How Physiotherapy can Help with Cervicogenic Headaches

Written by: Dr Katherine Kulp

Many of us quietly suffer with headaches, taking a pill in order to get on with our day. For a subset of people, their headache is actually coming from their neck; treating the neck then results in a significant decrease in headache pain, intensity and frequency.

A classic example is the headache that starts at the back of the head, and then radiates to the forehead or eye; these are generally one sided and can present similar to migraines even though the cause is actually in the joints, muscles and nerves of the upper neck.   Headaches that feel like a gripping or pressing tightness through the entire forehead and temple area are also examples of headaches driven by the neck.  When we choose to medicate our way out of a headache, especially if we’re taking medication twice a week or more, we can actually develop rebound headaches, leaving us with even more frequent headaches!

Is Physiotherapy Effective for Rebound Headaches?

If the cause is in the neck, then you must treat the neck! This is where a functional manual therapy approach comes in. A qualified physio will fully assess the root cause of the headache. If the problem is in the joints of the neck, the physiotherapist will restore natural motion and alignment of those joints. Through a combination of releasing tight and painful muscles and specifically retraining the correct postural muscles of the neck, a physio will help you to alleviate the pain generators driving the headache! Current research continues to demonstrate that this approach is effective for a large proportion of patients with a headache.

A quick checklist to help you start troubleshooting the cause of your headaches:

  • Do you awaken with headaches? If so, the position that you are sleeping in may be putting too much strain on the neck…. this is especially true for individuals who sleep on the belly. Changing your sleep position and properly supporting the neck will often help immensely. 
  • Do you tend to get headaches after you’ve been at work for sometime? In this case, the posture that you’re in may be contributing to overuse of some of the muscles of the neck.  When these muscles become stiff and tight, or even develop knots, the ensuing pain can be felt in the head.  Changing the posture and strengthening the proper muscles will diminish headaches.
  • Did your headaches develop after an injury to the head or neck?  Even a simple rear end collision that you thought nothing of at the time can essentially “shut off” the stabilizing muscle of the neck.  More significant car accidents or falls can essentially jam up the joints of the neck and create continued headaches if not addressed.

If you find yourself continually reaching into the medicine cabinet to address your headaches, you are likely just perpetuating the cycle as opposed to heeding the warning signals of your body.  A qualified physiotherapist will help you identify the root cause of your headache, treat the joints and muscles that are creating your pain, and show you how to break the habits that have contributed to your headaches.

Further Readings:

Advanced Lymphatic Treatment: The Latest in Lymphatic Drainage Massage

OHC offers Lymphedema Drainage Massage or Lymphatic Drainage Massage in Dubai.

What is Lymphedema?

Lymphedema is a medical condition that occurs when there is a blockage or impairment in the normal flow of lymphatic fluid. This leads to the accumulation of lymph in the affected area, usually in an extremity (arm or leg), but it can occur in other parts of the body as well, when these happens, lymphatic drainage massage might be one of the solutions.

Lymphedema can cause discomfort, swelling, and a range of other symptoms, which can impact your daily life. However, there is a treatment available that can help you manage your symptoms and improve your quality of life.

What is Lymphatic Drainage Massage? Is it for You?

Lymphedema or Lymphatic drainage massage is a therapeutic technique that can effectively treat lymphedema. It involves the use of gentle, rhythmic movements to stimulate the lymphatic system and encourage the drainage of excess fluid from the affected area. Recent advances in this technique have led to more effective treatments and improved outcomes for patients.

Advances in the field of lymphedema drainage massage include the development of new techniques and devices, as well as the use of diagnostic tools and techniques. Therapists can now tailor their treatments more effectively to the individual needs of each patient, leading to better outcomes overall. In addition, lymphedema drainage massage can provide a range of benefits, including reducing swelling and discomfort, improving lymphatic flow, boosting immune function, and reducing the risk of infection.

Read related article: How to Manage Lymphedema?

Benefits of Lymphedema/Lymphatic Drainage Massage

Lymphedema/Lymphatic drainage massage can provide a number of benefits for patients with lymphedema.

