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Productive healthy ageing and MSK health

Posted on 9th January 2018 by

Last month, Public Health England published new guidance, entitled Productive healthy ageing and musculoskeletal (MSK) health.

Over the last few decades, life expectancy has been steadily increasing, with the ONS estimating that by 2041, there will be an 3.2 million people aged 85 years and older in the UK.

The report highlights that older people have an abundance of skills, knowledge and experiences that benefits the wider community greatly, however, the opportunity to utilise these resources is dependent on good health as we age.

Challenge the view that retirement is about sitting more and moving less.

As life expectancy rises, we must promote the concept of productive healthy ageing. This involves many pillars including; financial security, resilience, social activities and physical health.

Productive healthy ageing

Physical Health 

MSK conditions are problems of the bones, joints, muscles and spine, and are a common cause of severe long term pain and physical disability. There are 3 groups of MSK conditions:

  • inflammatory conditions, for example rheumatoid arthritis
  • conditions of MSK pain, for example osteoarthritis, back pain
  • osteoporosis and fragility fractures, for example fracture after fall from standing height

The older a person is, the more likely they are to experience chronic diseases and disabilities such as poor MSK health.

MSK conditions have a massive impact on society.

  • Lower back and neck pain were the leading causes of disability in England from 1990 to 2016.
  • Estimated levels of MSK conditions in England for 2012 also found that 18% and 11% of people aged 45 years and above have knee and hip osteoarthritis, respectively.
  • An estimated 17% of all ages have back pain.
  • Fractures, which are often a consequence of falls, are one of the most serious MSK problems seen in the older population.

There are many risk factors that can increase people’s susceptibility to MSK problems, including age, being overweight or obese, lack of physical activity, and poor health habits such as smoking.

The two risk factors that often coincide are increasing age and reduced physical activity. As people age, they take part in less physical activity

In the 19 to 24 year age group 76.6% of people are physically active compared to 24.7% in individuals aged over 85 years.

Living for longer does not mean a lifetime of pain and ill-health. There are steps that we can take throughout our lives to maintain healthy productive lives, reduce the risk of developing MSK conditions and better manage our health.

Our Top Tips

As a physiotherapy, health & well being clinic, a significant number of the people we see are in the older age range. We see people with MSK conditions such as osteoarthritis, back pain and osteoporosis. We see people concerned about their reducing mobility or with balance problems that mean they are starting to loose their independence. More frequently, we are now seeing people who are really investing in their physical health – listening to the messages the Government are putting out and taking action to reduce the risk and impact of MSK conditions.

Physical activity in adults

So, what are the best ways of tackling physical health as we age?

  1. Stay as active as possible. Simply walking is fantastic, you can make it social or build it into functional tasks such as shopping. Set yourself some walking goals, to increase your distance gradually. Find a variety of physical activities that you enjoy – swimming, specialist classes, yoga or Pilates are all great ideas. It doesn’t matter what you do, the most important thing is that it’s fun and enjoyable, then you’re more likely to make it part of your routine!
  2. Sit less. Don’t be tempted to sit more. Activities such as gardening, going out shopping, looking after grandchildren and cleaning are all wonderful ways to stay active.
  3. Be health conscious. If you’re invited to check up’s at your G.P., don’t put them off. Keeping on top of your general health and managing any conditions you may have, will help with your physical health. You can also have check up’s or health MOT’s through schemes such as Health Works locally. Try and eat well, sleep well and have time for relaxation too!
  4. Keep on top of aches and pains. If you do pick up an injury or an MSK condition such as arthritis is giving you pain or limiting you, seek help. Seeing someone sooner rather than later will help make sure you can stay physically active and recover quickly, so you can continue enjoying life. “Use it or loose it” is a very apt saying as we age. If you can’t keep active due to pain or an injury, you can very quickly loose muscle strength, balance, fitness and flexibility. So it’s really important to be pro-active.

How we help 

We run a range of specialist services for the older residents of Chandlers Ford and surrounding areas of Hampshire. Our core service of physiotherapy is there for you if you want help and relief from pain or an injury. It’s also valuable if you have a diagnosis of an MSK condition such as arthritis or osteoporosis, and want to know more about the condition and be pro-active about managing it.

