Injury blog: Winging of the shoulder blades

Hey everyone! We hope you are keeping well. We’re carrying on with life as close to normal as possible, so here is your monthly reading material. Perfect time for a tea or coffee we say! This month we’re taking a close look at the shoulder, specifically a condition that affects the shoulder blade. Do you have, or have you ever seen someone whose shoulder blades stick out on their back and look a little bit like wings? This condition is aptly named ‘winging’ of the shoulder blades.

Anatomy

Osteopaths love a bit of anatomy! The shoulder blade or ‘scapula’ is a largely flat bone that sits on the back of the rib cage and is an important ingredient in what makes up the various joints of the shoulder. As well as the larger flat part, a few extra lumps and bumps makes for a very odd shaped bone when looked at in isolation. One of the bony protrusions actually makes up the ‘socket’ part of the ball and socket joint in the shoulder. The ‘ball’ part being made from the head of the upper arm bone (aka the ‘humerus’).

Interesting fact… There are 18 muscle attachments on the shoulder blade. It is through fine balancing of these muscles which keeps the shoulder blade stabilised and flush to the back of rib cage, and allows us to move our shoulders through an extremely large range of motion. As you can imagine, keeping all of these muscles in full working order takes a bit of co-ordination. And with so many players involved, there is room for dysfunction to creep in and movement to become affected. Sometimes the dysfunction is great enough to cause the shoulder blade to flip outwards from the rib cage, and this is what we refer to as ‘winging’.

Causes of winging

The causes of shoulder blade winging can be broadly broken down into:

•           Muscular: As we previously mentioned, lots of muscles are responsible for controlling the position and movement of the shoulder blade. Injury to these muscles, or an imbalance in the strength, length and function of the muscles over a prolonged period may lead to this issue. The main muscles involved here are the Serratus Anterior (a muscle which attaches to the ribs and the underside of the shoulder blade), and the Trapezius (a kite shaped muscle which covers the back of the neck, shoulders and upper back… Aka ‘traps’). It’s more complex and there are more muscles involved, but these are the key players when it comes to winging.

•           Neurological: Muscles require a nerve supply in order to move, so if any of the nerves that supply the key players (i.e. Serratus and Traps) are injured, this can stop the muscles from being able to perform their job. Nerves can be injured through entrapment, where something presses on a nerve as it travels from the spine down to the muscle it supplies. Other causes may be from acute traumas as seen with car or sporting accidents where the shoulder takes a direct blow while the arm or neck are suddenly pulled.

Other ways these injuries may come about include prolonged wearing of a heavy backpack, complications following surgery, or as a result of a viral infection that affects the nerve.

Signs and Symptoms

The main sign is a shoulder blade that doesn’t sit snug to the rib cage, particularly when trying to move the arm upwards in front of the body or out to the side. Many people with scapula winging feel no pain whatsoever, but this can be a very painful condition if the cause is from a severe nerve injury. Another key sign is the inability of a person to lift their arm above their head.

Treatment

The treatment of shoulder blade winging very much depends on the cause. If the shoulder blades are winging because of a muscular imbalance, these are a little easier and faster to rehab. After careful assessment of your shoulder, neck and other spinal movements, we will aim to restore full functioning of the muscles that control the position and movement of the shoulder blades. This might include techniques which aim to lengthen short or tight muscles which are pulling the shoulder blade out of position. If there is a weakness to a particular muscle or group of muscles, we will also prescribe you strengthening and movement re-training exercises which aim to return the shoulder blade to its functional position.

Winging caused from nerve entrapment or injury is notoriously harder to treat. If entrapment of the nerve is caused by muscular tension in another part of the body, or because you’ve been carrying a heavy backpack for too long, then we will work on the relevant muscles and nerves to release the entrapment and pressure. We might also need to adjust how you wear your backpack and how much weight is inside while we focus on improving your physical impairments. Nerve-related injuries can take much longer to resolve. Winging caused by paralysis of the nerve which supplies the Serratus Anterior muscle has been known to take up to two years to resolve. The good news is, most people will make a full recovery in this time with surgical procedures saved only for more complex or unresolved cases. Which if you ask any Osteo, is always the goal!

If you notice winging of the shoulder blades, or difficulty with achieving full shoulder range of motion, then get in touch today on 0439379847 and get you on the road to recovery as soon as possible.

