Back Skills Training Programme (BeST)

Physio Fanatics will be running a BeST programme. You will need an initial consultation with the Physiotherapist, and a referral letter from your Dr if you want to claim from medical aid. The course consists of a 1 hour session, once a week for 6 weeks.

Send an email to tanya@physiofanatics.com with any questions, or to book a slot.

The programme will begin on Saturday 20th July 2024

What is the Back Skills Training programme?

This programme is structured into 7 sessions, one individual session with the Physiotherapist and then 6 group sessions. Each session is designed to teach you a different skill in the steps you can take to manage, understand and learn to have control over your back pain and its impact on your daily life.

Often when you get to the stage of looking for a programme like this you have had back pain for many years and have developed your own coping mechanisms. BeST teaches you a “best practice” approach to your pain and pain management, from how often to perform daily tasks or exercise and how to progress them, understanding the mechanisms of pain and how to work with and around those mechanisms, relaxation techniques and dealing with the psychological and social impacts of your back pain (or any pain for that matter!).

When the Dr, Physiotherapist, Chiropractor and other medical professionals are not giving you all the answers you need maybe a more holistic approach is needed. The team that created this programme are aiming to do just that.

Physio Fanatics wants to help you to learn this approach.

Our team developed and evaluated a group programme called “Back Skills Training” (BeST) for low back pain.

The Back Skills Training programme was developed by a collaboration between experts in the fields of low back pain, psychology, physiotherapy, and cognitive-behavioural therapy, and patients with long standing low back pain.

  • The Back Skills Training programme helps people “undo” unhelpful beliefs about low back pain, and develop skills to become more active. It consists of 1 individual session lasting 60 minutes, followed by 6 group sessions of 90 minutes.

  • In addition to contributing to the development of the programme, patients provided feedback on the acceptability of the group format, content and materials. We also conducted in-depth interviews with patients who had received the programme in the trial to ensure that we could gain the patient perspective.

  • Our research demonstrated that the Back Skills Training programme reduces back pain and disability and is a highly cost-efficient intervention.

Patient reflections on the Back Skills Training Programme

“I found it very good because when you are by yourself you’re the only one with this problem and nobody else knows what you’re going through…to sit down with people who were actually the same or very similar it was reassuring that you are not by yourself and to hear how they do things and think ‘that’s a brilliant idea’…it was good.”

“…now I don’t think about it (my back), I’ve been going twice a day on the bus, that would have been unthinkable this time last year, and I go up the stairs now sometimes instead of taking the lift…you might see me in a couple of days running around the street!”

“What different people did and said helped because you learn so much through listening to other people with the same problems. I found that invaluable.”

“I found the cognitive behavioural content really interesting and it was like a lightbulb coming on really - the moment of ‘oh of course that’s why I feel that way’ and did a lot of nodding and agreeing with what was being said.”

Therapist reflections on the Back Skills Training Programme

“The Back Skills Training sets you apart from other clinicians.”

“Understanding chronic pain and why things develop like that gives you much more hope as a clinician that you can help people.”

“It has really helped me with other consultations…to manage my chronic patients.”

“As clinicians we can be didactic and tell people what to do, whereas my take on the Back Skills Training programme was trying to get participants onto a self discovery journey really with their back pain.”

© University of Oxford

Looking after your feet!

 

 

Feet, love them or hate them, we all need them. There are so many different things that can go wrong in your feet. There are 26 bones and 33 small joints, with ligaments and muscles and tendons holding them all together and making them work. They need to be strong, stable, flexible and be able to deal with a large variety of terrain or activity.

When you were little and start to toddle you may have flat feet, as you grow older they will develop their arch and their shape. As you get older they will once again broaden and flatten.

Pain in your feet can be frustrating and difficult to live with. It is hard to be in pain with every step you take, and can impact all aspect of your life, from your activity levels to your mood. Don’t ignore foot pain, especially if it persists for more than a couple of days.

 

Common causes of foot pain.        

Your foot is a complex structure of many different moving parts. As a result of all of these structures there are many different things that can cause or result in foot pain.

1)      Poor fitting or unsupportive footwear

2)      Being overweight

3)      Change in activity (new job, change in training schedule etc)

4)      Ageing

5)      Trauma

6)      Other conditions (arthritis, gout etc)

The pain in your feet can also be referred from somewhere else in your body. Or you may feel numbness, tingling or burning. Everyones feet are different and unique, therefore your symptoms and pain can be too.

Common foot conditions and their treatments.

Plantar fasciitis.