  • reducing swelling and discomfort
  • help to improve lymphatic flow
  • boost immune function
  • reduce the risk of infection
  • It can also help to improve range of motion and mobility
  • and can have a positive impact on overall quality of life.

However, it is important to note that lymphedema/lymphatic drainage massage should always be performed by a trained therapist with experience in treating lymphedema. Patients should also consult with their healthcare provider before beginning any new treatment, to ensure that it is safe and appropriate for their individual needs.

The Advances in Lymphedema Drainage

In recent years, there have been a number of advances in the field of lymphedema drainage massage, which have led to more effective treatments and improved outcomes for patients.

One of the most significant advances has been the development of new techniques and devices for lymphedema drainage massage. For example, pneumatic compression devices have become increasingly popular in recent years, and can be used to help encourage lymphatic drainage through the application of controlled pressure to the affected area.

In addition to these devices, there have also been advances in the use of manual lymphatic drainage techniques, with many therapists now incorporating a range of different techniques and tools to help improve the effectiveness of the massage. For example, some therapists may use specialized instruments to help target specific areas of the body, while others may incorporate stretching or exercise into the treatment to help improve lymphatic flow.

Another important advance in lymphedema drainage massage has been the development of new diagnostic tools and techniques. For example, lymphoscintigraphy is a technique that uses radioactive isotopes to help visualize the lymphatic system and identify areas of blockage or damage. This can help therapists to tailor their treatments more effectively to the individual needs of each patient, and can lead to better outcomes overall.

Finally, there have also been advances in the development of new medications and surgical techniques for the treatment of lymphedema. For example, there are now a number of medications available that can help reduce the severity of symptoms and improve lymphatic flow, while surgical options such as lymph node transfer or lymphaticovenular anastomosis (LVA) can be used in more severe cases to help restore lymphatic function.

How Can We Help?

If you or a loved one suffer from lymphedema, it is important to consult with your healthcare provider and consider lymphedema drainage massage as a treatment option. This therapy should always be performed by a trained therapist with experience in treating lymphedema.

We offer manual lymphatic drainage massage in Dubai (MLD) and it’s one of our clinic’s specialities. MLD is designed to stimulate the lymphatic system by using highly specialized techniques to restore drainage and find new pathways to drain lymph.

With the right treatment approach, you can experience significant improvements in your symptoms and quality of life. Don’t let lymphedema hold you back any longer, take action and explore the benefits of lymphedema drainage massage today.

Related article: Lymphedema Management

Hydrotherapy in Dubai: What Exactly is Hydrotherapy and How does it Help?

Hydrotherapy or Aquatic Therapy is movement or exercises in a warm water environment in a specialized hydrotherapy pool using floats or properties of water to assist or resist movement. Others know it as pool physical therapy. We offer Hydrotherapy in Dubai and run by qualified rehabilitation specialists and Physiotherapists, click here to get more info.

Watch the video below to understand more about Hydrotherapy:

How Does Hydrotherapy Help in Rehabilitation?

Water is an ideal environment for exercises and rehabilitation because of these four (4) properties:

1. Buoyancy

When you’re walking in water, 50% of your body is taken off because there is pressure from water pushing you up.

2. Dynamic Resistance

It’s the resistance of water when it presses up against you when you move, and can help strengthen our body and joints

3. Hydrostatic Pressure

It’s the pressure of water against your skin on your joint so it limits lactic acid build up and also limits inflammatory process of arthritis.

4. Temperature

A specialized hydro pool’s temperature is at 33 to 36 degrees Celsius and is kept warmer than your average swimming pool which helps the muscles to relax and is soothing for painful muscles and joints.

What are the Benefits of Hydrotherapy?

  • It helps to start rehab early and hence recover faster
  • Significantly reduce pain and swelling
  • Decreases joint stress
  • Increases strength and range-of-motion
  • Improves balance and gait
  • Eases spasms and tight muscles
  • improves your endurance
  • Induces a deep sense of relaxation
  • And most of all, it’s fun and stimulating medium for participation

What are the Conditions that Hydrotherapy can Treat?