Injury blog: Student’s elbow

G’day readers, it’s blog o’clock! This month's blog is about a common elbow injury. Ever heard of student’s elbow? “But I’m not a student!” we hear you say. Well you don’t have to be to fall victim to this condition. Students elbow, or ‘Olecranon Bursitis’ is a condition where a small sack of tissue over the tip of your elbow becomes inflamed and swollen. The pointy bit of bone at the end of your elbow is called the ‘olecranon’ and the small sack which sits between the bone and the skin is called a ‘bursa’. The ‘itis’ part of bursitis simply refers to inflammation of that bursa.

What are the causes?

The most common way to develop student’s elbow is repetitive trauma to the tip of the elbow which slowly irritates the bursa and causes inflammation over time. Think of a student who sits for hours, day after day writing at a desk with their elbow resting on the table. The constant pressure on the tip of the elbow could be enough to kick things off. Anyone whose elbows are subject to repetitive pressure could develop this problem; plumbers and office workers are other good examples.

Other causes include:

•           A single blunt force trauma or fall onto the tip of the elbow

•           Infection

•           Having an olecranon spur (an extra small bony growth which rubs against the bursa)

•           Having an extra pointy olecranon (some peoples skeletons are just a bit different)

This condition may also develop as part of having another medical condition, such as Diabetes Mellitus, Gout, Rheumatoid Arthritis, HIV or alcoholism.

Signs and symptoms

So, what does student’s elbow look like? Signs and symptoms include:

•           A painful or (often) non-painful swelling on the end of your elbow

•           Pain with leaning on your elbow

•           Painful elbow movement

•           Restricted elbow movement (although this is often unaffected)

•           Redness, warmth and a fever (if associated with infection)

Will I need to have any tests done?

Possibly. As with all lumps on the body, your practitioner will want to rule out anything serious going on first. We ask lots of questions so we can paint a picture of what’s going on in our clinical head. Depending on your signs and symptoms, if you have a history of cancer or if infection is suspected, you may be directed to your GP for tests. This is to make sure you are receiving the best treatment in the best time frame. Your doctor may need to take a sample of the fluid inside the swelling to be sent off for lab testing. This will be able to tell us if infection is playing a part or not.

Treatment

The treatment of bursitis is very much dependent on the cause. If the cause is infection, then your GP will start you on a course of antibiotics and anti-inflammatories to fight it off and control the pain. Other treatment may include the use of ice or contrasting hot/cold bathing to help reduce the swelling. In severe cases, your elbow may need to be splinted or elevated in a sling. Elbow pads and changes to your general activities may also help to protect the elbow from further injury. Your GP may offer to drain the swelling (this is called ‘aspiration’ and requires a needle to remove the fluid), and this can help to provide relief by reducing pressure around the elbow.

Once clear of infection, or if you have a non-infective bursitis, then your superhero osteo can step in and work their magic. Abracadabra!

During the inflammatory process, swelling and pain may have affected how you use your arm. With pain, people often stop using that part of the body and swelling can affect the joint's ability to move smoothly through its range of motion. This can have a knock-on effect on the muscles and other tissues which surround the elbow joint. Many muscles which cross the elbow and are involved in elbow movement also cross the shoulder and wrist to aid in their function. So, you can see how a problem at the elbow could affect the whole limb (and beyond).

Here at Holistic Hands Osteopathy we will get to work at restoring full function to the shoulder, elbow and wrist. We will look at your spinal movements too to see if they have been affected. You can expect to be mobilised and massaged and we may also perform some lymphatic drainage techniques to help restore fluid movement through the limb (which may have stagnated during the injury process). Your biceps, triceps and other arm/forearm muscles may have shortened over time so we may perform some stretching techniques and will give you some exercises to do at home to back up what they do in the clinic room. If necessary, strengthening exercises may be given to reduce the risk of future episodes.

If your bursitis doesn’t resolve with the above treatments or keeps coming back, a decision may need to be made on whether the bursa should be removed surgically. This is called a ‘bursectomy’ and is usually a last resort. Extra pointy olecranons or spurs can also be treated surgically if needed.

Back to school… And work!

Now that the festive season is over, the kids will be back to school and the parents back to work. Normality resumes. Keep an eye on those elbows people! If you think you are developing an elbow problem (or any body part for that matter) then please call us on 0439379847 and we’ll get working on it straight away.

