Lipoedema - What is it?

First described in the 1940s, it is a chronic and progressive disease that effects predominantly women and is the abnormal build-up of adipose (fatty) tissue around the hips, buttocks, legs and sometimes arms, leading to enlargement, swelling and pain.

It is a hereditary disorder effecting 11% of Australian women and is highly variable and unpredictable.

It is not the same as obesity or being overweight.

Signs and Symptoms of Lipoedema

• The legs are enlarged bilaterally - arms too can be affected

• The waist is small in proportion to thighs, buttocks and legs

• Feet and hands are exempt and a 'bracelet' effect can, in most cases, appear just above the ankles and wrists

• Legs/arms can be extremely painful, even to touch

• Affected limbs bruise easily

• The fat is soft to touch and wobbly, while skin can be cold to touch

• Lipoedema can become worse in hot weather

• Diet and exercise, while important, can have minimal effect

• Increase in Lipoedema is often noticed when significant hormonal changes happen

• Skin can have a cellulite or ‘mattress’ like appearance

• Skin on the legs and buttocks can be cold to touch.

• Associated with chronic venous and lymphatic insufficiency and early degenerative articular disease.

The onset of lipoedema usually begins at puberty and can develop further with hormonal changes such as pregnancy and menopause. For majority of women that develop symptoms during puberty most aren’t diagnosed until in their 30s-40s, when symptoms have become more severe.

A diagnosis will be made on clinical grounds through clinical assessment and discussing medical history with your doctor. However, many medical professionals are unaware of Lipoedema, and can get confused with Lymphoedema or simply diagnosing as obesity, but this is changing through organizations such as Lipoedema Australia.

There are many conservative treatment approaches that we can do to help, part of which can include Decongestive Lymphatic Therapy, a program that combines multiple treatment approaches to reduce the swelling and oedema-related symptoms of lipoedema. It involves regular sessions of MLD or intermittent pneumatic compression with a pump, compression garments, exercise, skin care and modified factors of daily living. Unfortunately, at this stage there is no cure for lipoedema, however with more awareness and proper management it can be well maintained.

More information can be found on the Lipoedema Australia website www.lipoedemaaustralia.com.au or speaking to a medical professional, qualified oedema therapist, myotherapist or physiotherapist.

Creating Healthy Habits

I’m sure you’ve all heard of SMART goals, a quick google will find 672,000,000 results discussing SMART goals. If smart goals were the (not so) hidden secret to success we’d all be retired and living on a yacht.

SMART goals are great but they often need a little more intention than this “set and forget” format. Which is where if/then planning come in.

After SMART goals are developed, it is time to implement the steps required to achieve those goals. These ‘implementation intentions’ specify when, where, and how the goal will be achieved. They take the form of an ‘If-then’ plan:

IF identifies the cue to act. This might be a time/place. Think about it as a ‘golden opportunity’ to act.

THEN identifies an effective goal-directed response.

If-then planning can also help us identify situations that you can link to the new behaviour. That is, it can help to seize opportunities to act.

For example:

·      If the kettle is boiling, then I’ll do my calf raises

·      If I’ve climbed into bed, then I’ll do my bridges + clams

·      If I’ve brushed my teeth, then I’ll take my medication

Essentially, when you make these plans you become much more aware of the cue in the environment that you are using as a trigger to act (ie the IF). This leads you to see these cues and leads to faster action of the plan. BUT – these plans need to be specific to your goals.

So when reflecting on your “new year, new me” goals for 2023, think to yourself what activity or time can I pair my goal with, to stop relying on motivation alone?

Written by Caitlyn Smith

Derived from Melbourne University

The mistreated ‘jarred’ finger…

The middle joint of the finger (known as the PIP joint) is the most frequently injured joint of the hand. Unfortunately finger injuries are frequently dismissed as just a ‘jarred’ finger or inappropriately treated. There can be long term complications associated with delayed treatment or mismanagement of PIP injuries such as recurring dislocations, chronic and flexed deformities. Unfortunately, these chronic issues can have significant impacts on your hand function and daily activities.

The PIP joint is a very complex structure requiring early assessment and diagnosis to provide patients with their best outcomes. Studies indicate that outcomes are significantly improved when they are treated early post injury, within 4 weeks.

PIP injuries include;

Ligament injuries:

Range from grade 1 tears (the true jarred finger) through to grade 3 full ligament ruptures and joint instability. Depending on the severity will depend on your best treatment. Grade 2 & 3 tears often require 2-6 weeks of splinting which must include exercises to prevent stiffness. Some severe ligament injuries may require surgical repair

Avulsions fractures:

Frequently a piece of bone where the thick ligament on the palm side of the PIP joints attaches can break off. These fractures are often very small but poorly treated. They are usually best treated by hand therapy unless the fracture is too large or unstable, they would require surgery

Dislocations +/- fractures:

Most stable finger fractures can be treated with custom splinting and hand therapy. Rarely will you have a finger fracture without complex soft tissue injuries. It is important to remember these soft tissue injuries won’t be seen on x-ray, so if you get the ‘all clear’ all might not be as it seems!