We also run weekly Positive Steps classes, which are specifically designed exercise classes for older people. They are a relaxed, sociable and fun way to exercise in a supportive environment, led by Clinicians who understand your exact needs and goals. You can try your first class for free, so why not get together with a friend or partner and give it a try!

We also have an extensive Pilates timetable. Our mat classes are ‘Clinical Pilates’, so adapted specifically to work on optimising physical health and run by Clinicians who understand the ageing process and the best way to exercise.

Wherever you find yourself, we’re here to help and support you. Not sure if and how we can help? Just pop in or give us a call and we can have a chat!

 

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Osteoarthritis

Posted on 12th October 2017 by

What is Osteoarthritis?

Osteoarthritis is a condition that affects your joints, causing pain and stiffness. It’s by far the most common form of joint disease, affecting people all over the world and at least 8 million people in the UK.

What causes Osteoarthritis?

Almost anyone can get osteoarthritis but certain factors can increase your risk, for example if you’re in your late 40’s or older, you’re overweight or you’re female (for most joints, especially the knees and hands, osteoarthritis is more common and more severe in women).

What might Osteoarthritis feel like?

The main symptoms of osteoarthritis are:

Pain – The pain tends to be worse when you move your joint or at the end of the day. If you have severe osteoarthritis, you may feel pain more often.

Stiffness – Your joints may feel stiff after rest, but this usually wears off as you get moving.

A grating or grinding sensation (crepitus) – Your joint may creak or crunch as you move.

Swelling – The swelling may be hard (caused by osteophytes) or soft (caused by synovial thickening and extra fluid), and the muscles around your joint may look thin or wasted.

Not being able to use your joint normally – Your joint may not move as freely or as far as normal. Sometimes it may give way because your muscles have weakened or your joint has become less stable. Exercises to strengthen your muscles can help to prevent this.

Your symptoms will often vary for no clear reason. Some people find that changes in the weather make the pain worse, especially damp weather along with falling atmospheric pressure. Others find the pain varies depending on how active they’ve been. In more severe cases, the pain might not go away. It might stop you sleeping and cause difficulties in your daily activities.

There are some great resources on the Arthritis UK website, where these images are from. 

How do the symptoms of Osteoarthritis progress?

Symptoms of OA can vary. That may start severe but settle down or pain and stiffness can progress and worsen. What you do and how you manage your OA can really impact on the progression of symptoms. Keeping active and taking part in regular exercise is one of the best ways of helping your OA.

Possible complications of osteoarthritis include an increased risk of developing gout and chondrocalcinosis.

Gout is a common type of inflammatory arthritis, which is caused by high levels of urate that lead to sodium urate crystals forming in and around your joints. The changes that osteoarthritis causes in cartilage can encourage crystals to form within your joint. If you have both osteoarthritis and a high level of urate in your blood, you’re at an increased risk of developing gout.

Chondrocalcinosis or calcification is the formation of calcium pyrophosphate crystals in your cartilage. It can happen in any joint, with or without osteoarthritis, but it’s most likely to occur in a knee already affected by osteoarthritis, especially in older people.

How is Osteoarthritis diagnosed?

Osteoarthritis is usually diagnosed based on your symptoms and the physical signs that your doctor finds when examining your joints. this can include:

  • joint tenderness
  • creaking or grating (crepitus) sounds
  • bony swelling
  • excess fluid
  • reduced movement
  • joint instability
  • muscle thinning

X-rays are the most useful test to confirm osteoarthritis, although you probably won’t need one. They can’t really show how much pain or disability osteoarthritis is likely to cause. Some people have a lot of pain from fairly minor joint damage, while others have little pain from more severe damage.

Rarely, an MRI scan of your knee can be helpful. This will show the soft tissues (cartilage, tendons, muscles) and changes in your bone that can’t be seen on a standard x-ray

What is the best treatment for Osteoarthritis

Besides painkillers, steroid injections or surgery (when causing severe pain or mobility problems), the best treatment, according to the National Institute for Health and Care Excellence (NICE), is exercise.