Injury blog: Shoulder impingement

Suffering from shoulder pain? Lucky for you that our December blog is all about shoulder pain… We’re good like that! As osteopaths, shoulder pain is up there as one of the most common complaints we treat, after lower back and neck pain. Office workers, gym goers and overhead sports people, such as basketballers and netballers are all regular victims of shoulder pain.

A common shoulder complaint that we see is shoulder impingement, otherwise known as subacromial impingement. Say ‘shoulder’ and most people think of a ball and socket joint. This joint does indeed make up a large part of the shoulder, but there is much more to it than that. Over the top of the ball and socket joint sits a bony ‘bridge’ which is made up of the collar bone (aka the clavicle), shoulder blade (specifically the ‘acromion’ part of the shoulder blade) and a joint which connects the two (aptly named the ‘acromio-clavicular’ joint). Beneath the bridge and above the ball and socket joint is a small gap called the sub-acromial space (sub = underneath).

It is within this space that the abovementioned impingement occurs and if present, may cause pain when moving the arm.

Why does impingement occur?

Well, there are quite a few soft tissues which run through this space that help keep the shoulder functioning. These parts include the tendons of the biceps and one of the rotator cuff muscles, a ligament and a fluid-filled sac called a ‘bursa’. Bursi allow smooth, frictionless movement around joints and can be found all over the body. Any of these body parts can be involved in shoulder impingement if they become inflamed. Repeated, overhead arm use in throwing sports, or chronic poor positioning of the shoulder and posture in desk workers can lead to these soft tissues becoming irritated and inflamed. For example, a cricketer who spends a large part of their career throwing a ball could lead to increased stress placed on the rotator cuff tendon that passes through the space, leading to inflammation, wear and tear, and poor movement. This then has a direct effect on other surrounding structures, so a person may end up with an inflamed bursa too.

 

Signs and symptoms

When someone has shoulder impingement, they may experience any or all of the following:

•           Pain when moving the arm (e.g. our cricketer above may feel pain when throwing)

•           Decreased range of motion in the shoulder

•           Weakness when using the arm on the affected side

•           Reduced ability to perform everyday tasks such as reaching up high in a cupboard, doing up a bra, putting on a coat or holding/lifting a child

Get to the osteo quick sharp!

If you want to get on top of your shoulder pain quickly, then we recommend a trip to see us here at Holistic Hands Osteopathy. After some thorough questioning and assessment, we will work out what lifestyle or movement factors are responsible for your pain. We’ll get to work with our hands straight away. Using a combination of soft tissue massage, joint mobilising, and many other techniques, we will aim to reduce your pain and get you moving better. Someone with a shoulder problem nearly always has an issue related to neck or back movement, so don’t be surprised if we go looking further afield on the body for answers to your problem.

If you are a thrower, we may ask you to demonstrate a throw so we can see how you are moving (don’t worry, we won’t ask you to do this if you are in acute pain). Likewise, if you are a desk worker, we may ask to look at your desk set up and sitting posture. Getting you to take a photo of yourself at your desk is often helpful for us to see if you need to make some changes that may be affecting your posture day-to-day. When it comes to any lifestyle advice, whether it’s the hobbies you have or the way you sleep, we’ve also got you covered!

We pride ourselves on awesome treatment, but shoulders are often tricky to treat, and some cases may take longer than others. To ensure you get back on the right path as quick as possible, always follow our advice between treatments, and please do your exercises! If you have weakness somewhere which is leading to your pain, a few treatments are not going to resolve this. Weakness and instability need strengthening, and strength takes time to build. Consistency is key with exercise. We will educate you on what you need to do, but you need to be the one to do it at the end of the day. It’s a team effort. We know it’s hard to keep motivated, but rest assured we will always be there on those days when you need a hand!

If you have shoulder pain, then don’t stand on ceremony, book an appointment today by contacting our clinic on 0439379847/www.holistichandsosteopathy.com.au. We’ll have you back throwing balls from the boundary quicker than you can say howzat! And if you have no idea what howzat means, then we suggest you ask the audience or phone a friend! ;-)

Safety at work

The great thing about Osteopathy is that it’s not just about ridding people of their pain. It is a way of life. Yes, people come to see us to get rid of pain, but once they are in our caring hands, our work doesn't stop there. We are huge advocates of ‘prevention is better than cure’. So, we will delve deep into your life - your diet, sleep patterns, hobbies, job and more. We look at you and your life as a complete package and will help you work out what areas need adjustments so you can live a long and healthy life (which is as pain-free as possible!).