Hydrotherapy can potentially help with the following conditions:

  1. Musculoskeletal Disorders: Hydrotherapy is commonly used to treat conditions such as arthritis, joint pain, back pain, fibromyalgia, and other musculoskeletal disorders. The buoyancy of water reduces stress on joints, allows for increased range of motion, and promotes muscle relaxation.
  2. Rehabilitation after Injury or Surgery: Hydrotherapy can aid in the rehabilitation process after injuries, surgeries, or orthopedic procedures. It helps with muscle strengthening, improving flexibility, and regaining functional abilities in a low-impact environment.
  3. Neurological Conditions: Hydrotherapy can benefit individuals with neurological disorders such as stroke, multiple sclerosis (MS), Parkinson’s disease, cerebral palsy, and spinal cord injuries. The water’s buoyancy and resistance can assist in improving balance, coordination, mobility, and muscle strength.
  4. Chronic Pain Management: Hydrotherapy may provide pain relief for individuals with chronic pain conditions like fibromyalgia, rheumatoid arthritis, or chronic lower back pain. The warmth and buoyancy of the water can help reduce pain and promote relaxation.
  5. Cardiovascular Conditions: Under the guidance of healthcare professionals, hydrotherapy can be used as a component of cardiac rehabilitation for individuals with heart conditions. The water’s buoyancy supports the body, reduces stress on the heart, and facilitates gentle exercise for cardiovascular conditioning.
  6. Stress and Mental Health: Hydrotherapy can have a positive impact on mental health and stress reduction. Immersion in warm water, hydrostatic pressure, and gentle movements can promote relaxation, reduce anxiety, and improve overall well-being.

What OHC Offers in Hydrotherapy Services in Dubai?

We regularly work in our pool on pre- and post- rehabilitation (i.e., conditioning of your joints before or after a THR/TKR (Total Hip Replacement/Total Knee Replacement) or any other bone or joint related procedures.

Pool-based rehabilitation for neurological conditions for adults and children are available as well. We offer a complete screening and assessment prior to coming to the pool. Providing the screening doesn’t flag up any contradictions, anyone is able to get into the water.

You do not have to be able to swim in Physiotherapy sessions in the pool.

Hence people of all ages can enjoy therapy, including children with special needs and senior citizens.

To know all the services that we offer under Hydrotherapy, please click this link.

Changes in Pelvic Floor During and After Pregnancy

Pregnancy and childbirth are beautiful experiences for any woman, but they can put a tremendous amount of pressure on her body. There are a lot of body parts that are affected during pregnancy but one area that is affected the most is the pelvic floor. It’s a group of muscles that support the bladder, uterus, and rectum. During pregnancy and childbirth, these muscles can get stretched and weaken. This can lead to a range of issues, including incontinence, pelvic organ prolapses, and pain during sex.

Mentioned below are some of the changes which can happen in the pelvic floor of women during pregnancy and pos-delivery:

State of Pelvic Floor during Pregnancy

During pregnancy, the weight of the growing fetus puts pressure on the pelvic muscles. This causes weakness in its muscles, resulting in urinary incontinence and difficulty with bowel movements. Hormonal changes during pregnancy can also affect, as increased levels of relaxing hormone cause the ligaments and muscles in the pelvis to become more flexible, in preparation for childbirth.

As the pregnancy progresses, the pelvic floor may become stretched and even torn during delivery. This can result in long-term problems such as urinary and fecal incontinence, and pelvic organ prolapse in which the pelvic organs (the bladder, uterus, or rectum) descend into the vaginal canal.

State of Pelvic Floor after Childbirth

In the postpartum period, the pelvic floor muscles and tissues need time to heal and recover. However, certain factors like engaging in strenuous activities right after delivery can slow this recovery. Women who give birth vaginally are more likely to experience the issues, but even those who have a c-section can experience issues because of the hormonal changes that occur during pregnancy. If the it does not recover properly, pelvic floor disorders can get worse. This is why it is important to seek treatment to address these issues and avoid long-term complications.

How can Physiotherapy Help to Strengthen Pelvic Floor?

Fortunately, these pelvic floor disorders are preventable and can be treated. There are ways to rehabilitate through exercises and physiotherapy. The rehabilitation exercises can help to strengthen the muscles and improve symptoms. Several different types of exercises can be performed, including Kegels, squats, and bridges.