NICE recommendations include:

  • advising patients to participate in exercise as a ‘core treatment’
  • offering weight loss interventions for patients who are obese or overweight
  • providing patients with holistic assessments

Exercise can help to manage some of the symptoms of arthritis. As Physiotherapists we provide advice and education on exercise, pain relief and ways to manage your condition. We can teach you how to improve your joint movement and your walking, as well as how to strengthen your muscles.

When you see us at goPhysio, we will assess your problem and give you tailored advice and a treatment programme. This may include some hands on treatments, an exercise programme and modifications to your lifestyle.

Prognosis for Osteoarthritis

It’s impossible to predict how osteoarthritis will develop for any one person. It can sometimes develop over just a year or two and cause a lot of damage to your joint, which may then cause some deformity or disability. But more often osteoarthritis is a slow process that develops over many years and results in fairly small changes in just part of your joint. This doesn’t mean it won’t be painful, but it’s less likely to cause severe deformity or disability. Sometimes the condition reaches a peak a few years after the symptoms start and then remains the same, or it may even improve.

Read more

6 Arthritis myths

Arthritis – an overview

New exercise guide for people with arthritis

How can physiotherapy help arthritis?

 


6 Arthritis Myths

Posted on 12th October 2017 by

Today is World Arthritis Day, aiming to raise awareness of the importance of early diagnosis and World arthritis day access to timely, evidence based treatment of rheumatic and musculoskeletal diseases.

Rheumatic and musculoskeletal diseases (RMDs) are commonly classified into inflammatory and non-inflammatory types:

Common non-inflammatory RMDs consist of degenerative spine diseases, osteoarthritis, osteoporosis and fibromyalgia.

Common inflammatory RMDs consist of rheumatoid arthritis, ankylosing spondylitis, reactive arthritis, connective tissue diseases and polymyalgia rheumatica.

There are many myths surrounding these conditions and to shed some light on these, Physiotherapist Gemma has explored them further.

Myth 1: There’s only one type of arthritis

There are several types of arthritis with very different causes, symptoms and treatments. Osteoarthritis is the most common form and is our normal wear and tear as we age. This can give symptoms such as pain, stiffness, and thickening around the joint and typically affects the knees, hips or spine in people over the age of 50. Rheumatoid arthritis is an inflammatory disease that typically starts in younger adults and cause redness, heat, swelling and pain often in the small joints of the hands and feet. There are many other forms including juvenile arthritis and psoriatic arthritis. If you are unsure about your symptoms check with your GP or physiotherapist.

Myth 2: My parents had arthritis so I will get it too

Whilst genetics do play a role in the development of arthritis, lifestyle has a much bigger influence. For example, if you are overweight, with a poor diet and a heavy occupation you may be more likely to develop arthritis than a sibling that is a healthy weight and has good strength in the muscles which help to support their joints.

Myth 3: You shouldn’t exercise if you have arthritis

It’s a common belief that if osteoarthritis is wear and tear in the joint, then further exercise will wear it out more. However, the reverse is actually true. By exercising we are mobilising the joint which helps to relieve stiffness, and we are strengthening the muscles around the joints which can help to support and offload the painful area. Low weight-bearing exercises such as cycling or swimming can be a great place to start if your joints are painful enough to limit the type of exercise you are able to do. Specialist classes such as clinical Pilates or our Positive Steps classes for older people are a perfect way to exercise with the right support and guidance.

Myth 4: Arthritis is always painful and will get worse as I get older

If you start noticing the symptoms of osteoarthritis there’s a lot of things you can do to help relieve and even abolish the pain yourself. Start simply by using a heat pack such as a hot water bottle or microwavable wheat pack to help ease stiffness and aches. Then begin gentle stretches of the affected joints, you need to do these little and often to be effective, but don’t push into pain.

Consider your diet and exercise levels, extra body weight puts a lot of extra stress and strain on our joints so shedding even a few pounds can help. A physiotherapist can give you personalised advice, hands-on treatment such as joint mobilisations, soft tissue massage, acupuncture and a tailored exercise prescription have all been shown to be effective in relieving the pain of arthritis. We see many patients who remain pain-free and active for years with these simple solutions.