Work is a big part of most people’s lives and is often a significant contributing factor to their pain. This month we’re giving advice on two key areas to ensure you are looking after yourself at work, so you can avoid injury and keep food on the table. All in the name of ‘National Safe Work Month’! Read on to ensure you are giving yourself the best possible chance of staying injury-free at work.

Lifting posture

We see lots of people coming in for treatment because they have hurt their back, neck or shoulders in a lifting-related incident. Our advice for you…

1.     Plan ahead to make sure you have a clear path from A to B for the object you are carrying. Make sure the object is stable and is not going to topple over whilst you are carrying it.

2.     Get close to the object and with your feet hip-width apart, and whilst keeping a straight back, bend at the hips and knees to get low to the ground (key words here – “STRAIGHT BACK”!).

3.     Ensure you have a firm grip of the object and whilst keeping your back straight (there it is again!), lift from your hips and knees until you reach an upright position.

4.     Always move using your feet rather than twisting or leaning through your back.

5.     Always keep the object close to your body. Never try to hold it out in front of you with your arms, as this places a great deal of stress on your shoulders, neck and back.

6.     Always get help from another person(s) if the object is too heavy for you alone. It is NEVER worth the risk of injury by tackling a task that may be slightly beyond your physical capabilities.

Desk set-up

Postural strain from a seated desk job is another common work-related injury we treat. To ensure you are sitting pretty, our advice to you is…

1.     Ensure the top of the screen is level with or just below the level of your eyes, and centred in front of you.

2.     Sit with relaxed shoulders, elbows bent at 90 degrees and avoid cocking the wrists back when typing (adjust your desk height to suit this if possible).

3.     Adjust the tilt of your chair to allow the hips to sit at an open angle of 100-110 degrees.

4.     Adjust the backrest of the chair to ensure you are supported in an upright position whilst seated.

5.     Avoid slouching back on to your tailbone. Instead, gently roll your pelvis forward to sit on your sitting bones and bring the curve of your low back into its natural position.

6.     Take regular breaks from sitting. Get up out of your chair every 30-45 minutes to allow your body to move and stretch.

So there you have it. Our skills are much more than just our hands. We’re full of good advice! No matter what job you do, we’ll help you break it down to make sure you are getting the most out of it and not putting yourself at risk of a workplace injury. Here’s to a happy workday, every day!

Osteoarthritis: aging and your body

Hello readers and welcome to October’s blog post! This month we are turning our focus to the elderly - an ever-growing population. Did you know that there are approximately 700 million people in the world aged 60 and over? And did you know that it is estimated that by 2050, there will be around 2 billion people on the planet that fall into this age bracket? That’s just over 30 years away! That’s quite difficult to comprehend, but with people beginning to work and live longer, it’s important that the elderly population get the attention and care they need to stay healthy and active; so they can enjoy the quality of life they deserve.

You might think that as people get older, they become less active and therefore are less likely to injure themselves. This may be true to a degree, especially once reaching retirement age, but the elderly population are generally an active population and are just as much at risk of injury as the next person. A 60-year-old person might not play footy or run around the basketball court as much as a teenager might, but they have other things to contend with - an ageing body with years of gradual degenerative change and weakening that we all experience at some point as we go through life. One of the most common causes of injury in the elderly is falling. Unfortunately, as the body ages, it becomes more prone to falls. This usually boils down to a combination of individual factors (i.e. having multiple diseases, poorer eyesight, or general weakening of the body) and environmental factors (e.g. trip hazards around the home setting). Some of the most commonly seen injuries sustained from falls include fractured hips, arms and forearms, cuts and lacerations, as well as head injuries.

In a clinical setting, us Osteos see our fair share of older patients. It’s less likely we’ll see someone in the acute setting immediately following a trauma like a cut, laceration or in many instances where a fracture is suspected, but it does happen. It is much more likely however, that we will see patients experiencing pain related to postural strain (think about the retiree who sits around a lot), or from degenerative changes in the body. A common degenerative condition affecting the elderly population is osteoarthritis (OA). This most commonly affects the joints in the hips, knees and spine - particularly those of the neck and lower back. It’s no coincidence that these are the main weight-bearing joints of the body.

So what is OA?

OA is a condition affecting the synovial joints in the body (the joints between two bones in the body that have a lubricating fluid between them). It is characterised by changes to the cartilage and underlying bone, as well as inflammation and irritation to the soft tissues that help to hold the joints together - known as the synovium - it’s the tissue that forms the lubricating fluid that sits between the joints.

