Newsletters

2014 Newsletter The Newlands Physiotherapy Practice - our latest news Sunny Spring greetings from all of us here at Newlands Physiotherapy. This time of the year makes us appreciate the beautiful city of Cape Town which has been designated as the World Design Capital of 2014. Kerry is on the Western Cape Branch of the Orthopaedic Manipulative Physiotherapy Group (OMPTG) of the South African Society of Physiotherapy (SASP). She is on the work committee of the OMT Course. She continues to do part-time lecturing on the OMT course and on the master’s programme at Stellenbosch and UCT. Lara was asked to assist UCT 4th year students with part-time clinical supervision. She has enjoyed this introduction to teaching. The OMT course is running in Cape Town again this year. She is assisting on the course and continues to be a member of the OMT course committee. Pauline celebrates 25 years since the inception of the Practice in 1989. Avril and Di continue to run the reception admin efficiently, we thank them for their ongoing support. We welcome Annie who has joined us at reception in the afternoons. Pauline, Kerry and Lara have continued to expand their knowledge regarding pain. Pauline and Lara attended the “Principles of Pain” course presented by Bev Bolton and Romy Parker who run the Pain Management Physiotherapy Group. Kerry and Lara thoroughly enjoyed international lecturer, Michel Coppieters who taught us about nerves and how to treat them when they are one of the structures contributing to our pain experience. And Kerry attended another “Explain Pain” course presented by international lecturer Adriaan Louw. We have about 400 individual nerves in our body which are equivalent to about 70km, and they connect all our body parts. The nervous system is a continuous structure which moves, stretches and glides during body movement. Our nerves are our body’s built in “alarm system”. The alarm is always connected, which is normal and shows us that we are alive, and it is “activated” when our tissues are in danger. For example, when we sprain our ankle, the nerves around the ankle light up like a Christmas tree, sending alarm signals to the spinal cord and ultimately the brain. The brain produces pain and this makes us take action... limp to the freezer and put ice on it! It is a very clever design! The tissues heal and normally the alarm system settles down again, but sometimes the alarm system can stay a bit sensitive. We know that nerves stay more sensitive by testing them with certain movements (neurodynamics tests) and by palpating them. Healthy nerves are dependent on a good blood supply, on sufficient space around them and on an adequate ability to slide and glide during movement. They become sensitive when either one of these factors become compromised as a result of trauma, inflammation and joint or muscle stiffness. Physiotherapy can help reduce the sensitivity of our nerves using techniques which improve the blood flow to the nerves and help the nerve to move more freely during movement. We as physiotherapists are able to perform these techniques in the clinic, and we also prescribe what we call, neural mobilisation exercises, which are included as part of a home programme. Nathan et al (2001) have also shown that aerobic exercise helps with nerve sensitivity. Aerobic exercise pumps blood and oxygen through our body and therefore helps to calm nerves down. An important message we have learnt through these courses is that pain is a response by the brain based on the perceived threat and the alarm system is activated. The perceived threat is multi-faceted based on beliefs, past experience, stress and fear. The pain we experience is real, however it may not be a true reflection of the state of our tissues ie. very intense pain does not necessarily mean severe tissue injury and in contrast, sometimes we can have quite a significant injury but experience very little pain. Pain is just a normal response to a sensitive “alarm system” and there is a lot that can be done to help calm the system down, with safe movement being the physiotherapist’s first choice! Remember that...... movement is medicine! When visiting our website, www.newlandsphysio.co.za go to ”Click to view our newsletter” and you will see two sections. Newlands Physio, where you will find our previous Newsletters. Equilibrium, which is a monthly newsletter submitted by the South African Society of Physiotherapy (established in 1924) www.physiosa.org.za. There are tips and information on health events, health conditions, various injuries and self help tips. Read about “Starting a walking programme”, “How to manage sports injuries”, “It’s all about balance” and more..... We also continue to keep up to date with talks and workshops organised by the Special Interest Physiotherapy Groups, namely the Western Cape OMPTG and Sports and Pain Management Physiotherapy Groups. Further information is available on their websites: www.omptg.co.za www.sport-physio.co.za www.pmg.co.za National Physiotherapy Back Week is in September. The theme is: “Movement of Good Health - Exercise”. For more information about our Back Classes look at “Services” on our website. We have 4 back rehab classes a week: Monday 17h15 - 18h00 Tuesday 08h00 - 08h45 and 08h50 - 09h35 Thursday 17h15 - 18h00 The practice hours are: Monday - Friday 07h00 - 18h00 Saturdays 09h00 - 12h00 By appointment only

2013 Newsletter

The Newlands Physiotherapy Practice - our latest news

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Warm winter greetings from all of us here at Newlands Physiotherapy

Kerry is on the Western Cape Branch of the Orthopaedic Manipulative Physiotherapy Group (OMPTG) of the South African Society of Physiotherapy (SASP). She is on the work committee of the OMT Course. She continues to do part-time lecturing on the OMT course and on the master’s programme at Stellenbosch University and UCT.