Myth 5: If I have arthritis I will need a joint replacement

Joint replacement surgery is a major operation and always considered a last resort rather than a quick fix. Start by following the tips above and if you still find you are struggling with everyday activities seek advice from your GP. They will be able to organise an x-ray to assess the degree of wear and tear in your affected joint and ask you questions about the types of activities you are struggling with and if you have tried modifying lifestyle factors such as diet, weight and exercise. Remember some unaffected joints may show equal or even worse wear on x-ray but be completely asymptomatic. Therefore, there is no need to undergo the risks of surgery if it is not causing you any pain.

Myth 6: Supplements help

A lot of research has been conducted into supplements such as glucosamine and chrondroitin which are thought to help rebuild damage cartilage in arthritic joints. However, the vast amount of the research in this area is flawed or bias (i.e. research conducted on animals rather than humans, or conducted by the company’s manufacturing the product with a vested interest in positive results). The more recent unbiased research shows these supplements to be no better than a placebo. That said, some people do feel they get some benefit from supplements so consider trying them for up to 3 months to weigh up the cost versus the benefit yourself.

If you need any help or support then please do get in touch. Our team of Clinicians and range of services can really help educate and inform you about your condition and find ways for you to help live with your condition positively.


New report shows health benefits of swimming

Posted on 22nd June 2017 by

A new report has just been published, that outlines the health benefits of swimming.

Based on significant evidence and research, the report summarises that:

“As one of the most popular modes of physical activity, swimming/aquatic exercise confers significant physical health benefits for both healthy individuals and those with disease. Furthermore, these health benefits extend across the entire life-course – from foetus through to the frail elderly.”

As physiotherapist, we often recommend swimming to our patients. Water is an excellent environment for exercising in, not only as a regular, low impact form of exercise but also if you’re recovering from an injury. The buoyancy of water helps promote freedom of movement, increasing joint mobility and easing pain and stiffness. You don’t have to go to a pool and swim lengths! We often give people exercises to do in the water, that they wouldn’t always be able to do on dry land. It is also a fantastic way of maintaining fitness if you aren’t able to take part in your normal high impact exercise (such as running) due to an injury. Swimming can be a way to maintain cardiovascular fitness and endurance, whilst your injury heals and progress is being made at gradually returning you to your normal exercise.

A recent example of a young patient we’ve had at goPhysio, where swimming has been excellent. An 11 year old keen footballer with Severs (heel pain related to growth), Unable to play or attend football training more than twice a week due to heel pain, this young boy was becoming increasingly frustrated, starting to gain weight and loose cardiovascular fitness. Part of the management of Severs is to modify activity and treatments are limited, with time and normal growth rate  being a key part of symptom reduction. So, he was advised to start swimming regularly and his progress has been amazing. He’s felt more positive, been able to maintain and improve fitness and has gradually increased his time on the pitch, without aggravating his pain. Swimming has paid a key part in helping his endurance, strength, muscle flexibility and psychological wellbeing.

The report summarises that  for musculoskeletal health “evidence suggests that aquatic exercise has positive effects for a wide range of musculoskeletal conditions, favourably influencing pain, function and, for some, quality of life. The nature of the aquatic environment is ideally suited to individuals with MSK problems, given the reduced compressive joint force secondary to buoyancy.”

Health Benefits of Swimming

Source: The health & wellbeing benefits of swimming. Commissioned by Swim England’s Swimming and Health Commission, chaired by Professor Ian Cumming, Produced June 2017

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New Exercise Guide For People With MSK Conditions From Arthritis UK

Posted on 15th March 2017 by

A new report has been launched, ‘Providing physical activity interventions for people with musculoskeletal conditions’ by Arthritis Research UK.

The report highlights that physical activity is a key part of a public health approach to musculoskeletal conditions and it has a range of benefits for people with musculoskeletal conditions in terms of improving quality of life and supporting people to be independent.

Musculoskeletal conditions, such as osteoarthritis and back pain, are the greatest cause of pain and disability in the UK. They’re the reason why so many people seek out our help at our physiotherapy clinic in Chandlers Ford day in, day out. As physiotherapists, exercise and activity has always played a key part in our treatment and recovery programmes, so it’s great to see this being highlighted and the recommendations supported.

Exercise can reduce joint and back pain by 25% while also improving sleep, managing stress and reducing depression, anxiety and dementia.