Primary OA refers to changes in the joints that relate to the ageing process. It will often run in the family, so if your granny or dad has it, you may be more at risk to develop it. Secondary OA is arthritic change from any other cause. For example, following on from trauma, repetitive stress, poor posture, or from diseases such as gout.

Signs & symptoms

The main symptoms (things the person experiences) of OA include pain, stiffness, poor joint function and muscle weakness. Signs (things we look for in the clinical setting) that a joint is degenerated include popping and clicking, poor range of motion, bone and joint swelling, deformity and instability.

What to do if you have or think you have OA

First things first, book an appointment to see your local Osteo. After questions and assessment, we’ll get to work on your body and putting you on a pathway to moving better. There is a good chance your arthritic joint is paining you because you aren’t moving well, and the joint is being loaded incorrectly. The good news is, we know how you should be moving, and what needs to be done to get you there. We’ll aim to reduce your pain down by releasing tight and over-worked muscles and mobilising your stiff joints. Mobilising the joints helps to increase range of motion and will help promote production of the lubricating synovial fluid that sits between the joints to allow smooth fluid movement. You should get off the treatment table feeling less pain and moving better. There is a good chance you’ll need to do some form of strengthening to the surrounding weakened muscles, so the joint is more supported when you move it. More good news, we know which exercises will be beneficial to get you on the path to stronger muscles. Unfortunately, we cannot claim to cure your OA, but we can certainly get you moving with less pain or in an ideal situation, no pain at all.

What’s the outlook with OA?

More often than not, if caught early, significant changes can be made to stunt the progression of this degenerative condition. So, don’t ignore pain, it’s your body’s way of telling you something isn’t right. With early treatment, the best possible outcome will be achieved. If you pop into the clinic and we determine your issue is not OA-related, we can provide you with a sense of relief and get you on the right track for your situation (a positive outcome, either way!). In severe cases, you may require the opinion of a specialist orthopaedic surgeon. Sometimes people require joint replacements and can go on to live a very good quality of life with a new hip or knee for example. Always see your Osteo first though. Using our skills, we can possibly keep you from having to go under the knife a bit longer, and maybe even at all. Worth a shot don’t you think?!

Carpal Tunnel: Symptoms and treatment

It’s been a long day at the office, the kids are fed, bathed, and down for the night, and it’s time for my head to hit the pillow. Exhausted doesn’t cut it, but I still cannot sleep… What IS this tingling in my fingers and wrist pain I keep getting?! I felt it a bit at work earlier too, but why now? I’m nowhere near a desk or computer!

Sound familiar? Wrist pain is quite common, and one of the most common causes for pain over the palm side of the wrist and hand is Carpal Tunnel Syndrome (CTS). CTS presents when one of the larger nerves that travels from your shoulder down to the tip of your fingers (it’s called the Median nerve) gets compressed as it passes through the wrist. The ‘tunnel’ is a small space in the wrist, made up on one side by the wrist bones (the ‘carpals’), and a soft tissue covering on the other side. Alongside the nerve travels a group of tendons from the forearm, and once all of that has passed through the tunnel, there isn’t a lot of room for anything else. Throw in a heap of repetitive wrist movements over a prolonged period (for example typing at a desk day in, day out), and the structures running through the tunnel can become irritated and inflamed making an already small space even smaller. Once the nerve becomes compressed, symptoms start to creep in.

Signs and symptoms

CTS can be characterised by the following signs and symptoms:

•   Burning wrist pain (on the palm side of the wrist)

•   Numbness, pins & needles or tingling of the thumb, index, middle and inside part of the ring finger

•   Night time symptoms

•   Pain that radiates to the forearm, elbow or even the shoulder

•   Reproduction of symptoms when compressing or tapping over the palm side of the wrist

As well as repetitive motions of the wrist (seen commonly in desk-based workers, sports people, and even our very own manual therapists), CTS can be caused by some underlying conditions, such as Diabetes Mellitus, Thyroid disease, Rheumatoid Arthritis, high blood pressure, and from fluid retention associated with pregnancy or menopause. Trauma or fractures in the wrist may also lead to this condition. Unfortunately, if you are female, you are also three times more likely to experience this problem.