Lara has settled in well at our practice after being here for 3 years, and continues to be a member of the OMT course committee.

Pauline celebrates 24 years since the inception of the Practice in 1989.

Avril and Di continue to run the reception admin efficiently, we thank them for their ongoing support.

We hope you enjoy looking at our website.

Details of our attendance at recent courses will be found on “About Us”.
www.newlandsphysio.co.za

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The Western Cape OMPTG hosted 2 international lecturers, Dr Anneliese Pool - Goudswaardt and Dr Paul Hodges. Pauline and Lara attended Anneliese’s course, and Kerry attended Paul’s course, both of which were on the topic of compensation strategies and motor control in Lumbopelvic pain patients.

If you are someone that has experienced neck or back pain, it is quite possible that you adopted a certain posture, or avoided certain movements, in order to avoid pain. This is obviously a protective response. Your brain has concluded there is a threat, taken action, and changes occur in our motor cortex with low back pain. However, our connective tissue like our joint capsule and ligaments, also adapt to these protective postures and lack of movement within minutes.

Anneliese presented some research that was done on astronauts in space. On earth, our spine is loaded due to gravity, but in space there is zero gravity. One of the astronauts gained 10cm in length. This is due to the fact that the connective tissue adapts to the lack of loading and lengthens. They have also found that astronauts become osteoporotic for the same reason.

Loss of movement and loading results in tissue changes, and the impact of this is that the tissues are not as strong, and their ability to withstand load is less. It is extremely important that following injury, we give input to our ligaments and joint capsules through movement. There is a perception that in the presence of back pain or even after the pain has resolved, one needs to “brace” and stiffen our muscles all the time. However, this can sometimes lead to too much stiffness, when in fact we need a pliable vertebral column during daily activities. We need a balance between the ability to resist an incoming load by stiffening our spine, and the ability to respond to an incoming load with movement.

We can refer to this as motor control where we have optimal control of our spine. Thus we can adapt to different tasks and loading using a variety of movement strategies. So our posture, movement, muscle recruitment, breathing and balance are all part of good motor control.

Both Anneliese and Paul conveyed the importance of breathing. Effective, deep breathing causes movement of our spine. However, this movement is impaired when one braces the abdominals too much and breathing is hence shallow. Any exercise where one moves and breathes deeply is beneficial.

Our back classes, are an example of an effective means to improve your dynamic motor control, posture and muscle recruitment with motor learning. Options are given to breakdown a task, and practise components of it with progressions. Different aspects of strengthening, control, balance and breathing work with feedback are practised to improve dynamic function.

So get moving and breathing and remember:
Motion is lotion!

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When visiting our website, www.newlandsphysio.co.za go to ”Click to view our newsletter” and you will see two sections.

• Newlands Physio, where you will find our previous Newsletters.
• Equilibrium, which is a monthly newsletter submitted by the South African Society of Physiotherapy (established in 1924) www.physiosa.org.za. There are tips and information on health events, health conditions, various injuries and self help tips. Read about “Starting a walking programme”, “How to manage sports injuries”, “It’s all about balance” and more.....

We also continue to keep up to date with talks and workshops organised by the Special Interest Physiotherapy Groups, namely the Western Cape OMPTG and Sports and Pain Management Physiotherapy Groups. Further information is available on their websites:
www.omptg.co.za
www.sport-physio.co.za
www.pmg.co.za

National Physiotherapy Back Week is in September. The theme is: “Movement of Good Health - Exercise”.

For more information about our Back Classes look at “Services” on our website.

We have 4 back rehab classes a week:

Monday	17h15 - 18h00
Tuesday	08h00 - 08h45 and 08h50 - 09h35
Thursday	17h15 - 18h00

The practice hours are:

Monday - Friday	07h00 - 18h00
Saturdays	09h00 - 12h00

By appointment only

2012 Newsletter

The Newlands Physiotherapy Practice - our latest news

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Kerry is on the Western Cape Branch of the Orthopaedic Manipulative Physiotherapy Group (OMPTG) of the South African Society of Physiotherapy (SASP). She is on the work committee for the OMT Course, and on the General Executive Committee of OMPTG. She continues to do part-time lecturing on the OMT course and on the master's programme at Stellenbosch.