So next time you suffer a ‘jarred’ finger on the court or field, consider if there might be more to it? Early assessment and treatment for fingers is essential for good outcomes.

Content provided by Kate Cameron, Practitioner of Hand Therapy

Lymphatic Therapy with Nicole

I have studied with the Casley-Smith Method of Decongestive Lymphatic Therapy, which involves the treatment for lymphoedema, lipoedema, swelling, fibrosis and scarring. Treatment includes manual lymphatic drainage, gentle exercise prescription and recommendations for skin care, precautions and activity modification.

Manual Lympatic Drainage encourages the natural process of the lymphatic vessels to eliminate waste products. It stimulates the lymph system to absorb and transport lymph more effectively which promotes tissue health, detoxification and the immue system. It can be a beneficial treatment for; lymphoedema (preventaion and management), lipoedema, oedema reduction, pregnancy related swelling, post liposuction, pain relief, fibromyalgia, pre/post surgery, arthritis and headaches.

Lymphoedema is the accumulation of excessive amounts of protein-rich fluid resulting in swelling of one or more regions of the body. Lymphoedema may arise because the lymphatic vessels or nodes have been damages or were not formed correctly.

Sexual Pain... Physio can help

Did you know….Sexual pain and discomfort is a common issue amongst all genders. It may be associated with endometriosis or childbirth, however, many people suffer with sexual dysfunction for other reasons. Many genito-pelvic pain disorders appear in the form of pelvic floor muscle tension, which makes any type of penetration (sexual, tampons, gynaecological examination tools) very difficult or impossible.

One of the roles of pelvic floor physiotherapy is to assist in the treatment of sexual pain, by increasing muscle awareness and proprioception, improving muscle relaxation, strengthening muscles and increasing the elasticity of the tissues in order to eliminate or reduce pain. Different exercise techniques, biofeedback, manual therapy and insertion techniques are used to achieve positive results. These techniques, when performed by an appropriately qualified therapist, have been shown to have positive results in many women with sexual and pelvic pain difficulties. We are very fortunate to have two Physiotherapists who are trained in pelvic floor physiotherapy and are passionate about helping people with pelvic pain disorders. 

Content provided By Shannyn McGrice, Womens Health Physiotherapist.

Choose physio for dizziness and vertigo

Dizziness is a common issue in the general population. It is estimated that at least five percent of the Australian population (over one million people) will experience dizziness issues at some point in their lifetime. There are a number of causes for dizziness, and treatment options include medical management (eg, medications), physiotherapy and psychology intervention. Your GP can help determine the appropriate clinician for your specific needs.

Vestibular physiotherapy can be a very good option for treating symptoms of dizziness and vertigo, especially if these symptoms are triggered or aggravated by movement. In many cases dizziness that is worse with movement is caused by a disorder involving the inner ear (vestibular) system. Research has shown that vestibular physiotherapy is highly effective in treating vestibular disorders, such as benign paroxysmal positional vertigo (BPPV), viral infection of the inner ear (vestibular neuritis) and vestibular migraine (a form of migraine that causes vertigo and dizziness with or without symptoms of headache).

Your physiotherapist with specific skills in vestibular rehabilitation would conduct a comprehensive assessment of your dizziness and vertigo, and, in many cases, would be able to establish the cause for your symptoms. If unable to establish a cause for your symptoms, your physiotherapist would refer you to a medical specialist who would be able to order more extensive testing.

Vestibular physiotherapy involves:

• Habituation exercises: These exercises involve specific movements that are designed to gently stimulate the symptoms of dizziness in order to desensitize the vestibular system to those movements. These are designed to reduce symptoms of dizziness.

• Eye-head coordination exercises: These exercises are designed to improve focus and reduce symptoms of dizziness.

• Balance and gait exercises: These exercises involve challenging the vestibular balance system in order to strengthen it. They are designed to improve balance and confidence when walking.

• Re-positioning techniques: These techniques are used for a specific inner ear (vestibular) condition known as benign paroxysmal positional vertigo (BPPV). This condition results in significant symptoms of vertigo when changing position, such as when lying down or rolling over in bed. Techniques such as the Epley manoeuvre can successfully treat BPPV but should be performed by your physiotherapist with specific skills in vestibular rehabilitation.

HEALTHY HABITS FOR 2019

Whilst most people make New year resolutions to lose weight, eat healthier and start the gym, did you know that there are some really simple habits that can make a big difference to your health?

Here are some tips for a healthy body and mind in 2019: 

1)   Get enough sleep: the average adult needs 7-9 hours sleep per night to be healthy.  Lack of sleep can contribute to chronic pain, weight gain, chronic diseases, anxiety and depression and also leads to poor work and sporting performance.