Treatment

If caught early, this problem can be managed conservatively with a combination of the following treatments:

•   Soft tissue release, joint mobilisation/manipulation (contact your local Osteo

•   Anti-inflammatory medication

•   Splinting of the wrist (particularly at night time)

More severe and persistent cases may require more invasive treatments including having a steroid injection, or possibly surgery to decompress the nerve.

If you have wrist pain, and you think it could be CTS, then our best advice is to visit your local Osteo where you can be assessed thoroughly, diagnosed accurately, and given the best advice and tools to manage your problem. We’ll get you waving goodbye (pain-free) to pain in no time!

Find the Balance: Upper Crossed Syndrome

FINDING THE BALANCE: UPPER CROSSED SYNDROME

This month we’re focusing some attention on postural balance throughout the body. It’s the 21st Century, and our lives are filled with lots of weird and wonderful technology, such as TVs, laptops, computers and mobile phones, just to name a few. While we are thankful for being lucky enough to surround ourselves with such luxuries, they often come at a cost. All this technology and entertainment means we tend to sit a lot more… Sit to watch, sit to play, sit to work! And over prolonged periods, this can wreak havoc on our bodies, altering our posture, and placing undue strain on our muscles and joints. One common condition that might come out of this said lifestyle is Upper Crossed Syndrome (UCS). Read on… (Please sit with a good posture to read!)

 

What is Upper Crossed Syndrome?

 In simple terms, UCS is a condition where some of the muscles on the front and back of the upper body become tight, and others become weak, leading to a forward head, rounded shoulders, and increased spinal curves in the mid-back and neck. When you line up the tight muscles from front to back, and the weak muscles from front to back, it forms a cross or ‘X’ shape when looked at from the side.

Who does it affect?

 The most common cause for this condition is people having forward head posture over a long period of time, usually when sitting or standing. Think of your classic desk-based worker, people who watch TV or play computer games for hours on end – even drivers and students!

What does it look like and what are the signs and symptoms?

 Someone with UCS will adopt a posture where they have a forward head, shoulders that rotate inwards and sit forwards, increased inward curve of the neck, and an increased outward curve of the mid-back. They may also experience the following:

•   Neck, shoulder and upper back pain

•   Headaches

•   Tightness in the chest and shoulders

•   Reduced neck and shoulder joint range of motion

•   Pain, numbness and tingling of the upper limbs, possibly down to the hands

•   Jaw and low back pain

•   Difficulty watching TV, reading a book, or driving for long periods

What can be done about it?

 Treatment for UCS usually includes a combination of manual therapy (i.e. visit your trusty local Osteo and exercise… Again, usually prescribed by your awesome Osteo.

 In a nutshell, the manual treatment aims to release the tight muscles around the neck, shoulders and chest, while the exercises aim to strengthen the weakened muscles, and stretch the tight muscles. Your Osteo may need to mobilise (and in some cases manipulate) your shoulder, rib and spinal joints to aid the process. Remember, habits that take a lifetime to build will always take time to undo, so work hard at your exercises, keep every appointment with your practitioner, and between you both, you will get the results that you want in the end.

 Remember to take regular breaks from sitting, think about your posture and desk set-up, and do your exercises! Take a stand (excuse the pun) and say no to UCS!

Are you 1 in 6 Aussies complaining of this condition?

Pain in the... back?

 

Talk stats - 

It is estimated that 70–90% of people will suffer from lower back pain in some form at some point in their lives, and 1 in 6 Aussies will experience back pain each year

This makes it quite a common condition to see in practice!

It is important to understand that pain is the body’s protective mechanism, and that we can still move without fear of causing tissue damage. With experience I’ve gained in practice, I have prepared some of my top tips to help with managing back pain should it arise:

Keep your body moving!

It can be all too easy to slump on the couch in an attempt to “rest” and ease your back pain, however according to research, movement is one of the most effective ways to minimise your pain! So try and get yourself upright and walking around! Your Osteopath can help prescribe exercise that is both safe and beneficial for you, to help keep your joints moving and muscles relaxed.

Early treatment intervention

In other words, get yourself checked out by your Osteopath sooner rather than later! We can assist in decreasing your recovery time, getting you back to moving pain free and doing what you love – sooner! Interventions can include gentle mobilisation, soft tissue work, muscle energy techniques and devising strategies and modifications to allow you continue doing your daily activities with comfort.