The plantar fascia is a strong ligament that runs from the front of the heel bone to the toes. It can become irritated and inflamed. This is usually due to overloading or repetitive loading. This can be anything from long standing, tight calves, changes in your arch, unsupportive shoes or heel pain.

Initially you can try reducing the load and irritation by checking your shoes (they do have a mileage limit!), or making sure that they are supporting your foot correctly if you spend a lot of time standing. This may mean that you need to do specific exercises for your feet, buy better/new shoes or seek professional advice with regards to shoes and or orthotics.

You can also try some ice on your feet (rolling a frozen bottle under your foot) or stretching your arches and calves. If this makes no difference, ask for help from a medical professional.

Physio can help with assessment and advice on foot wear, exercise and stretches. Treatment will involve a detailed assessment of your symptoms followed by treatments to deal with your symptoms as your Physio sees fit. You will be given some homework in the form of stretches and strengthening. The Physio will also asses your foot placement in standing, walking and possibly running, and do a gait analysis to see if any of these may be contributing to your symptoms.

 

 Achilles Tendonosis.

The Achilles tendon is the thick cordlike structure that connects the two big calf muscles (gastrocnemius and soleus) to the heel bone. These together create the heel raising motion for walking and running.

Most injuries to the Achilles tendon are due to overload or over use. Trauma or injury are common causes of Achilles pain. Other possible causes can be poor fitting shoes, calf weakness, ageing or simply the shape of your own feet!

You can try reducing mileage, gentle stretches and foam rolling. If you felt or heard a loud snap or pop, or unable to point your toes please seek medical advice immediately.

If the problem does not settle of gets worse seek help from a professional.

Physiotherapy will once again consist of a full history to understand your mechanism of injury, along with a movement and gait analysis, and your activity levels and exercise expectations. The Physiotherapist will then create a program to regain your strength, balance, speed and flexibility.

 

Ankle sprains.

It is likely that at some time in your life you have sprained an ankle. Either mildly or severely. This happens when your ankle is either rolled, twisted or turned in a forceful uncontrolled way. This will likely result in soft tissue trauma to both the ligaments and soft tissue in your ankle, anything from a pull to a tear. Usually the ankle will roll inwards, resulting in pain on the outside of your ankle and sometimes up your leg.

Although this may seem like a relatively mild injury it can have far reaching effects and needs to be correctly assessed treated. Sometimes you can just “walk it off” but you may have swelling and bruising, pain on weight bearing, and limited range of movement in more severe sprains.

Immediately after injury apply an ice pack. This should be done for approximately 10 mins, every two to three hours. Never apply ice directly to the skin as you may cause skin damage and be careful not to freeze yourself, and ice burn can be very painful.

You will need to rest your ankle, and prevent the movement that created the injury. This may mean a splint or just a bandage. If the pain is severe you may need to use crutches, but a little weight bearing will usually help to improve swelling and promote healing as long as it is within a tolerable range (less than 3/10 on a pain scale).

You can also do some simple ankle mobility exercises, like ankle pumps or writing the alphabet with your toes to begin regaining mobility.

Some ankle sprains will heal on their own without needing any intervention, some may need to be checked to rule out a fracture, you may need to have extensive rehab to strengthen and regain balance, movement and power.

Your Physiotherapist can assess and see how much rehab you will need to return you to full function.

Some easy, general exercises.

1)      Ankle pumps. Point and flex your foot up and down 10 to 15 times.

2)      Alphabet writing. Imagine you are writing out the letters of the alphabet with your foot.

3)      Calf stretches. Stand on a step, hold on to something for safety. Let your heels hang down over the step while balancing on the balls of your feet. Hold this position for 30 seconds

4)      Ice bottle rolling. Roll your foot over a plastic bottle of frozen water.

5)      Toe and heel tapping. Sit in a chair with your feet flat on the floor. Alternately tap your toes and then your heels. 15 times each.

6)      Single leg stand eyes open and closed. These are more advanced. Try and maintain your single leg stand for 10 seconds.

If any of these help reduce your pain, great, keep doing them. If they make your pain worse stop doing them immediately and seek advice from a medical practitioner. If they no effect at all and you still have sore feet, seek the advice of a medical practitioner.

 

I hope that we can all have Happy Feet!

Be SMART

Be SMART .

A new year, a new page, a new slate a new start! Whenever we get to this stage and the times comes for me to sit down and write my goals I have to take a deep breath. My husband introduced me to goal setting. He is a pro at it. I think he cheats. He works and worries at his goals all year round and then come January they are all polished and shiny and ready to go. Well, ok, maybe that is not cheating and it is the way it should be done!

