We often associate strength training with dedicated body builders, grunting and sweating away at the gym for hours working on their physical appearance. Barry Nguyen, a sports & musculoskeletal physiotherapist and health technologist shares with us other reasons why we should all participate in strength training. 1. Increase bone strength - Strength training stresses on your bones leading to increased bone density and reduce the risk of osteoporosis ('brittle bones'). 2. Weight control - Strength training helps convert fat into lean muscle raising your basal metabolic rate. This helps you burn more calories even at rest. 3. Improve brain power - Some studies have suggested that strength training can help improve your memory and focus, particularly in older adults. 4. Manage chronic disease - Strength training can help alleviate the symptoms of chronic diseases including back and shoulder pain, osteoarthritis, heart failure and diabetes type II. 5. Improve stamina - Strength training can help you do more physical activities in your daily living without feeling tired and inefficient. 6. Boost your self-esteem - Strength training has been shown in studies to boost your self-confidence. 7. Improve posture - Strength training can help you move while performing your daily activities in a more relaxed and efficient manner. 8. A large number of research studies have demonstrated that strength training can improve running performance, efficiency and reduce the risk of injury. Below is a useful infographic summarising the benefits of strength training for recreational and elite runners based on the latest scientific research studies:
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What is Dry Needling?
Dry needling is a form of therapy in which fine needles are inserted into myofascial trigger points (painful knots in muscles), tendons, ligaments, or near nerves in order to stimulate a healing response in painful musculoskeletal conditions. Dry needling is not acupuncture of Oriental Medicine, that is, it does not have the purpose of altering the flow of energy (“chi”) along traditional Chinese meridians for the treatment of diseases. In fact, dry needling is a modern, science-based intervention for the treatment of pain and dysfunction in musculoskeletal conditions such as neck pain, shoulder impingement, tennis elbow, carpal tunnel syndrome, headaches, knee pain, shin splints, plantar fasciitis, or low-back pain. How does Dry Needling help? After, you may have less pain, feel more relaxed and/or have better range of motion. You may also be able to do activities you couldn’t do before or experience reduced symptoms (such as pain) whilst doing them. What are the Risks of Dry Needling and is it safe? Drowsiness, tiredness or dizziness occurs after treatment in a small number of patients (1-3%) and if affected, you’re advised not to drive. Minor bleeding or bruising occurs after dry needling in 15-20% of treatments and is considered normal. Temporary pain during dry needling occurs in 60-70% of treatments. Existing symptoms can get worse after treatment (less than 3% of patients); however this is not necessarily a “bad” sign. Fainting can occur in certain patients (0.3%), particularly at the first treatment session when needling the head or neck regions. Dry needling is very safe; however serious side effects can occur in 0.01% of people. The most common serious side effect from dry needling is pneumothorax (lung collapse due to air inside the chest wall). The symptoms of dry needling induced pneumothorax commonly do not occur until after the treatment session, sometimes taking several hours to develop. The signs and symptoms of a pneumothorax may include shortness of breath on exertion, an increase in breathing rate, chest pain, a dry cough, bluish discoloration of the skin, or excessive sweating. If such signs and/or symptoms occur, you should immediately contact your physical therapist or physician. Nerves or blood vessels may be damaged from dry needling which can result in pain, numbness or tingling; however, this is a very rare event and is usually temporary. Damage to internal organs has been reported in the medical literature following needling; however, these are extremely rare events (1 in 200,000). What can be done instead of Dry Needling? You can choose not to do any treatment at this time and see if the condition gets better on its own. Other choices are: soft tissue mobilization alone, shockwave therapy, joint manipulation, and/or specific exercise How will I feel after Dry Needling? You may be sore right after treatment where Dry Needling was used. This does not always happen, but it is normal. Soreness may begin in a few hours or even the next day. The soreness may be different for each person. It usually feels like you had a hard workout at the gym. Soreness usually lasts 24-48 hours. Tell your physiotherapist at your next visit how long the soreness lasted. Bruising from Dry Needling is possible. Some areas are more likely to bruise than others. The shoulders, chest, face and portions of the arms and legs are more likely to bruise than other areas. Large bruising is not common, but can happen. Use ice to help decrease the bruising. If you are worried, please call your physiotherapist It is common to feel tired/fatigued, energized, emotional, giggly or “out of it” after treatment. This is normal and can last up to an hour or two after treatment. If this lasts more than a day contact your provider as a precaution. Rarely, Dry Needling may actually make your symptoms worse. If this continues past the 24-48 hours, keep note of it. This can help your therapist change your treatment plan if needed. This does not mean Dry Needling cannot help your condition What should I do after my treatment? It is highly recommended that you should drink more water for the next 24 hours after Dry Needling treatment. This helps avoid or reduce soreness. After dry needling treatment, try this if you wish. Please note that if it hurts or makes your symptoms worse, stop the activity.
