Compiled by our Masters trained Physiotherapist Kirsten Rose. To book an appointment with Kirsten, or read her Meet the Team profile CLICK HERE

What is a Health Coach?

“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. - WHO (1948)

Most people want to be healthy and well, but there is an enormous gap between those thoughts and the everyday reality of actually making it happen. Nearly all of us can probably identify with a time in our lives where we wanted to get healthier, be more active, lose weight, be less stressed, be happier….the list can be endless. Also most of us can probably reflect on how making the required changes was much harder than we might have initially thought it would be. We start off with a hiss and a roar, but then our motivation wanes, our old habits creep back in, and we give up on our new way of life. Sound familiar?

If your answer is yes, then don’t beat yourself up too much. Inside every one of us is the urge to stay with the status quo, resisting change or challenges outside of our comfort zone. There’s another part, deep inside, that whispers to us that maybe we could change, maybe we could actually achieve those health goals and live the healthy lifestyle we dream of. But change is hard so those whispers often don’t get the chance to grow louder. The reality is that most of us need to build new life skills in order to create a truly sustainable plan for our well-being. We need to learn to believe in our own ability to take charge of our health and to implement the necessary changes. Our day-to-day lives are full of small choices that could help us inch our way to the life we want to create, however, in the modern day world there appears to be an overwhelming amount of choice so often we don’t know which ones are right for us.

Health Coaching encompasses the sciences of positive psychology, behaviour change, nutrition, exercise science and lifestyle medicine with the dynamic art of relationships, teamwork and community. As a Health Coach, I am a behavior change specialist who supports you to make sustainable diet, lifestyle, and habit changes that will actually work for you.  I help you optimise your health and well-being by enhancing your resourcefulness, self-regulation, and self-motivation, so that you can successfully navigate the journey of change. 

Some common areas that clients wish to work on include:

If you think that Health Coaching could help you on your journey to better health and wellness then take advantage of the 30 minute free sample consultation. These are available in the clinic or online. 

Our Ask A Physio series is a collection of microblogs aimed at giving a basic understanding of some frequently asked questions. If you have an injury or are experiencing discomfort please book an assessment or contact reception for more information.


Is hot or cold best for sore muscles?

This is actually a topic of pretty intense debate, even after all of these years! We know that both heat and cold can provide good pain relief, so the difference really comes down to timing. In a fresh injury, I usually advise ice in the first 72 hours, as local of an area as possible, and for about 20 minutes three times a day. Beyond this, the research seems to say that going over the top with ice can actually slow down healing.

The side note here would be about ice baths for recovery, which come and go with other exercise trends. There’s no good evidence that ice baths speed up your recovery or make muscles work any better. They do however improve your perception of how well you’ve recovered after a big workout. The good old placebo effect maybe? If you’re going to give it a go, make sure to check in with your GP or physiotherapist first, and always have someone else around to help you.

After the first couple of days, I think heat makes more sense. It drives blood flow and nutrition to a healing area and can be really soothing, particularly for back pain. Heat can also make your soft tissues softer, potentially making moving and stretching a bit easier. Similar to the ice, I would recommend 20 minutes three times a day, just with a simple hot water bottle or wheat bag. One thing to be careful of here is that painful areas can sometimes lose their sense of hot and cold, so make sure that your skin doesn’t get irritated, and check the heat with an injured hand before you apply it.

Stress Part 1

It’s Men’s Health month in September so we’re bringing you a series of blogs on Stress and how best you can mitigate the negatives (and also harness the benefits) to improve both your physical and mental health. Plus we’ll be bringing you some insights from the men in the Auckland Physiotherapy team as to how they deal with stress. 

So what does stress look like for you? We can probably all relate to the fact that how we experience stress is individual to each of us. Some people appear to thrive under pressure, others not so much. Sometimes we don’t even attribute our thoughts, feelings or physical symptoms to stress and put them down to something else. 

