Also in the same journal this year was a report looking at different approaches in Pilates to different stages of back pain (acute and chronic). There was a significant reduction in disability scores and pain in all types of back pain but no one form of Pilates was superior.

(Source: Journal of Bodywork and Movement Therapies, Volume 13, Issue 1, Pages 104-111)

So, if you’re thinking of Pilates, we have two classes a week and an excellent instructor. There’s some space but not much! Call or email to make a booking!

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October 28, 2009

How does a free massage grab you?

Filed under: ProPhysiotherapy — admin @ 3:03 am

This is simple. Any patient who we’ve treated in Wimbledon who recommends us and their name is written down as the referral source, gets a free sports massage for half an hour. Normally that costs £30 but we wanted to provide an incentive and a thank you to the patients that we have seen! The refer-a-friend scheme is already working in Earlsfield and is going down a storm! So get referring! Thanks from the Team.

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October 16, 2009

Feedback from patients

Filed under: Uncategorized — admin @ 8:05 am

We endeavour to send all of our patients a customer satisfaction survey so that we can gauge the feedback and make improvements. The response has been terrific with nearly all good comments. So here’s a taster of the last 40 we have received for all our therapists in our Earlsfield Physiotherapy Clinic. The rest just ticked boxes marking us – but here are the comments from our recent patients.

20.09.09 Can’t fault the clinic in any way. My treatment has been fantastic! HM.

24.09.09 Peter provided a good level of explanation for the lay person without getting too technical. I felt a honest assessment was offered of success and level of treatment required [sic]. BDG

11.09.09 Yes I was very pleased. Anon

14.09.09 Am really pleased. Thank you. MC

01.07.09 very happy, will recommend to friends. RW

22.09.09 Very friendly and informal (in a good way!) whilst being totally professional. PP

20.06.09 I had never been to a physio before but I was very happy with my treatment. CE

12.06.09 Bit warm upstairs. BT

10.06.09 I saw Peter and he was very professional! PW

20.04.09 Difficult to find the first time, great detail re mechanics of treatment, lowyresque pictures of exercises good. ML

11.02.09 There were no negatives to my visits. I always got an appointment when I wanted and treatment was great. JC

04.12.08 A very happy customer! It makes things easier that you deal directly with the health insurance. CV

03.03.09 I would defintely recommend this clinic to others! TC

24.05.09 All in all very helpful! I’ve already recommended Kate to quite a few friends… CH

15.06.09 Many thanks to Kate who made my recovery so much easier than expected, complemented by the location of the clinic and great appointment times. THANK YOU LB

12.06.09 Treatment and service was first class. BN

22.07.09 Very satisfied with the whole service! TC

29.08.09 Excellent – both diagnosis and treatment. Sorry i couldn’t make the pilates class!

30.08.09 One of the most satisfactory physio experiences I have had. The therapists were clear and helpful in aiding me with understanding what had happened, what needed to be happen and how I could achieve that. Little personal touches make all the difference (follow up phone call/email/diagrams of exercises). The only reason I didn’t tick excellent is that I wish it was slightly cheaper although the costs are similar in other practices. DS

15.09.09 Superb knowledge and advice from specialist althogh clinic {small} it is a relatively small business so can’t expect big rooms. Anon.

24.09.09 Not that it matters but I was promised an email to check up on my progress a few weeks after my last appointment but didn’t get one. VW (We checked – she did!)

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October 9, 2009

South West London’s Clinical Expert Returns!

Filed under: News, ProPhysiotherapy — admin @ 8:22 am

ProPhysiotherapy is very very pleased to announce the return of it’s co-founder and lower limb expert, Kate Robertson after her maternity leave. Kate gave birth to son, William, in June and has had a summer of adjusting to a very new role in life.

Both patients and staff alike are delighted to see her back for at least 2 days a week (but we’ll see if we can talk her into some more!).

Welcome back Kate!

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October 8, 2009

Clinical Updates for Wandsworth and Wimbledon GPs

Filed under: Uncategorized — admin @ 9:09 am

Over the summer we have provided the local GPs with monthly clinical updates on musculoskeletal medicine and the feedback so far has been very positive! With millions of medical citations on Medline and other medical research sites, it can be hard to keep abreast of what’s new in orthopaedics. However, as we’re very keen to promote evidence-based treatment and we feel that it’s important that we know our stuff, we plan to do the research and then pass it on to GPs and the public alike! Here’s an example of this month’s research:

KNEE PAIN: PREDICTING OUTCOMES IN GENERAL PRACTICE

Prognostic factors in adults with knee pain in general practice: Arthritis & Rheumatism Vol 61 (2) 143-51

A recent report looked at non-traumatic knee pain (480 subjects) and tried to use subjective and objective markers to predict outcomes a year later. The main prognostic features of future symptoms were characteristics like chronicity beyond 3 months at presentation and bilateral pain. Moderate prognostic strength came from crepitus on passive extension but other features of the physical examination did not predict outcomes. Factors such as educational background and kinesophobia were not predictive of future knee pain at 1 year.

