Facing a cancer diagnosis is a life-altering experience that brings with it a multitude of physical and emotional challenges. As medical advancements continue to improve cancer treatment outcomes, the significance of integrating Physiotherapy rehabilitation into the care plan of cancer patients has gained substantial recognition and research backing.
Ideally it would be part of everyone’s cancer journey, so we’re delighted to be able to restart our cancer rehabilitation service here at Auckland Physiotherapy. Kirsten will now be providing PINC and STEEL certified cancer rehabilitation in 1-1 sessions and group classes.
In this blog post, we'll delve into the essential reasons why exercise and Physiotherapy have been shown to be incredibly beneficial for individuals navigating their cancer journey.
Inclusive Programs for All Stages:
The PINC and STEEL programs have emerged as beacons of hope for people with cancer, embracing individuals from the initial diagnosis to those 25+ years post-diagnosis. This inclusivity underscores the understanding that exercise and rehabilitation are essential not only for recovery but also for enhancing long-term quality of life. It’s never too early or too late to start.
Embarking on cancer treatment is daunting, but early intervention through Physiotherapy can provide a sense of preparedness and understanding. Starting rehabilitation prior to surgery or other treatment can equip you with tools to counteract and manage potential challenges, ultimately facilitating a faster recovery process.
Remaining physically active during cancer treatment is paramount. Physiotherapy helps to reduce pain, increase energy levels, minimise side effects, prevent complications, and alleviate stress and anxiety. It counteracts the adverse effects of inactivity, enabling you to maintain your strength and resilience throughout treatment.
Post-surgery and treatment can bring various physical hurdles. Physiotherapists specialise in identifying these challenges and designing interventions that address specific issues like pain, strength reduction, body image concerns, and fatigue. By reintroducing movement and exercise, secondary health conditions can be prevented, and the likelihood of cancer recurrence reduced.
Individually Tailored Treatment:
Cancer rehabilitation extends beyond medical treatment by acknowledging the importance of holistic well-being. With a focus on empowering you to regain control of your life, Physiotherapists create bespoke exercise regimens that cater to your specific needs and limitations. This personalised approach ensures that rehabilitation aligns with your unique condition, treatment trajectory, and goals. Some of the benefits of engaging in rehabilitation include:
In summary, the role of Physiotherapy rehabilitation as part of a cancer journey is nothing short of transformative. We can offer hope, strength and a roadmap to recovery. With each session we can support you to take a step closer to reclaiming your life from the clutches of cancer. It really is making better lives possible.
If you’d like to find out more about our cancer rehabilitation service click here or you can book a complimentary call with Kirsten to discuss your needs.
We have been approved funding for a group cancer rehabilitation class. We're looking for 5 women to join our first group. The classes start on Tuesday 17th October at 12.30 for one hour and will run once per week for 6 weeks. Cost for the classes is covered by the PINC & STEEL Foundation.
To be eligible for the group:
If you think this class could be for you please book a complimentary call with Kirsten to discuss your situation.
The recovery shorts/ leggings help to speed up your post-pregnancy recovery and:
If that doesn't convince you, here are seven compelling reasons why you should consider choosing SRC Recovery Compression garments:
For the best fit and performance, it is recommended to have someone else take your measurements, as proper sizing is crucial for the garment's effectiveness. You can find a helpful video and size chart on our website. If you need further assistance or advice, please do not hesitate to contact our reception at 093664880 or reach out via [email protected].
Serves 2, Prep; 10 mins plus 1 hour chill, Cook; 15 mins
What you need:
2 salmon fillets (125g each)
100g quinoa, cooked
1 zucchini
1/2 tbsp. olive oil
1 garlic clove, crushed
70g sundried tomatoes, rinsed, chopped
Salmon Marinade:
2 tbsp. tamari
1/2 tbsp. olive oil
1/2 tsp. paprika
1/2 tsp. hot paprika
1 tbsp. rice vinegar
1 tbsp. black sesame seeds
chilli flakes to taste.
What you need to do:
Mix together the ingredients of the marinade and cover the salmon to marinate for about 1 hour.
While the salmon is marinating, cook the quinoa and spiralise the zucchini.
Heat the oil in the pan, add the crushed garlic and fry for 1-2 minutes. Add in the zoodles and stir occasionally until it softens, but still firm, for about 3-4 minutes. Towards the end add the chopped tomatoes, and season with salt and pepper, to taste.
Heat the oven to 250C and place the salmon on a baking tray. Bake for about 7 minutes.
Remove the salmon from the oven to rest for a moment and in the meantime pour in the salmon juices into the quinoa, mixing well.