Kegels are a type of exercise that involves contracting and relaxing the muscles. It helps in strengthening them. To perform a Kegel, a woman should tighten the muscles as if she is trying to stop the flow of urine, hold for a few seconds, and then relax. This exercise can be performed several times a day. Other than this, squats and bridges also help to strengthen the muscles in the legs and thighs resulting in a stronger pelvic floor.

Physiotherapy for the Pelvic Floor

Mariem Assidi
Physiotherapist
Women’s Health

In addition to rehabilitation exercises, physiotherapy can also be used to help strengthen the pelvic floor. Physiotherapists at Osteopathic Health Centre Dubai specialize in pelvic health and can provide a range of treatments, including manual therapy, biofeedback, and electrical stimulation.

Our physiotherapists will first assess the function and determine the extent of any damage that may have occurred during pregnancy and childbirth. Once the observation is done, the physiotherapist will educate the patient about the anatomy and function of the pelvic muscles and teach her how to properly engage and relax them. This helps in preventing further damage and improving overall pelvic health. The physiotherapists also teach various exercises to strengthen the pelvic floor muscles, which help in improving bladder control, reducing pain, and improving sexual function.

The physiotherapists at Osteopathic Health Centre Dubai also use biofeedback techniques to help our patients better understand how their pelvic floor muscles are working. This technique uses sensors to monitor the activity of the muscles. The sensors are placed on the skin around the vagina or anus, and they provide feedback on how well the muscles are contracting and relaxing. It helps them to improve their muscle control and strength.

Manual Therapy is also used by our physiotherapists to address any muscle tension or imbalances that may be contributing to pelvic floor problems. It involves the use of hands-on techniques to help improve muscle function and reduce pain. This can include massage, stretching, and trigger point release.

Overall, physiotherapy can be a very effective way to help women recover from pelvic problems after pregnancy. It is important to seek the help of qualified and experienced physiotherapists at Osteopathic Health Centre who specialize in pelvic floor health to ensure you receive the best care possible.

In conclusion, the pelvic floor undergoes major changes during pregnancy and childbirth. However, with proper care and exercise, many of these disorders can be prevented or managed effectively. Women need to seek medical care and advice from their health care provider or a specialist if they experience symptoms of dysfunction. With the right treatment and care from our experts at Osteopathic Health Centre Dubai, women can improve their pelvic floor function and enjoy a healthy and active lifestyle.

Neuro Physiotherapy for Stroke Rehabilitation in Dubai

When a certain part of the human brain is damaged, it creates new neural pathways so that the body may function normally. This process is called Neuroplasticity. There are certain treatments and exercises which are done to achieve maximum benefit from new nerve pathways and to facilitate the process of Neuroplasticity. These treatments are known as Neuro physiotherapy. OHC offers stroke rehabilitation in Dubai as part of our Neuro Physiotherapy program.

Neuro Physiotherapy is done to increase mobility and functionality after a stroke. It is done by a neurological expert called Neuro Physiotherapist who has special training to diagnose and treat patients who have a neurological injury or stroke. It is recommended that a 45-minute long neuro physiotherapy session should be done at least five days a week.

What can Neuro Physio do for Stroke Patients?

A neuro physiotherapist has a proper understanding of the function and movement disorders that originated due to any problem in the nervous or neuromuscular system of the body. They work alongside the patient and his family to improve coordination, muscle tone, balance, and movement. They create a specific and customized plan for each patient depending on the stroke and the area of the brain that is affected, they are all part of stroke rehabilitation program OHC offers to patients in Dubai.

A neuro therapist has experience working with patients having neurological disabilities and knows how to rehabilitate them and improve their condition. He also provides assistance in pain management which a patient usually experiences after a stroke.

An excellent Neurophysiotherapist will talk to the patient, or the family of the patient, and will understand the goals and what sort of results they want to achieve. After having a stroke, the goal of the patient differs from being able to sit safely and independently to being able to shower, feed, and walk on their own. The neuro physiotherapist discusses the treatment plan and tells his patients about the results of Neurotherapy that are achievable in their case.