Prevention is better the cure

Work with your Osteopath to address your weak areas that are impacting your back pain. Tackling these areas with an appropriate treatment, management and exercise plan will assist in preventing future bouts of back pain.

Avoid heavy lifting

It goes without saying that heavy lifting (often coupled with poor lifting technique) is an aggravating factor for back pain as it creates extra stress and inflammation to already unhappy tissues. Your Osteopath will take you through proper lifting techniques to avoid re-aggravation.

Heat packs!

For more chronic back injuries, heat packs are great to use over the lower back to help relax sore and achy muscles.

Read this interesting article put by the ABC here…

http://www.abc.net.au/news/health/2018-06-11/treating-lower-back-pain-without-drugs-and-surgery/9850798

If you have any questions about how we can help you, give us a call! 0439 379 847

Office Ergonomics

If you work 40 hour weeks - you spend 25% of your week sitting!

Now is the time to really think about your Ergonimic set up... before it starts becoming an issue!

Ergonomics is the study of the workplace equipment design or how to arrange and design devices, machines, or workspace so that people and things interact safely and efficiently.

If you work at a desk all day, you should really be thinking about your ergonomics. The typical 9-5 desk workers spend a quarter of their week sitting. Therefore it is important to recognise ergonomic issues that may affect the health, safety and well-being of people working in offices.

If your work station is not set up with ergonomic considerations in mind, you could be subject to potential occupational overuse injuries and musculoskeletal disorders. Examples of these are postural complaints like neck pain, headaches and low back pain, overuse injuries to the elbow and wrist and neck.

The work station should be set up in a way that requires minimal to no twisting of the head or body, with the chair, computer screen, key board, mouse places comfortably and conveniently for the worker. Lighting is also relevant as glare or reflections on the screen may cause a worker to adopt an awkward posture than can cause a postural strain if maintained over a prolonged period.

SO WHAT’S CORRECT?

Chair height: The height of the chair should allow forearms and hands to be just slightly above the desk, horizontal to the key board with no bend to the wrist. The chair should have many adjustable features such as the seat height, back support height, back tilt, seat pan in and out, arm rests and a stable base.

Foot rest: If your feet are dangling off the floor, you may need a foot rest or a lower desk. When your feet don’t touch the floor, pressure can build up behind the knees and under the thighs, causing pinching of blood vessels or nerves and result in pins and needles in the lower legs and swelling in the ankles and feet.

Height adjustable worktop: These desks are easy to work with because they allow the correct set up to be achieved without the use of foot stool or monitor risers. As mentioned, no matter if you are sitting or standing, your elbows and forearms should be slightly higher than the desk.

Back rest: The back rest should support your entire spine and recline from vertical 10-20 degrees. This will encourage you to sit upright and prevent slumping in your seat, thereby minimising risk of low back pain.

Seat depth: There should be a small gap between the back of your knees and the end of the seat. If not, may need a different chair with a shorter bottom cushion.

Arm rest: If your chair has arm rests, adjust them so they support your forearms when they sit at a right angle to your body.

Computer monitor: Your monitor should be directly in front of you within an arm’s length, with the top 1/3 of screen in line with your eyes. If you have more than 1 monitor, it should be placed in front of you depending on use. For example if you have 2 monitors, used at a 70:30 split, the former should be in 70% of your line of vision. This minimises the twisting of the head and neck. Tension in the head and neck can lead to head aches and muscle tension around the neck and shoulders.

Mouse position: The wrist position should be neutral with the mouse adjacent to the key board, not with the arm out stretched.

Keyboard: The keyboard should be placed on the desk so that the forearms have enough support and there is no bend to the wrist.  

Document placement: A document holder should be at the same distance away and height as the monitor. If you use more frequently than the monitor itself, the document holder should be directly in front of you with the monitor to the side.

Lighting: Lighting is essential but must also be controlled. Lighting should be over head and behind the operator. Natural light sources should be controlled with blinds, sun shades or tint to the windows.

Desktop Accessories: Avoid reaching or twisting eg phone, reference material. Place equipment in accessible places. If you are constantly on the phone, use a head set is possible to minimise the risk of neck and shoulder pain from holding a phone to your ear. 

Desk Zones: Commonly used desk equipment (keyboard, mouse) should be placed within easy reach (primary zone). The less frequently used equipment should be placed in the secondary zone, accessed with an outstretched arm.further away from the worker.

Below are visual guides provided by Corporate Work Health Australia on how to properly set up for work station.