What should I avoid after treatment?
Tendons and ligaments have poor blood supply as they do not have direct blood vessels travelling through them. As a result of the poor blood supply, they are generally slow to heal. Shockwave Therapy has been clinically proven to naturally accelerate healing by targeting injured soft tissues with acoustic waves through:
Clinical Indications:
Contraindications:
When should you consider Shockwave Therapy? Shockwave Therapy is often considered as an alternative to surgery when traditional conservative management with a physiotherapist or podiatrist fails, as it is non-invasive, safe and can be highly effective for tendinopathies. Leading physiotherapists often combine traditional exercise rehabilitation and manual treatment with shockwave therapy to optimise outcomes. Are there any particular restrictions after treatment? You are generally advised to rest from physical activity for about 48 hours after each treatment session. What is the latest evidence for Shockwave Therapy? The best evidence for the use of Shockwave Therapy was available for tendon disorders and tendon calcifications in a “comprehensive rehabilitation framework.” (The Journal of Bone and Joint Surgery: February 7, 2018 - Volume 100 - Issue 3 - p 251–263) Randomised control trial for Achilles Tendinopathy: Eccentric loading alone was less effective when compared with a combination of eccentric loading and repetitive low-energy shock-wave treatment. (The American Journal of Sports Medicine 2017 Volume: 37 issue: 3, page(s): 463-470_ Systematic Review on Shockwave Therapy and Soft Tissue Injuries: There is evidence that Shockwave Therapy is effective for a number of soft tissue musculoskeletal conditions, particularly for plantar fasciitis, calcific tendinitis. There is a low level evidence for lack of benefit for non-calcific rotator cuff disease and mixed evidence in lateral epicondylitis. (British Journal of Sports Medicine 2014; 48 1521-1521) 3. How will you incorporate Shockwave Therapy into a physiotherapy consultation? As per normal routine, the patient will require a 40 minute initial consultation to conduct a comprehensive examination and require 20 minute follow up sessions. 3-5 weekly treatments may be required with shockwave therapy. A standard exercise rehabilitation as well as potentially other physiotherapy treatment techniques if clinically indicated. FREQUENTLY ASKED QUESTIONS 1. Does the treatment hurt? You will generally feel discomfort. Treatments last for about 5 minutes so they are generally tolerable. The dosage can also be adjusted by the physiotherapist to cater for comfort. However in general, the higher the dose, the more effective the treatment outcomes. 2. How many sessions will I need? 3-5 in general depending on the condition, its severity, patient tolerance and tissue response. Often, patients will feel immediate relief after the first session. 3. Will I feel pain after the treatment? You will often feel discomfort within 2 hours after the treatment. This is generally tolerable and not functionally limiting. I decided to start blogging to help log my self-reflections and clinical thoughts from a paper diary to a digital format, as I practice as a physiotherapist on a daily basis. The purpose of the blog is to benefit all my patients and health professionals who may refer to my clinic at Acland Street Physiotherapy.
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