The Benefits of Neuro Physiotherapy for Stroke Patients

Every stroke survivor is different. The condition they face depends upon the part of the brain which is injured so the results of neuro physiotherapy are different for different patients. Mentioned below are some of the improvements that a stroke patient may show after receiving regular neuro physiotherapy sessions.

  • Prominent reduction in shoulder pain
  • Decreased muscle weakness
  • Improved balance and coordination of the body
  • The patient is able to walk better
  • Reduced fatigue
  • Improvements in hand and arm function and other motor skills
  • Better sensations and improved overall awareness of the surroundings
  • Increased muscle strength

These are the most common results shown by stroke survivors after neuro physiotherapy sessions. Keep in mind that the improvements shown by the patients also depend upon the quality of neuro physiotherapy given to them. It is best that you search for the best stroke rehabilitation centers in your area and only choose the best neurotherapist. If you are anywhere closer to Dubai, you must visit Osteopathic Health Center.

Stroke Rehabilitation in Dubai

A stroke patient should be given personalized neuro therapy that aligns with his condition and goals. The patient or his family should properly communicate with the therapist regarding the possibilities of the treatment. It is important to keep in mind that after a stroke, there is very little chance that the patient will go back to a 100% healthy state.

A good neuro therapist will try his best to achieve maximum positive results. Depending upon the type of brain area affected, there are some cases when the patient or his family only wants the stroke survivor to do basic tasks on their own like eating, sitting, walking, or using the loo. A good neuro physiotherapist will examine and discuss all the possibilities and will do his best to achieve the desired results.

Getting a well-qualified and expert neuro therapist is very important for effective therapy. Although there are various rehabilitation centers for stroke, not all of them cater to the patient’s properly. At the Osteopathic Health Center, we make sure to understand the patient’s goal and work towards it.

Dry Needling in Dubai: The Miracle of How it can Heal Muscle Pain?

Dry needling is a procedure used mainly to treat and heal muscle pain. In this technique, a ‘dry’ needle; the one without any injection or medication, is inserted directly into the muscle or skin. This procedure is also known as trigger point dry needling because a specific muscle is triggered at deep tissue or superficial level to relieve pain. It is mainly done by acupuncturists, physiotherapists, or medical doctors. Dry needling is available at OHC Dubai.

Sometimes, a muscle in our body develops a knotted area that causes pain. Those areas are known as myofascial trigger points. These trigger points of a muscle are super sensitive and touching them can be painful. These painful areas can be healed using the dry needling technique. A thin needle (without any medication) is inserted into to trigger point of the muscle to stimulate the tissue and relieve any pain.

It is said that dry needling alters the way a muscle and brain talk to each other. When a needle is inserted into the muscle, it may twitch, ache or be sore. All of these responses are considered to be normal and a sign that the muscle is healing.

Triggering the right Muscles

In order to find out the trigger point of a patient and to heal muscle pain, the clinician palpates the entire area using his hands. This helps him to identify which part of the muscle is causing pain and needs to be treated. Once the trigger point is found, a thin, dry needle is inserted directly into the skin. Sometimes, the clinician moves the needle a bit to induce a muscle spasm. In case a muscle reacts to the needle, it is a good sign meaning the muscle is responding to the technique of dry needling. Muscle soreness for a day or two after the treatment is normal and nothing to worry about.

Mode of Action of Dry Needling for Muscle Healing

Dry Needling has been used for treating various sorts of muscle pain for decades. It is one of the most popular medicine-free ways of healing pain. There are various ways in which dry needling works. Some of them include:

  • Altering the blood flow – Sometimes a contraction in the muscle may result in ischemia or hypoxia in that specific area of the body. This means that the levels of oxygen in that muscle decrease, resulting in soreness and pain. Dry needling on that area causes dilation of small blood vessels and increases the blood flow and oxygen. This helps in relieving muscle pain.
  • Blocks pain receptors – The process of dry needling induces the release of neurotransmitters like endorphins, dynorphins, and enkephalin. All these neurotransmitters are natural painkillers, which block the transmission of pain receptors from the brain and spinal cord, resulting in minimizing the pain effect.
  • Muscle Regeneration – When a needle pricks the muscle, it results in a focal traumatic lesion. This lesion activates the process of tissue healing by beginning the migration of the cells toward the affected area, it activates the replacement and repair of muscle fiber and regenerates the muscle
  • Inducing a twitch response – A twitch response is an involuntary spinal reflex that can be induced through the process of dry needling. This response can lead to changes in the tension and length of the muscle and can heal any pain inside it.
  • Causing neurophysiological effect – Through dry needling, our central nervous system can produce a local neurophysiological effect at the site of the trigger, which can reduce sensitization of muscle pain.