 


 

Then in 2022 I did a course on rehabilitation and exercises for people suffering with Rheumatoid Arthritis in the hands. And suddenly the two worlds of my finance expert husband and physiotherapist self collided. Here was goal setting that I had been doing for years with people of all ages and abilities. I was the pro for once. It is the same but different.

 

 

Goal setting for Physiotherapy.

 

Following injury or trauma there is often pain, loss of function and loss of strength. Physiotherapy looks at how to restore your ability to carry out the activities of daily living relevant to you to the best possible level and as pain free as possible. Ideally full function pain free, but no one is perfect!

Goal setting is an integral part of that outcome, and is something that you and your Physio should do together. Often it is a big goal (I want to get back on my bicycle) but has smaller goals along the way to get to it (I want to be bend my knee!).

The SMART goal setting system breaks the goals down into chunks that make you mindful of how and when you are going to achieve these goals, and research shows that the act of writing them down and internalizing them makes them more likely to be achievable.

2 examples of SMART physical goal setting.

One

          Specific         I want to be able to climb 3 flights of stairs so I can go and visit my                             family who live on the third floor.

Measurable   Right now I get tired going up three steps. I have a flight of stairs at work. I will begin the first week going up the stairs in the morning and then using the lift for down every day.

                    The following week I will try to go up and down the stairs once every day.     .

                    The following week I will go up the stairs twice and down once.

                    I will continue increasing like this.

Attainable     I have no major issues with my general mobility so this is just fitness and strength.

Relevant       My family have no lift so if I want to visit I have to be able to climb the stairs.

Time bound  I would like to visit in the summer, so I have 3 months to do this.

                   

Two  

Specific         I broke my right wrist 8 weeks ago and want to be able to clean my teeth again!

Measurable   I currently cannot turn my hand to put my toothbrush in my mouth, but with exercises I should be able to regain function.

Attainable     I could do it before, and the break is healed.

Relevant       I need to use my right hand, it feels awkward cleaning my teeth with my left hand.

Time bound  I am going to set myself a goal of a month.

 

So they don’t have to be earth shattering, amazing goals. They just have to be relevant to you and your current situation and be able to take you to the next thing you want to do. Try it!

Debunking the Myths around Physiotherapy

All around the globe, Physiotherapy has been helping people recover, rehabilitate and transform their lives. It enables people to take charge of their health and improve their overall fitness, mobility, and quality of life.

There are a number of myths and misconceptions about Physiotherapy, including its use, what is involved and the cost. Debunking the common ones is important to better enable us to take charge of our health and improve our overall fitness, mobility, and quality of life.

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MYTH: I need a doctor’s referral to see a physiotherapist.

FACT: This depends on many factors. Physiotherapists are extremely thorough when screening their patients. At your first visit they take a detailed medical history and perform specific assessments, and may send you to a Doctor for further tests. Physiotherapists in many countries are now first line practitioners. This means patients can seek treatment from a Physiotherapist without a Doctor’s prior referral. However, your medical insurance may require a referral.

MYTH: Physiotherapy is painful.

FACT: Physiotherapists seek to minimize pain and discomfort—even if it is chronic or long-term. They work within the range of your pain threshold to help you heal, and restore movement. On initial contact you may experience discomfort and some pain but the aim is to keep it very minimal and for you to leave feeling better than you walked in.

MYTH: Physiotherapy is only for injuries and accidents.     

FACT: Physiotherapy can be used to help a diverse group of people wanting to keep active. It helps in rehabilitation, as well as prevention of injury and promotion of health and fitness. One does not only have to see a physiotherapist when injured, you may seek physiotherapy for preventative measures.

MYTH:  Surgery is the final/only option.

FACT:  From treating degenerative disc disease, rotator cuff tears, forms of knee osteoarthritis to meniscal tears, physiotherapy has proven to be as effective as surgery. Therefore having surgery is not your only option. Consult a physiotherapist and you could be glad to have made that choice in the long run. In many cases, physiotherapy has been shown to be on par with surgery in treating a wide range of conditions – from rotator cuff tears and degenerative disk disease to meniscal tears and some forms of knee osteoarthritis. And if you do chose to go for surgery you will still need physiotherapy intervention.

MYTH:  Physiotherapy is an art not science

FACT:  One of the most common myths around Physiotherapy is that it is an art and Physiotherapists are artists. In reality, Physiotherapists are qualified to assess, diagnose and treat disabilities. Four years of undergraduate studies, learning the human body, human medical science and hours of clinical work before you acquire your Bachelor of Science in Physiotherapy is more than just an art.