Potentially the most essential ingredient in learning to manage stress and overwhelm is to know yourself. We can call it self-knowledge or self-awareness or just plain old knowing me. But this is really our first step because if we can’t recognise the warning signs that things aren’t going so well, then it's that much more difficult to access those great coping tools that help you get back on track.

Take some time to recall the last time you felt overwhelmed or stressed. Perhaps it was within your family, your job (or lack of one), paying bills, on the road…How did you know you were stressed?

Once we can identify some of the signs or symptoms of stress and overwhelm we can take this one step further. The diagram below shows that these things are all interlinked. They feed off one another.

For example, a negative thought about yourself (“what if I can’t cope with this…”) can quickly lead to a surge in anxiety (mood/emotion) which can increase your heart rate and breathing (physical symptoms/biology) and cause you to avoid the situation (behaviour) you were worried about, resulting in you never getting the opportunity to realise that you can in fact manage it.

Very often, stress and overwhelm can feel like a profound mess or intense phenomenon. In fact, sometimes, we don’t even identify the phenomenon we’re experiencing as part of the stress family. Do we ever stop and contemplate how we respond to stress or do we just keep ploughing through?

The skill of being able to ‘step outside of yourself’, to observe your reactions and actions, enables you to take steps to promote good health.

Over the next few days, see if you can reflect on your experiences of stress in these terms – thoughts, emotions, behaviours, and physical symptoms. 

Our Ask A Physio series is a collection of microblogs aimed at giving a basic understanding of some frequently asked questions. If you have an injury or are experiencing discomfort please book an assessment or contact reception for more information.


Will back pain be forever?

80% of the adult population will experience back pain this year, and for the vast majority, it will be no more serious than a cold. Even though the first few hours and days can be really uncomfortable, most people are pain-free within 2-4 weeks and will have no lasting issues.

As with all health issues, there is a small risk of back pain sticking around for more than 3 months. We can’t predict this perfectly, but we know that people who have a really distressing injury or other health issues can be at higher risk. Again, a bit like a cold, flu or stomach bug. We know that getting good advice and pain relief early on can take this risk right down, so if you’re worried then a simple checkup goes a long way.

All is not lost if people do end up with long term issues. I like to use the analogy of my own experiences with asthma, or even something like allergies. If I look after myself, take medication at the right times and recognise my triggers, I never really get any symptoms. The same is true of people with long term back pain, it really comes down to being an expert on your own issue, and having good people around you.

Our Ask A Physio series is a collection of microblogs aimed at giving a basic understanding of some frequently asked questions. If you have an injury or are experiencing discomfort please book an assessment or contact reception for more information.


Why are shoes important for lower limb issues?

It’s not just with leg and lower limb issues! We spend more time in our shoes than any other piece of clothing, and they can have the same impact on us that tyres have on our cars. A sudden change or wearing out of footwear is a really common reason or contributing factor to what we see in the clinic.

When in doubt, go for a shoe which is neutral, supportive, and comfortable. All of our current research says that the flash measuring devices and pressure plates aren’t as good as your own idea of comfort. Another good tip is to check out the wear on the tread of your shoes, again a bit like tyres. If the tread is starting to sit flush with the rest of the shoe, chances are the innards aren’t looking too good, and it’s time for a new pair!

Our Ask A Physio series is a collection of microblogs aimed at giving a basic understanding of some frequently asked questions. If you have an injury or are experiencing discomfort please book an assessment or contact reception for more information.


Pain Medication: Importance of still feeling pain?

The first thing to recognise here is that pain isn’t just a physical thing, it's also an emotional and psychological response to keep us safe from harm. It’s really trying to change our behaviour when something is wrong, with the goal of giving us a better chance of staying or getting well. So completely wiping out pain with tons of pain relief is counterproductive, and taking lots of medication early and often can cause side effects.

The flip side to this is that we know a really strong and untreated early pain experience is also counterproductive. It makes it hard to get things moving and makes the pain more likely to stick around for longer. I use two quick questions to get an idea of how well someone has their pain under control. “Are you coping?”, “Are you able to sleep a full night despite the pain?”. If the answer is no for either, check in with your GP or pharmacist for some help.