Physical activity is a broad term. It doesn’t have to be thought of as officially exercising or playing a sport. It can include all forms of activity, such as everyday walking or cycling, … active play, work-related activity, active recreation such as working out in a gym, dancing, gardening or playing active games, as well as organised and competitive sport.

What the report does highlight, is that a one size fits all approach is not appropriate. People with different MSK conditions will have huge variations in their physical ability, levels of disability and also lifestyles. This is where a skilled health professional, such as a physiotherapist would come in, to help advise on and tailored physical activity for the best outcomes.

How can physiotherapy help with physical activity?

  • Advise on a specific exercise programme tailored to your condition and lifestyle. As part of our service we always provide a customised exercise programme, including clear explanations and videos, which we email to you.
  • Help you modify your daily activity so that you can stay physically active, balancing activity with your condition, pain levels and physical abilities.
  • Give you confidence to be physically active. With our support and knowledge we will empower you not to be afraid of being physically active.
  • Help you manage your pain so you can stay physically active. We give you the tools to help manage and work with any pain you may be experiencing, as well as using our physiotherapy skills to help ease your pain.

Read more about arthritis and how physiotherapy can help here:

An overview of arthritis

How can physiotherapy help with arthritis?

The importance of lean muscle mass

In addition to our one to one physiotherapy service, we offer a range of other services to help support your physical activity and wellbeing if you’re managing an MSK condition. This includes our specialist Physio led Pilates classes, which are a great way to exercise gently and safely under the supervision of a physiotherapist. We are also introducing clinical yoga and Positive Steps, a supervised exercise class specifically for over 60’s keen improve and stay active.

If you need any help with your MSK condition, please do give us a call on 023 8025 3317 or book an appointment online.


physical activity older adults


An Arthritis Overview

Posted on 19th May 2014 by

Arthritis means joint inflammation – arthro = joint and itis = inflammation. It’s an umbrella term used to cover many different types of joint inflammation.

Many people know they have arthritis or have heard of arthritis, but sometimes aren’t sure which one they have or what the different types are.

This blog will cover the 4 most common types of arthritis and give you more information on what it is, which joints are affected and how it can be treated.

Physiotherapy has a crucial role in helping all types of arthritis by helping to maximise muscle strength, joint mobility and flexibility and supporting functional independence, so helping you to keep doing the things you enjoy.

Osteoarthritis

This is the most common type of arthritis and tends to develop gradually over time.

What Happens?

The cartilage at the joint becomes worn and rough, sometimes wearing out completely. This leads to osteophytes, or small bony growths, forming at the edges of the joint to try and replace the cartilage. The joint space becomes narrowed and tissues surrounding the joint can thicken. Often, there is inflammation making the joint stiff and painful to move.

Which Joints?

Osteoarthritis is most common in the hands, knees, hips, feet and spine.

How Is It Treated?

Medication: Analgesics for pain relief, non-steroidal anti-inflammatories for reducing inflammation and pain & steroids to reduce severe inflammation.

Surgery: Arthroscopy – to clean out the joint and remove any irritants & in more severe cases, joint replacements – most common in hips and knees.

What Can You Do To Help?

  • Keep mobile
  •  Strengthen muscles to help support joints
  • Learn to pace activities

Rheumatoid Arthritis

This is an inflammatory disease, affecting joints and tendons. It tends to present with episodes of ‘flare ups’.

What Happens?

Inflammation usually helps to heal the body, but with Rheumatoid Arthritis, prolonged inflammation causes damage. The immune system starts to attack joints, causing the prolonged inflammation. The joint capsule also becomes inflamed, leading to pain, stiffness and swelling.

Which Joints?

Rheumatoid arthritis is most common in the neck, hands and feet.

How Is It Treated?

Medication: Non-steroidal anti-inflammatories and disease modifying anti-rheumatic drugs to reduce inflammation and slow the damage being caused. Steroids may be used in severe cases of inflammation.

Surgery: Joint replacement surgery if joint function is lost or at risk.

What Can You Do To Help?

  • Learn to pace yourself and accept help on difficult tasks
  • Speak to an Occupational Therapist and Physiotherapist for help with activities of daily living.