Dive the quinoa and zoodles between plates, then place the salmon on top, sprinkle with chilli flakes to srve.
Incorporating strength/resistance training into our daily lives
As we age, we naturally begin to experience some reduction in lean muscle mass, strength and function, a process known as sarcopenia. Strength training, also known as weight or resistance training is highly beneficial to everyone because it helps build strength, stability, endurance, preserves bone density and builds overall muscle mass.
Research has been showing us for a number of years now, that strength and resistance training are just as important as the cardio aspect of your workout. Depending on your health and fitness goals, there are many reasons why strength and resistance training is the key to achieving them.
What is strength training?
For some people, the phrase strength training is intimidating, but you actually need to look at it in a different light - that it’s enhancing your ability to move safely and effectively in your life, not becoming the next bodybuilder! For example; your ability to lift something and put it on a shelf, carry your groceries in the door, bend down and pick something up.
Strength training is a type of physical activity which focuses on the use of resistance and weights to induce muscle contraction which builds strength. The basic principle is to apply load and overload the muscle so it needs to adapt and get stronger. When training for strength, we are aiming to train the nervous system as much as we are muscles. The nervous system adapts by firing more rapid impulses and activating more muscle fibres which in turn make us stronger. One reason why people can be much more prone to injury if strength or resistance movement is not part of their life is because their muscles and connective tissue are weak due to never being stimulated.
At its heart, strength training is based on functional movements — lifting, pushing, pulling in order to build muscle and coordination needed for everyday activities. The stronger you are as you age, the more robust you will be in the real world.
Why strength training?
Did you know that a reduction in lean muscle mass, strength and function can begin as early as your 30's and continue at a rate of 3% to 5% per decade! So the outcome of regular strength or resistance training can actually slow down the loss of skeletal muscle mass/strength quite significantly. Therefore it is great for people of all ages to adopt some strength and resistance movement into their lives as it can help you preserve and enhance this natural loss of lean muscle mass that comes with ageing.
The benefits of strength training
Many ongoing physical health conditions can be managed better and reduced by regular strength training, but there are many benefits for everyone that make adding some resistance to your workout worthwhile:
How to integrate strength/resistance training into your fitness regime:
Many people find using a dedicated exercise studio or facility to do their strength training is a good option, as they often have a range of equipment available, as well as help from exercise professionals if you need it. However this is not your only option! Your strength training workout can be done at home or at your local park using your own bodyweight …. whether it’s squats, lunges, push-ups, or one of the endless variety of exercises.
There is a large range of resistance equipment available for all levels - many of these are in our very own Auckland Physiotherapy Health Collective shop. If you are not sure what you need, our team at Auckland Physiotherapy can help you with this.
Do I need a professional to help with my strength training?
There are no downsides to being stronger. The only thing you need to consider is this: how much does strength contribute to what you want to achieve? If you are going to start down the path to getting stronger, it is important to have a solid plan from the start. Getting advice from a qualified and experienced Personal Trainer can help you to make sure you are using the correct exercises that are the best fit for your biomechanics, past/current injuries, exercise goals and fitness level. Get in touch with Adele at Auckland Physiotherapy if you are interested in adding some strength training into your daily exercise routine and she will be able to help you out.
Overall, here at Auckland Physiotherapy we always say - at the end of the day, moving and being active in any way is a great start. The short version is we stand a much higher chance of actually avoiding injury if we are strong, flexible and well balanced. Specific types of exercise have some pretty awesome benefits, with strength training definitely being one and this is certainly going to help you to live a more mobile, energetic and longer life!
Lessons from working in high performance sport
Having worked within high performance sport in the UK, the pressures on young, promising athletes to reach their full potential is immense and can lead to extra physical as well as emotional stress, especially where injury is concerned. I’ve seen it on many occasions where an injury occurs and the player’s immediate thoughts are one of:
‘’is it serious?’’
‘’when will I be back playing?’’
Fair questions to ask, and similar to the thoughts of parents and coaches alike.
When the injury occurs, players are deflated, understandably so and therefore it’s vitally important to talk to the player, reassure them, explain the injury process and to make informed collaborative decisions around the recovery process. These decisions absolutely need involvement from the player, parents, coaches, performance staff as well as physios.
In the high performance set up, we have the luxury of being able to provide regular input to each player, each day/week and can guide them through the recovery process, monitoring them carefully and utilising state of the art technology.
However, outside of the high performance setting where there are still promising young athletes needing rehabilitation and a return to sport, that type of regular monitoring of training load and player wellness, just isn’t there. As a result, it’s not uncommon for some athletes to burn out very quickly and even struggle to return to sport post injury, let alone performance. This could be for a variety of reasons - time pressures, unable to access appropriate rehabilitation, ignorance of recovery and it’s importance, unable to afford rehab services.