Our Ask A Physio series is a collection of microblogs aimed at giving a basic understanding of some frequently asked questions. If you have an injury or are experiencing discomfort please book an assessment or contact reception for more information.


Why do we collect soo much health history & background?

We always used to hear at university that a good history is 90% of making a good diagnosis, and we really put this to the test with our online appointments over the COVID lockdowns! Of course, it is true, and even some of the things you might think are small talk (where do you work, do you have kids, what are your hobbies) give us tons of information about picking and solving your issue. We even got some interesting research over the lockdowns, showing that taking away our physical tests made a tiny if any difference in how accurate we were.

Generally, by the time we’re done taking a history we like to have narrowed things down to 2 or 3 likely suspects, which means that we don’t have to use every physical test under the sun on your sore body! That’s also why we like to run long initial appointments, a good history will often take 15 minutes or more, and a good history makes for an easy and accurate diagnosis.

HOW DO I GIVE MY HIPS & KNEES THE BEST CHANCE OF SURVIVAL?

Osteoarthritis is the medical name for the changes which happen in a joint with age. In most people, this process plays out as a natural part of aging, and is really nothing to worry about (no more so than grey hair and wrinkles!). In some people, osteoarthritis can start to become painful, and it's a pretty common reason for seeing your GP or physiotherapist. While we can’t cure arthritis, there’s plenty we can do in terms of exercise and lifestyle to manage it well. Joint replacements are often discussed as a potential treatment, but it's not just as simple as swapping out a mechanical part. It involves a pretty substantial surgery, a years worth of rehab, and the new joint will need replacing again after roughly 15 years.

In the past, we’ve always thought of arthritis as being mainly a mechanical issue, wear and tear. This has always made exercise sound a bit counterintuitive, why would you exercise on a joint which is already worn out from too much use? More recent research has found out that rather than worrying about the wear, we should be thinking of osteoarthritis as being in the same camp as things like high blood pressure, type II diabetes and heart conditions. For this reason, regular general exercise, at least 30 minutes every day is essential.

On top of general exercise, we also know that specific strengthening of your thigh, buttock and trunk muscles can take some pressure off the sore joints, and make them last longer. These can range from simple squeezing exercises all the way to weighted squats. This is where it's worthwhile checking in with a physiotherapist, too much or too little strength work will be like taking medication at the wrong dose.

Lastly, your general health and wellbeing plays a huge role in the comfort and health of your joints. Your GP is your best port of call for general check ups and pain relief. Getting a nutritionist or dietician to take a fine tooth comb over your diet is also really helpful and worthwhile. Body weight and general inflammation play a huge role in making arthritis better or worse, and even small changes to your diet can make a huge difference.

We know that people who make a sustained effort with their general fitness, strength, general health and lifestyle can put off joint replacements for years, or even get rid of the need altogether!

Our Ask A Physio series is a collection of micro blogs aimed at giving a basic understanding to some frequently asked questions. If you have an injury or are experiencing discomfort please book for an assessment, or contact reception for more information.


What is manipulation and is it enough to treat injuries?

Have you ever clicked your fingers or between your shoulder blades and felt some pressure release? That’s manipulation; in technical terms it's a quick thrust right at the end of where a joint can move. There’s a bit of debate about what the “click” actually is, but our best guess is that quickly changing the shape and space of a joint makes tiny gas bubbles “pop”.

It can be a really useful treatment technique in the right situation, particularly for stiff backs, but there are a few caveats. Manipulating a joint early on can make swelling and damage worse; imagine trying to click your fingers when you’ve just sprained one. The other important thing is that manipulation is only for relieving pain and stiffness, it doesn’t solve your issue, or put anything into place.