Ankylosing Spondylitis

This is another form of inflammatory arthritis that affects the spine. Ankylosing means stiffening and spondylitis means inflammation of the spine.

What Happens?

The joints in the lower part of the spine become painful and inflamed, where the sacrum joins the pelvis. This inflammation then starts to travel up the spine, affecting vertebra at higher levels. The inflammation causes scar tissue to form in the joint spaces between the vertebra, reducing movement. Over time, the scar tissue may become calcified – turning into a bony-like tissue, which fuses the joints together and limits the available movement in the spine.

Which Joints?

Ankylosing Spondylitis mainly affects the spine, but can also affect the hips and shoulders.

How Is It Treated?

Medication: Non-steroidal anti-inflammatories and disease modifying anti-rheumatic drugs to reduce inflammation and slow the damage being caused. Steroids may be used in severe cases of inflammation.

What Can You Do To Help?

  • Keep active
  • Give up smoking – AS can lead to restrictions in rib movements and smoking will reduce lung function further

Gout

This type of arthritis responds well to treatment and further joint damage can be avoided with effective treatment.

What Happens?

Gout is caused by high levels of uric acid crystals building up in the joints. This happens when levels of uric acid are too high in the body – either because more is produced or not being effectively removed as a waste substance. Once the uric acid forms crystals around the joints, there may move into the joint space – this is when the pain, swelling and inflammation starts. It tends to last a few days and then settle, letting the joint return to normal.

Which Joints?

Most commonly affects the big toe joint, but can also affect the ankles, knees, hands, wrists and elbows.

How Is It Treated?

Severe acute attacks will be treated with non-steroidal anti-inflammatory drugs. For people affected regularly, preventative medication like allopurinol or febuxostat may be given to stop uric acid build up in the body.

What Can You Do To Help?

Drink plenty of water Avoid alcohol and red meat – these can increase uric acid levels


How can Physiotherapy help with Arthritic Joints?

Posted on 21st March 2014 by

Arthritis care at goPhysio joints
Each week in the clinic we get new patients coming in asking for help and advice in looking after, treating and improving arthritic joints.
Here are some of the many ways we can help you or someone you know with arthritis:

Prevention

  • We take a very pro-active approach to helping maintain a healthy, active life. As physio’s we are perfectly placed to advise on helping minimise the impact of some arthritis’s. For example – if you’ve suffered with an injury or pain for some time, it is no doubt going to have an impact on how you move. The adjustments your body can make to compensate can be incredible and subsequently this can cause wear & tear on other areas of the body. By making sure you move as optimally as possible during your rehabilitation, we minimise any unnecessary impact on other areas of your body, helping you move ‘normally’.
  • By advising people on how best to support and look after their joints, often we can help to delay the onset of arthritis or reduce the impact it has on their daily lives. After all, prevention is always better than cure!
  • We can look at joint movement, muscle strength, posture, gait and alignment and give tips on areas that are weak or may need work to stop them from developing into a more serious issue. You may benefit from a course of Physiotherapy, a home exercise programme or joining one of our Pilates classes or Positive Steps sessions to keep mobile.

Treatment

  • If you book an appointment to see us to help resolve your arthritic pain, we’ll fully assess, diagnose and treat your symptoms, getting you back to your normal self as quickly as we can. We take into account your lifestyle, your aims & goals and are realistic with helping you work out what you can achieve.
  • The initial assessment will look at movement, strength and function of the painful joint or region. We’ll also look at your posture and gait to make sure you are moving correctly. Treatment will be tailored to your needs and you’ll also get a home exercise programme to help with your recovery. Treatment may consist of the following:
  • Joint Mobilisations – to loosen stiff joints and increase the range of movement available.
  • Soft Tissue Work – including massage, trigger point release and myofascial release to relieve muscular spasm and tightness that could be limiting movement or causing pain.
  • Exercise Programme – this could cover a variety of areas, including strength, mobility, flexibility, balance and proprioception. This is an essential part of your treatment.
  • Acupuncture – to help with pain relief or to loosen out soft tissues that may be tight or overactive.

If you would like to book an appointment or speak to one of our Physiotherapists about how we can help – just give the Reception team a call on 023 8025 3317.

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