Reasons to Get Dry Needling Done for your Muscles

There are a lot of benefits to getting dry needling done for your muscles, these include:

  • Relieving soreness – Dry needling can be done to relieve your chronic musculoskeletal pain.
  • Getting rid of Muscle Tightness – Tightness of the muscle can be reduced through dry needling.
  • Restoring muscle functions – Dry needling is very beneficial for players and athletes, as their muscles may become tense because of overuse. This results in producing proper motion range and mobility in the muscle.
  • Improves injury recovery – As dry needling causes vasodilation, the affected area receives a high level of nutrients and blood flow which increases muscle recovery and lowers pain.
  •  Cost-effective and efficient – The entire process of dry needling doesn’t take much time. People can resume their normal daily routine right after the procedure. This process has become famous as it is not very costly so people can afford it easily. Dry needling is basically a minimally invasive technique as compared to other surgical methods and has a low risk of complications.

Conditions that can be Treated by Dry Needling Technique

Dry needling can be used to treat pain in any part of your body. Various health practitioners recommend this procedure for:

  • Knee pain
  • Hip pain
  • Chronic muscle injury
  • Low back pain
  • Sciatica
  • Muscle spasm or muscle pain

Who can Get Dry Needling Done

Anyone with acute or chronic muscle pain can undergo dry needling. Even though it is quite safe, still it is recommended that the person seeks advice from their doctor before getting this procedure done.

Duration of Dry Needling

For some patients, only one session of dry needling is enough but for others, it may take more depending upon the condition of their muscles. Mostly, the duration of dry needling is determined by the type of pain and muscle which is being treated. The whole procedure can be as short as a few seconds and can be longer which means it could be up to 10-15 minutes.

Although there are no major side effects of dry needling, a patient may experience some soreness, fatigue, or bruising right after the treatment which would go away on its own after some time. Dry needling is a very safe procedure, the only risk can happen in case a needle is injected improperly, which may result in a major organ puncture, so it is highly recommended that the patient should only get dry needling done by a well-trained and professional physiotherapist.

The Osteopathic Health Centre offers world class physiotherapy with a large team of physios specialising in different areas including Dry Needling. Our goal is to help boost the quality of your life and get you back to the condition you were in before the injury or illness.

Click here to view our Physiotherapy Services, or you can contact us directly by filling-out this form.

You Probably Didn’t Know this Assisted Stretching Technique

Muscle energy techniques MET are a form of assisted stretching done by a trained physiotherapist; it has many advantages over normal stretching. Muscles can become chronically shortened due to many factors, such as overtraining, poor posture, sitting for long hours, and overall muscle weakness. If the shortening is chronic, regaining flexibility on your own can be a challenging task. You should note that inflexibility contributes to many injuries in the sports field, as well as musculoskeletal pain with normal everyday activities.

Muscles become tight as a protective mechanism, when an unexpected increase in muscle length occurs, certain receptors in the muscle belly called muscle spindles are activated, causing the muscle to contract and prevent further lengthening. If the muscle is shortened for a long time (due to sitting for example), it can easily register any increase in length as harmful, and therefore tightness exists. So how do we as physiotherapists treat that? One of the ways is to utilize the concept of muscle energy techniques MET.

First, we perform muscle length (MLT) and range of motion (ROM) assessments as they are a crucial part of the basic physiotherapy checkup and can easily detect shortened muscles. Then, we compare findings to normal values, if tightness is detected, we begin performing MET by taking the muscle gently to where to the resistance is encountered, we then ask the patient to move the limb in the opposite direction against our resistance and maintain this for 10-15 seconds, as soon as the patient relaxes after this contraction, the muscle can be stretched further to a new range. This process is repeated many times, and slowly but surely, the tightness is overcome.