BACK PAIN – SHOULD WE LEAVE IT ALONE?

Overtreating Chronic Back Pain: Time to Back off? Deyo et al JABFM 2009 22 (1)62-68

Richard Deyo has recently written a provocative but thought-provoking article regarding Chronic low back pain in the American Journal of Family Medicine. He suggests that a 423% increase in the opioid expenditure; 629% increase in opioid epidural injection; 307% increase in lumbar spine MRIs and a 202% increase in spinal fusion rates in the American Healthcare system has done nothing to reduce the incidence or management of LBP. He suggests more rigorous trials and a move towards chronic disease management rather than cure with chronic LBP.

WHAT’S NEW IN SHOULDER AND ELBOW SURGERY?

Speciality Update: What’s new in shoulder and elbow surgery? Ramsey et al 2009 J. Bone and Joint Surgery 91:1283-93

There was rather a lot actually! The full article can be downloaded from the journal website for free. Two key things that came up in the meta-analysis of literature in relation to frozen shoulder and impingement syndrome. They found Level 1 evidence for the use of 3 steroid injections to reduce pain and improve function and movement but further injections conferred no further benefit. Kivimaki et al 2007 was quoted as a high quality study that showed that MUA conferred no benefit over exercise alone. Overall, the reviewers suggested steroid injections and supervised exercise were the primary treatments based on best available evidence. Regarding impingement, Lombardi’s work (2008) was highlighted as being of good quality (Level 1) in which a progressive resistance training programme for patients with sub-acromial impingement improved greatly in terms of pain reduction, quality of life and muscle strength compared to controls. Their overall conclusions highlighted the role of exercise in the management of shoulder impingement.

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September 6, 2009

A Weighty Issue from Prophysiotherapy

Filed under: News, ProPhysiotherapy — admin @ 8:45 am

It is summer … apparently. The season of BBQs, Wimbledon and panic dieting by a very high percentage of women. What vigour and determination we show in a bid to ban our wobbly bits before they are exposed on a beach or poolside.

Now, if only we would inject such dedication to our physical conditioning before conceiving. Because, while those layers of extra padding may be embarrassing on holiday, they are downright dangerous when you are pregnant.

The truth is, women who start pregnancy overweight, or gain too much weight during the 40-weeks, are more likely to suffer from a range of complications including hiatal hernia, urinary tract infections, hypertension, gestational diabetes and bleeding/wound complications. In addition, half of obese woman have a C-section, almost twice the rate of those with a desirable BMI before pregnancy (Medical News Today 2008).

Complications are also increased in babies born to obese women: they include intruterin growth defects, stillbirths, congenital malformations, increased risk of neural tube defects, increased risk of fetal death and higher rates of childhood obesity (ACOG, 2005: Cesario, 2003).

So, how can you lose those excess pounds before getting pregnant? The answer is, I am afraid, what we all know deep-down – sensible, healthy eating and regular exercise. Crash dieting is definitely not the way to go, as it will leave your nutrient levels low and could affect fertility. A good start is to cut out alcohol and refined sugars (both empty calories), and to increase daily activity by at least 30 minutes – get out for a walk in our lovely English weather!

When you are pregnant, be sure to monitor your weight gain so that you are not gaining too much, or too little. The most recent research recommends the following gains: Women who are underweight at conception (a BMI of 19.8 or less) should gain 28lbs – 40lbs, women who are of normal weight (a BMI of 19.8 – 29) should gain 25lbs – 35lbs, and women who are overweight (a BMI of over 29) should gain 15lbs – 25lbs.

Making sure your weight gain during pregnancy is appropriate will help reduce your risk of the condition highlighted earlier … and ensure that next year’s bikini regime is not such a chore! Bonus.

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Manual physiotherapy techniques decrease shoulder pain more than just exercise alone.

Filed under: News, ProPhysiotherapy, Treatments — admin @ 8:41 am

Studies over the last 3 years have demonstrated that techniques that stretch the joint capsule and mobilise the tissue around the shoulder reduces pain more than an exercise programme alone. The patients were given a standardized exercise programme but half the group were given hands on treatment in addition to their exercises. The manual therapy group had much reduced pain scores compared to exercise alone. The implications for physiotherapy suggest that a return to manual techniques is warranted – please visit Prophysiotherapy in Wimbledon and Earlsfield for more information!

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