2)   Sit Less: Humans are designed for movement! Motion is lotion! Movement lubricates our joints and pumps blood around the body which reduces pain and stiffness, improves metabolism and has a whole host of other health benefits! Try to limit sitting to 4 hours per day if possible or consider a standing workstation.

3)   Drink enough water: It is so easy to forget to drink enough when you’re busy! Simply having enough to drink can improve concentration, reduce fatigue and headaches.

4)   Move a little bit more: Exercise doesn’t have to be a chore if it is something you enjoy.  All movement counts, it doesn’t have to mean going to the gym! Choose something that you enjoy doing with people you like spending time with, it makes a huge difference!

5)   Stress less: Stress contributes to a huge range of health problems, including chronic pain.  Taking steps to reduce stress can be hugely beneficial. If you think stress is an issue for you, speaking to a GP or Counsellor can help.  Other strategies such as exercise, mindfulness, meditation and yoga can be beneficial. 

Lymphoedema... something Physiotherapy can help with.

What is Lymphoedema?

Lymphoedema occurs when the body’s ability to drain lymphatic tissue is compromised. This can lead to swelling in the legs, arms, torso or head and neck

The lymphatic system is important in managing the fluid levels in the body, filtering out bacteria, and housing types of white blood cells crucial to the body’s ability to fight infection.

Symptoms:
· May feel a heaviness in the affected region
· Skin can feel tight
· Swelling, often with pitting oedema
· Warmer skin
· Aching
· Pins and Needles
· Joint pain

Causes: Primary Lymphoedema: Is the rarer of the two types characterised by structural problems with the lymphatic system. Often the system which pumps the fluid around the body becomes sluggish. This may develop at birth, during puberty or middle age.

Secondary Lymphoedema: This is caused by obstruction within the lymphatic system which may be caused by:

· Surgery – particularly cancer-related surgery where lymph nodes are removed

· Radiotherapy – May damage the nearby lymph nodes

· Trauma – injuring the lymphatic system

· Parasites – such as worms, which may inhabit and block a lymphatic vessel

· Reduced movement –Lack of movement allows the lymph to pool, particularly in the legs. Muscle contraction help pump fluid, particularly up the legs against gravity.

· Allergy – allergic reactions may affect the lymphatic system.

Treatment: Includes education, skin care and infection prevention, exercise, manual lymphatic drainage/massage and compression bandaging and garments.

Our Physiotherapist Brooke has had extensive training and experience in managing Lymphoedema

WELCOME MYOTHERAPIST NICOLE

We're so excited to welcome Nicole to our Equip team! Nicole is a Myotherapist with lots of training and experience, which we'll introduce in another post, but for now here is a little bit about Myotheray

What is Myotherapy we hear you ask?

Myotherapy is the evidence based assessment, treatment and rehabilitation of musculoskeletal, neuromuscular and myofascial pain and associated conditions. Myotherapists use massage in their treatments but also use a wide range of other treatment approaches like dry needling, and thermo and electro-therapeutic techniques, cupping, corrective exercise prescription, education about pain management, activity modification and lifestyle modification.

What conditions can Myotherpists treat/manage?

Myotherapy can treat and manage a wide range of conditions including;

•  Neck and shoulder pain

•  Sports Injuries

•  Headaches and Migraines

•  Tennis Elbow

•  Sciatica & Hip pain

•  Frozen Shoulder

•  Carpel Tunnel Syndrome

•  Chronic Back Pain

•  Restricted movement & inflexibility

•  Foot & Ankle pain

•  Postural conditions

If you’d like an appointment with Nicole, give the clinic a call on 5382 0276 or press the book now button.

WELCOME TO Mikaela

We’re so excited to welcome to Mikaela to the Equip Physiotherapy and Pilates team!!

Here is a little more information about Mikaela.

Mikaela is an Accredited Exercise Physiologist and Sports Scientists. Throughout her degree, Mikaela had extensive experience in the area of orthopaedic surgery and cardiopulmonary rehabilitation. Mikaela also worked with clients with chronic pain, cancer and diabetes.

Mikaela strongly believes in designing exercise programs that are tailored to the client’s goals and interests. She enjoys utilizing different modes of exercise, such as hydrotherapy, Pilates and gym based exercises.

Mikaela is always interested in furthering her knowledge, recently gaining her Matwork Pilates Instruction qualification. She is also undertaking study in Ante/Post Natal Pilates. Furthermore, Mikaela dreams of completing further research through a Master's Degree in the area of cardiopulmonary exercise rehabilitation.

Originally from a farm in the Warracknabeal area, Mikaela is extremely happy to be living and working locally. She is passionate about improving the health and wellbeing of her client's and looks forward to working with the local community.