You often hear about people going to get their backs “clicked” every week, and after a couple of days the effect wears off. It’s a bit like taking a cough drop or a panadol, you still need to put some work in with a well set out home programme if you want a long term fix.

Compiled by our Masters trained Physiotherapist Chris Smith. To book an appointment with Chris, or read his Meet the Team profile CLICK HERE


Why am I still in pain?

In a previous blog we explained why things hurt and how the bodies' pain system works. In this blog we will explain what persistent pain is, how common it is and why our pain systems sometimes still remain active when our injuries may have healed.

What is persistent pain?

As humans it makes sense to have a pain system as an alarm to warn us when we have injured our body. The pain signals us to change our behaviour and rest in order to allow our injuries to heal. Most soft tissues within the body including muscle, ligament, tendon and bone will heal in approximately 12 weeks, and therefore you would expect that as the injured tissue heals the corresponding pain signal we experience reduces in intensity to advise you to increase what you do without coming to further harm. The trouble is this doesn’t always happen!

Infact, up to 25% of people's pain still remains once the healing should have occured. Pain that does not settle in 3 months is termed chronic or persistent pain. To understand why this occurs we need to know a little more about our bodies pain systems. Electrical signals picked up in the injured tissue by pain cells (nociceptors) are passed into the spinal cord and then up to the brain for processing. Pain science has shown us that within the spinal cord and brain 2 types of sensitisation can occur which can amplify and prolong our pain experience.

These are called peripheral and central sensitisation. 

Sensitisation

Peripheral sensitisation means increased pain sensitivity to movement or pressure in the area where the injury occurred. The injured area becomes sensitive to movement and touch that would usually be non-painful. This is a normal response and helpful following an injury. However, the longer your nervous system produces pain, the better it gets at producing it. Your body learns pain! This process is called central sensitisation and occurs in the central nervous system (brain and spinal cord). Think of a sensitive car alarm going off with a strong gust of wind. The gust of wind (movement) is not dangerous anymore, but the car alarm (brain) is too sensitive. This type of sensitisation can keep driving pain long after the initial tissue healing has occurred and can go on for months and even years.

Scientists think that both genes and environment play a role in explaining why some patients develop central sensitisation and persistent pain and some do not. It is likely that the way humans perceive and make sense of their pain experience may lead to persistent pain. Our pain centres are in our brain and the brain also processes our thoughts and feelings. Stress, worries, fears and beliefs about the pain may all lead to prolonged pain. The pain can also have a wider impact on our lifestyle, jobs, relationships and hobbies, all of which can create worry, depression and frustration. These feelings can actually keep the pain system sensitised in the brain. It is well known for persistent low back pain for example that low mood, anxiety and depression and worries of long-term disability are associated with developing persistent pain.

How do I know if I have central sensitisation?

Firstly, if your pain has gone on for more than 3 months it is likely that some degree of central sensitisation may be occurring. There are some other signs also. If pain becomes more widespread and if it can be affected by lifestyle stressors easily then you may have central sensitisation. Also, if you’ve become more sensitive to stimuli that impact the nervous system. These may include movement, exercise, noise or light.

How do we help with persistent pain?

When managing persistent pain everyone's individual situation is different and will require a tailored approach. As physiotherapists we need to look at things more broadly in addition to specifically at the original injured area. Through asking further questions about lifestyle such as sleep, stress, beliefs, fears and general health we are likely to be able to suggest techniques to help calm down the pain. Techniques such as graded exercise, sleep hygiene, relaxation, meditation and mindfulness are essential to promote a calm environment for the pain to settle.

In addition it is important for patients to have a basic understanding of how pain works because once you understand why your pain remains and how common it is it can instantly make it less scary, worrying and reduce anxiety around the issue. The more you understand, the more empowered you feel to manage the pain.

As physiotherapists with holistic knowledge of pain science, psychology and physical activity and lifestyle we are well placed to treat people with persistent pain, Therefore, if you’re struggling with a persistent pain problem come in to see me or a member of our team for an assessment to see how we can help you move forwards.

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