Take a knee injury as an example; Often when the player regains full range of pain free movement and strength, can run and jump, hop and land, can change direction, they can be discharged from Physio, however, in my opinion, that end stage of rehabilitation is a vital component of the recovery pathway which is missed or cut short where injury is concerned especially if players are drifting back into school or club set ups that have minimal frameworks or resources for end stage rehabilitation. I.e. bridging the gap between rehab and return to sport.
In the high performance setting, end stage rehabilitation would involve the player transitioning more to working in the gym and on the field with physios and strength and conditioning professionals, getting closer to mimicking a weekly training pattern/frequency to what would be expected when fully fit. Those sessions would be challenging for the player in order to provide the right overload stimulus, whilst he/she is carefully monitored during and after the session. One has to take into consideration the length of lay off from the injury and the load demands with return to sport/training. This cannot be rushed. I.e. Building up running load, volume and intensity can take anywhere from a few weeks to several months, depending on the injury and the players training schedule. Certain injuries like hamstrings and calf strains are notorious for re-occurring within the first 2 weeks when the athlete is reintroduced to sport too early.
With all my clients I like to keep in regular contact with them through the recovery process, keeping check on things like training load, intensity and specifics and also just making sure they’re coping with the demands. Small little changes can easily be made through the training week if it means minimising the risk of injury or preventing slowing of the recovery process. Providing the player and all relevant parties involved are aware of the changes, player welfare is kept top of the agenda. Being able to have a 1:1 focus on field and gym based rehabilitation is key for me because we can keep on top of the variables within our control and modify rehabilitation/performance sessions depending on the player that day/week. The rehab process is never straight forward; There are highs and lows, sometimes some setbacks and a whole plethora of emotions. If the latter stages of the rehab process can be done well, under appropriate guidance, the risk of injury setback can be minimalised, allowing the athlete to return to sport at the right time.
If you or your child is a keen athlete and need to get back to high level sport - talk to our expert David to help. He can use his skills to ensure end stage rehabilitation and return to sport is completed correctly, reducing the risk of injury setback and emotional stress. Click HERE to book a session.
Serves 4. Prep 5 minutes, Cook 15 minutes.
WHAT YOU NEED;
• 2 tsp. coconut oil
• 3 1⁄4 cups (400g) leek, chopped
• 4 cups (1L) water
• 2 vegetable stock cubes
• 3 cups (450g) garden peas
• 1⁄2 cup (15g) fresh basil, chopped
• 1 1⁄4 cup (150g) feta, crumbled
WHAT YOU NEED TO DO;
Heat the oil in a large saucepan and cook the leek for 2 minutes.
Add the water and the stock cubes. Bring to the boil and cook for a
further 5 minutes.
Add in the garden peas and cook for another 2 minutes. Put three-
quarters of the basil into the soup, turn off the heat and puree
with a hand blender until smooth.
Divide the soup over 4 bowls and sprinkle with the crumbled
cheese and the rest of the basil to serve. Season with freshly
ground pepper.
By Chris Smith
Greater Trochanteric Pain Syndrome (GTPS) is a condition characterised by pain and tenderness on the outer aspect of the hip, specifically around the bony prominence called the greater trochanter. It can significantly impact an individual's daily activities and quality of life. In this blog, we will explore the symptoms of GTPS, discuss the associated risk factors, and discuss how physiotherapy can help.
Symptoms
The primary symptom of GTPS is pain on the outside of the hip. However, the pain may also radiate down the lateral thigh, mimicking other conditions such as sciatica. Individuals with GTPS often experience pain during activities that load the gluteal muscles like walking, running, or climbing stairs. Prolonged sitting or lying on the affected side can also exacerbate the pain, in addition to sitting cross legged.
Risk factors
Several factors can increase the risk of developing this condition. GTPS is more prevalent in women, particularly during and after menopause, likely due to changes in tendon properties related to oestrogen changes. Middle-aged individuals are more prone to developing this condition. Obesity has also been shown to increase the likelihood of developing GTPS. A dramatic increase or change in load placed on the gluteal tendons (for example starting to run after never doing so before) may also lead to GTPS as the gluteal tendons are placed under increased load and cannot cope.
Management
Research has demonstrated that physiotherapy is the gold standard treatment for this condition (Mellor et al., 2018). Physiotherapists will provide education regarding rest and activity modification. Reducing or modifying activities that aggravate the pain is crucial in the early stages of GTPS. Patients should generally avoid positions which directly compress or stretch the gluteal tendons. This will include activities such as sitting cross-legged, standing with your hips off centre, sitting in low chairs and laying directly on the side of pain.