Lara after being a student on the 2010 OMT course, has now taken up Kerry's challenge and joined the OMT committee. She is assisting on the course that is currently being run in Cape Town.

Pauline celebrates 23 years since the inception of the Practice in 1989.

Avril and Di continue to run the reception and admin efficiently, we thank them for their ongoing support.

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Kerry, Lara, Dr. Lorimer Moseley and Pauline
Dr Lorimer Moseley PhD, a clinical and research physiotherapist in Australia, came to South Africa to run the Explain Pain course in Johannesburg and Cape Town. Pauline, Kerry and Lara have all attended this very worthwhile course.

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We hope you enjoy looking at our website. Details of our attendance at recent courses will be found on About Us. 

www.newlandsphysio.co.za

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Pain is more than an unpleasant sensory and emotional experience (Mersky and Bogduk, 1994). Butler and Moseley (2003) mention that although it is unpleasant, pain is a very normal response to what our brain perceives to be a threat.

Our brain interprets the messages coming in and responds by making us move, think and behave differently, which is essential for healing. If our brain thinks that experiencing pain is not the best option at the time, it will block the pain experience of even a severe injury. Or, our brain can become extremely focussed on pain.

David Butler and Lorimer Moseley, authors of the well-known book Explain Pain believe that there are many misunderstandings and unnecessary fears about pain. They believe that understanding pain can help people change the way they think about pain, reduce its threat value and improve the management of pain.

The Explain Pain book highlights some valuable insights into understanding pain:

• Pain is normal. Simple everyday pains like sprains and postural pain are easily related to changes in our tissues and our brain responds by alerting us to the fact that our tissues are under threat and action is required – like moving when we are feeling a bit stiff after sitting for a long time, for example.
• Pain can be much more complex: amputees can experience foot pain in a foot that is no longer there.
• The amount of tissue injury does not always equate to the degree of pain our brain makes us experience.
• It has been shown that people with severe degenerative changes in the spine, seen on x-ray, can have no pain whatsoever. Butler and Moseley simply say that if there is no pain, it means that these tissue changes are not perceived by the brain to be a threat. The brain decides whether something hurts or not.
• Our brain scrutinises incoming messages within the context of our prior experiences, beliefs, knowledge, culture and current emotional state. The amount of pain produced in a location in our body, will depend on this evaluation.
• Pain is always an output produced by our brain.
• Understanding pain is a crucial part of the healing process and can help us feel less threatened by a pain experience.
• Neurotags are groups of brain cells activated together in many areas of our brain to produce an experience. We can have pain neurotags from previous pain episodes that can be re-triggered and therefore heighten our response when we experience similar pain again.

Pain is a vast subject and not possible to clearly summarise in a few paragraphs. There is a large amount of literature on pain and we have some informative articles and books at the practice that you can access should you be interested in doing some reading.

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When visiting our website, www.newlandsphysio.co.za click on “view our Newsletter” and you will see two sections.

• Newlands Physio, where you will find our previous Newsletters.
• Equilibrium, which is a monthly newsletter submitted by the South African Society of Physiotherapy (established in 1924) www.physiosa.org.za . There are tips and information on health events, health conditions, various injuries and self help tips. Read about Should you go cold or hot, Putting your health first, and more...

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We also all continue to keep up to date with talks and workshops organized by the Western Cape OMPTG and Sports physiotherapy groups.

We are members of the OMPTG and further information is available on their website. www.omptg.co.za

National Physiotherapy Back Week is in September. The theme is More than just back care...from prevention to function.

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For more information about our Back Classes look at Services on our website.

We have 4 back rehab classes a week:
Monday 17h15 – 18h00
Tuesday 08h00 – 08h45 and 08h50 – 09h35
Thursday 17h15 – 18-00

The Practice hours are:
Monday – Friday 07h00 – 18h00
Saturday 09h00 – 12h00

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2010 Newsletter
The Newlands Physiotherapy Practice - our latest news

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The year has been a busy but exciting one with the build up to the World Cup Soccer in our own South Africa.