 

MET recognizes that inflexibility has a neural element and not only structural. One of the MET techniques works by activating or deactivating certain receptors in the muscle that control length, through a series of controlled resisted contractions, followed by a stretch that is done by a trained physiotherapist.

If you have chronic muscle tightness, or you are an athlete who trains regularly, it is important to have your muscle length and flexibility evaluated and restored or maintained.

Reach out to us at OHC and we can help. Call 04 348 7366 or email info@osteopathydubai.com.

Lymphedema Management

As one of the leading clinics in Dubai that offers lymphatic drainage massage. We give you this guide that will help you to understand the importance of prevention, control and management of lymphedema in the maintenance phase.

What is the lymphatic system?

The lymphatic system is a network of tiny vessels and small, bean-shaped organs called lymph nodes. They work together to move a colorless, watery fluid called lymph from cells and tissues back into the circulatory system. The lymphatic system has many functions, the key ones being:

1.) Maintaining fluid levels in the body

2.) Protecting the body against foreign invaders (is part of the immune system)

3.) Transporting and removing waste products and abnormal cells

What is lymphedema?

In cancer patients, damage to the lymphatic pathways can be caused by the cancer itself, infection or certain treatments such as lymph node removal or radiation therapy. All these conditions can cause a lymphedema, which is the buildup of lymphatic fluid underneath the skin. The swelling can lead to pain, feeling of tightness, heaviness and recurrent skin infections. Lymphedema mostly affect the arms and legs but can also occur in the head and neck, the belly or the genitals. Sometimes lymphedema appear right after surgery or radiation and go away again quickly. In other cases, they develop months or even years later.

There are steps that can be taken to prevent a lymphedema from starting or to reduce and relieve symptoms:

Compression garments
A compression garment (sometimes called a compression sleeve) is a tight-fitting piece of elastic clothing that covers all or part of the arm. It works by putting pressure on your swollen arm and stopping the collection of lymph in any one area. Good compression garments are custom-made and should be replaced every 4 to 6 months or when they begin to lose their elasticity. You can wear the garment up to 24 hours, research shows that long-term and consistent wearing yields best results. It’s optimal to have 2 garments since they should be washed frequently. Your Physiotherapist will advise you where to get a custom-made compression garment.

Manual lymph drainage
Manual lymph drainage massage is a technique performed by a trained physiotherapist. It’s a very light and gentle technique that helps the fluid drain from the affected area. You will be instructed certain massage movements by your therapist that you can perform at home to support the lymphatic system. Ideally a compression bandage or garment is applied right after the manual lymph drainage massage to avoid the lymph to return into the tissue.

Exercise
Daily activities as well as specific exercises and deep breathing are an essential part of a good lymphedema management. Activities involving many different muscle groups (such as walking or swimming) activate the circulatory system and help the lymph drainage. Since the lymphatic system depends on the muscles working as pumps, light exercises of the affected area are encouraged. Your physiotherapist will give you exercises appropriate to your needs.

Skin Care
Due to the reduced lymph flow the immune system is slightly depressed. It is therefore very important to avoid anything that could increase the risk of an infection. Disinfect little wounds immediately, prevent sunburns and other burns, wear gloves when doing gardening work, use a clean razor when shaving underarms, etc. Protect the skin in the affected area from drying and cracking by cleaning it daily, gently drying it well, and applying lotion with a pH of 5 to 5.5.

Lifestyle

  • Avoid any constriction, such as tight clothing or jewelry.
  • Carry your handbag or heavy packages with the unaffected arm.
  • Be cautious about exposing yourself to hot environments (saunas, steam baths, hot climate, etc.). Heat can make your lymphedema worse.
  • Diet and weight management. Eating a healthy diet and controlling body weight is an important part of treatment. Being overweight can contribute to the development of lymphedema and may make the use of compression garments less effective.
  • Eating less salt will help reducing fluid retention. Carbs may also cause extra water storing.
  • Resting the arm in an elevated position. Raising the arm above the level of the heart when possible lets gravity help drain the fluid.
  • If you have a compression garment you should wear it when traveling by air.
  • Ask for injections and blood pressure tests to be done on the unaffected arm.
  • Avoid vigorous, repetitive movements against resistance, such as scrubbing, pulling, or pushing with the affected arm.