Physiotherapy will also implement a graded strengthening program to place increased load on the gluteal tendons over 12 weeks. This seminal study from 2018 has shown 12 weeks of gluteal strengthening improves pain and disability scores significantly (Mellor et al., 2019).
In addition to physiotherapy, medication may be useful in reducing pain. This could include Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, however this should be discussed with your GP prior to taking. For persistent irritable cases which are non-responsive to physiotherapy there is also support for corticosteroid injections which may reduce inflammation and provide temporary pain relief alongside a strengthening program. Extracorporeal Shockwave Therapy (ESWT) may also be useful. This is a non-invasive treatment option that utilizes shockwaves to promote tissue healing and reduce pain. It has shown promising results in managing chronic tendon issues, including GTPS.
So, in summary, if you're struggling with this stubborn condition, Physiotherapy is the first option and can lead to dramatic improvements in pain and function. Give us a call and arrange to see one of our physiotherapists for an individualised treatment plan or if you're unsure, book in for a complimentary call to discuss with one of our expert Physiotherapists.
Paul White. Physio and Running Movement Coach
Over the past week, I've had the incredible opportunity to work closely with the Auckland U18 girls hockey team. Collaborating with these talented athletes has been a rewarding experience, but it hasn't been without its challenges. One recurring issue that a significant number of the girls have faced during the hockey season is calf tightness. It has become evident that their preparation could be improved to alleviate this concern and potentially enhance their overall performance. In light of recent research on strength training and its benefits, I believe we have a promising solution.
Unleashing the Potential: The Soleus Muscle:
A recent article caught my attention, shedding light on the positive impact of strength training on performance. The study focused on runners, demonstrating that an 14-week strength protocol specifically targeting the soleus muscle (note: the study only had one exercise strengthening the soleus) led to a remarkable improvement of 4% in their running efficiency. This finding is undoubtedly exciting for those seeking to enhance their running speed. However, I propose that this protocol could also hold the key to relieving the calf tightness symptoms experienced by the young girls on the Auckland U18 hockey team.
Understanding the Significance:
On the picture on the left hand side we can view the two large calf muscles. The 2 heads of gastroc are the most superficial (near the surface), then under those heads is the soleus. The picture on right, shows a cross section on the lower leg (at the level of the dotted line on the left picture). I wanted to show this picture to give an indication of the size of this muscle. This muscle is actually really substantial. (note: there is variation in the size of soleus, gastrocnemius. This cross section is taken from a distance runner.)
The soleus muscle, located in the calf, plays a vital role in lower limb movement and stability. It is a key driver during activities such as running, jumping, and pivoting—the very actions frequently required in running and hockey. How these muscles function in sporting movement (sporting movement: running, turning, acceleration etc) is incredibly complex. Hence, I am going to take the liberty of simplifying part of this function. That concept is that when we see a tight muscle, that muscle is not strong enough to deal with the load being applied. Hence a tight calf muscle in hockey, is that muscle not being strong enough to deal with the force that it sees in hockey. The body wants to protect itself from damage. Hence it creates tension to help protect in this environment. The negative is that it can get tighter and tighter, which then increases chances of injury due to this tightness.
The strength protocol focused on targeting the soleus muscle through specific exercises designed to improve its strength. By incorporating this type of training into the Auckland U18 girls' hockey team's routine, we could potentially alleviate the calf tightness issues they have been experiencing. Moreover, this approach might also lead to a host of additional benefits, including improved agility, enhanced power, and increased resilience against injuries.
Read the Research here. https://doi.org/10.1098/rspb.2020.2784
Devil in the Details: The Strength Protocol
The Resistance training was performed for 14 weeks and was characterized by five sets of four repetitive isometric ankle calf raises (3 sec loading and 3 sec relaxation) at 90% of the maximum voluntary contraction (MVC) strength (adjusted every two weeks), three to four times a week (see picture below). This loading regimen has been shown to provide a sufficient magnitude and duration of tendon strain to promote AT adaptation in addition to increases in plantar flexor muscle strength
Strength Protocol
14 weeks, 3-4 x week
5x 4 ( sets / reps)
90% Max isometric. 3 sec hold. 3 sec relax
Seated soleus strengthening (with knee at 90 deg flexion). Note: forefoot on box. And heel dips below zero degrees.
High wall sit. With the heel slightly off the ground. In this position, your soleus is helping to stop you sliding off the wall. Hence for those that do not have access to gym, this can help strengthen the soleus. Note: although this does help strengthen, you may need to add more weight to help create an environment that is similar to the research article. I suggest holding 10 -15 kg to help overload that muscle.