Kerry remains very involved in running and lecturing on the OMT Course in the Western Cape and Namibia this year. She is also kept very busy being the Chairperson of the Western Cape OMPTG Branch and on the National Executive Committee of OMPTG. Nikki resigned at the end of May, and after nearly four years with us, now looks at continuing her physiotherapy more independently - we wish her well in her new venture. We are very excited about welcoming our new physiotherapist, Lara Groeneveldt, currently doing the OMT Course, who joins us in July. She will be running the Thursday back class and is an accredited Pilates instructor. Pauline celebrates 20 years since the inception of the Practice in 1989.

Avril and Di continue to run reception and admin efficiently, we thank them for their ongoing support.

We hope you enjoy looking at our website. Details of our attendance at recent courses will be found on “About Us”

www.newlandsphysio.co.za

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A brief outline of some of the interesting courses we have attended this year already.

A yearly event is the Current Concepts Symposium organised by the Western Cape Branch of the OMPTG, a special interest group of the South African Society of Physiotherapy. The Third Current Concepts Symposium was held on April 30 and May 01 2010 in Stellenbosch. The theme of the symposium was: Research Evidence on Peripheral Neural and Soft tissue Dysfunction.

Two international speakers, Michael Shacklock and Glenn Hunter were invited to present courses and papers on their areas of interest and research in Physiotherapy. We found the symposium very professionally run and most stimulating. The speakers provided us with evidence-based information based on scientific research they had carried out in the UK and Australia.

Six local Physiotherapists were also invited to speak. Kerry presented the research she did as part of the Masters programme.

Michael Shacklock founded “Neurodynamic Solutions” which offers practical clinical solutions for therapists with an interest in neuromusculoskeletal problems. He presented a two day course on the Upper Quarter and a two day course on the Lower Quarter. One of the key principles of the course is the mechanics and physiology of the nervous system. Understanding the physiology of nerve pain and the mechanics of how the nerve slides and glides in relation to the tissues around it, and, if there is a problem in either of these areas how nerve pain can often result. His system of assessing and treating these neural disorders is very useful to us in clinical practice.

Glen Hunter presented a one day course on Specific Soft Tissue Mobilization in the management of muscle injuries. He is head of the Elite Sports Unit in the UK and has published work on the management of muscular problems. Again, his approach was how to clinically assess where in the muscle the problem lies; to treat the muscle by gradually tensioning it; to strengthen the muscle as it heals, to promote optimal recovery and return to sport.

We also regularly attend evening lectures organised by the Western Cape Branch of the OMPTG and Sports Interest Group. Lectures are given by our local doctors or therapists.

Physiotherapy Back Week is on September 06-10. Information regarding our profession will be on radio. Talks at schools and a fun run will also be organised.

When visiting our website, www.newlandsphysio.co.za click on Newsletters, and you will see two sections. Newlands Physio, where you will find our Practice newsletters, and Equilibrium, which is a monthly newsletter submitted by the South African Society of Physiotherapy. We are sure you will enjoy browsing through them both, as there are tips and information on how to prevent back pain at work, what exercises are useful for busy Moms, and the importance of regular stretching. There are also suggestions on how to handle stress - all in the interest of your improved health.

Attending Back Classes reinforces knowledge, and continues to educate you on the correct movements to be utilized. This information however needs to be practiced daily at home, until it becomes an instinctive part of your physical life-style. For more information about our Back Classes look at Services on our website.

The practice hours are:

Monday - Friday		07h00 - 18h00
Saturdays		09h00 - 12h00

We have 4 back rehab classes a week:

Monday		17h15 - 18h00
Tuesday		08h00 - 08h45 and 08h50 - 09h35
Thursday		17h15 - 18h00

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The South African Society of Physiotherapy established in 1924 - why Physiotherapy?

Physiotherapists are trained to assess spinal problems and treat them in a holistic manner. (We will always refer you to a doctor or specialist where necessary.)

• Severe pain is treated with a “hands-on” approach as well as with appropriate machines.
• Chronic stiffness is eased with mobilising or manipulative techniques and an exercise programme.
• Muscle imbalances are addressed with specific exercises.
• Advice is given on postural shortcomings, working conditions, sleep or sport to prevent or minimise recurrences.

Orthopaedic Manipulative Physiotherapists have a special interest in the management of neuromusculo-skeletal conditions, based on clinical reasoning, using highly specific treatment approaches, including manual techniques and therapeutic exercises.

Orthopaedic Manipulative Physiotherapy (OMPT) encompasses and is driven by the available scientific and clinical evidence, and by the biopsychosocial framework of each individual patient.

Our physiotherapists are members of the Orthopaedic Manipulative Physiotherapy Group (OMPTG) and further information is on their website. www.omptg.co.za