Make these precautions part of your daily habits and plan to follow them for the rest of your life. Compare your hands and arms regularly. Look at them in the mirror. Learn what’s normal for you so you can detect changes right away. If you notice any worsening of symptoms, see your healthcare provider as soon as possible.

The Elephant Club: TMD, Bell’s Palsy and Cervicogenic headaches

Elephant Club Tuesday 26th February 2019. 

Focus: TMD, Bell’s Palsy and Cervicogenic headaches 

Participants to this meeting were invited to attend. 

The meeting took place at the Osteopathic health Centre from 7:00pm to 9:00pm. 

There were several practitioners present including osteopaths, a homeopath/ health coach, a TCM practitioner and a psychologist/ exercise physiologist. each giving their own perspective on the treatment of the conditions mentioned above. It became obvious by the end of the evening that despite the different approaches from osteopathic practitioners and TCM practitioners, the result would be beneficial to the patient. 

It was agreed that for patients suffering from Bell’s Palsy, early intervention was best, and that a combined approach of osteopathy with acupuncture could work well. 

Discussion points: Is traditional allopathic medicine becoming increasingly holistic in its approach? 

This is a monthly event for healthcare practitioners working in UAE. If you would like to join future events, please send an email on: anissa@108.160.159.203

What is Manual Physical Therapy?

Manual orthopaedic physical therapy is a clinical approach to addressing joint, muscle and nerve tissues that restrict movement, perpetuate pain, and/or limit the functional potential of a person. It is the skilled, reasoned application of specific hands-on techniques to address dysfunctional tissues to modulate pain, restore movement, and improve function.

Manual physical therapists (PTs) are direct access providers, meaning they have the knowledge to rule in and out various orthopaedic conditions and reach a clinical diagnosis for a condition. Beyond just diagnosing the problem, a manual PT will systematically observe and test your alignment, movement, muscle balance and joint mobility, to understand why the problem developed. Based on these findings, the therapist will then create a treatment plan to target the identified dysfunctions. They will educate you on how to manage your issue, and plan with you for a progressive return to the activities that you love.

How Physical Therapy is it different?

Orthopaedic manual physical therapists have a strong foundational knowledge of biomechanics (how joints and muscles move the body in space) and how limitation in one area can compound dysfunction in another. They use hands-on techniques to address these dysfunctions, and to facilitate specific muscle coordination and control to restore normal movement to dysfunctional areas. Exercises are prescribed based on the individual, instead of a one-size fits all approach. Insofar as possible, the treatments applied are informed by current research.

What does the research show about Physical Therapy?

There is a growing body of research demonstrating orthopaedic manual physical therapy is as effective as surgery in the management of many conditions. These include:

  1. Sciatica: A study published in the British Medical Journal reports that patients undergoing spinal surgery for sciatica had short term benefit, but by 6 months following surgery, they had no significant difference in pain relative to patients with sciatica receiving physical therapy. (Peul WC et al. BMJ 2008; 336(7657):1355-8)
  2. Neck pain with arm pain: when cervical fusion surgery was compared to physical therapy, researchers concluded that there were no significant differences between the two treatments, prompting the researchers to suggest that “a structured physiotherapy programme should proceed a decision for ACDF (surgery).” (Peolssona et al, Spine 2013 15:38(4):300-7)
  3. Shoulder pain: In patients with rotator cuff tears, patients who underwent physical therapy had the same clinical improvements in pain and function as those who underwent surgery. (Ryosa et al, Disabil Rehabil 2017 39(14) 1357-1363)
  4. Knee pain: Dr. Reed Siemieniuk, heading an expert panel on management of knee pain, concluded that “physical therapy and other management strategies should be utilised for knee pain due to osteoarthritis, NOT arthroscopic surgery.”

Try physiotherapy first! The sooner the better, as this changes outcomes. It is a quicker, cheaper and less painful alternative to surgery for many conditions, including back pain, neck pain, knee pain and rotator cuff tear.