MYTH: Physiotherapy treats only muscle pain

FACT: Physiotherapists are qualified to treat wide range of diseases and their expertise is not limited to muscle pain and ligament related issues. Conditions such as vestibular rehabilitation, paralysis, sports injuries, chronic pain, pelvic floor rehabilitation and many more can be treated by Physiotherapy.

MYTH: Healing takes a long time

FACT: Another common myth around it is that it takes forever to heal. Though Physiotherapy aims at complete cure and not just temporary fix, results are usually visible in few sessions. Depending on the severity of the problem, the treatment plan can vary and might be longer than others but results are visible from the initial sessions itself. 

MYTH: Physiotherapy is just a modernized term for massage therapy

FACT: Physiotherapy and massage are two completely separate things. Physiotherapy is a practice to cure pain and disabilities using many different treatments, one of which may well be massage. A massage therapist uses only massage. Besides, physiotherapy is based on physical examination and diagnosis, up to date research, evidence based practice.

MYTH: Physiotherapy It is expensive

FACT: Physio treatment sessions are reasonably priced - most are covered by medical aid but even those who pay for their own find huge value in the relief they get from rehabilitation.

MYTH: Physiotherapists are diploma holders

FACT: Historically Physiotherapy was a diploma course, but as the profession progressed, in the early 1980’s it was converted into a 4 year BSC Degree (Bachelor of Science) followed by a mentored/supervised internship.

We hope this helps! If you have any questions please contact us on 3159303 or 71221237

Based on an article by  HealthCare at HOME

Interactive Pilates Online

Pilates. We know what it is now. We have been exposed to it for years. What is the best way of learning Pilates? Well face to face and in a studio setting of course! Videos are ok, but you need to be supervised and corrected so having an instructor there to watch and correct you is important.

Pilates is not a “copy me and try to keep up” type of exercise. It needs to be done right!

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When lockdown came this was an issue for me. A lot of my clients with long term issues rely on the Pilates classes to keep them moving and pain free. So how could I continue this for them?


The learning curve for me (a technophobe) has been huge over the last 5 weeks. I have been dragged kicking and screaming into participating in the computer world.

Some things, however, have been a revelation.

Interactive Pilates on Zoom

It works…….

What do you really need for Pilates? A mat/towel/carpet/rug to lie on, a space where you can wave your arms and legs around when lying down and an instructor. Most people can mange that and Zoom means that I can be there with you. I have been able to watch, correct, interact while teaching. I have also discovered some unexpected advantages.

  1. It has made me work much harder! I really have to think about how I am explaining the exercise, the way that I describe the movement I am after, and be more imaginative in the language I use.

  2. I can see you all so much more easily from the angle I need to see you and in more detail so it is easier for me to help you do the exercises perfectly.

  3. You can see me more clearly and have a better idea of what I am asking for with each exercise. You can make me the biggest person in the room so your attention is more on me and you are not thinking about anyone else in the room.

  4. And you do not have to go anywhere! I am teaching people in different parts of the country and different counties. So now you can take me on holiday with you without actually having to have me with you!

I have had some amazing feedback from people taking part in the online classes both new participants and ones who have been doing Pilates for a while. So much so that I will be continuing with the online classes in the future.

So if you have not tried them be brave. Give it a go. You might be surprised.




Back Skills Training Programme (BeST)

What is the Back Skills Training Programme?

Back Skills Training helps people learn to manage their back problem better by learning about their backs and trying out different skills such as exercise and relaxation.

Why is this the best treatment for your back pain?

Traditional approaches to treat back pain have included ‘hands on therapy’, such as massage or acupuncture. You may have tried some of these treatments in the past. However, as our knowledge of back pain has improved, we now know that these traditional treatments often do not help in the long term. Since back pain often reoccurs over time, treatments that have a long term benefit are important. Therefore, the Back Skills Training programme focuses on teaching you about your back pain, and providing you with a range of skills and tools that you can use to manage your back pain over time. The Back Skills Training programme has been extensively researched, and has helped a large number of people to reduce their low back pain and improve their quality of life.

How does it work?

The programme consists of 6 meetings (face to face or on Zoom) each an hour long. There will be up to 8 people per session. The session will be led by the Physiotherapist. Each session will have a “theme”, you will get the opportunity to ask questions and be given an exercise programme to follow (don’t worry it is very gentle). You will be given some weekly homework tasks that are relevant to you.

You will be monitored throughout for progress, and can contact your Physio for more support or info if you need to.


Feedback from a previous participant:

When I ouched my way into your practice in Sept last year, my life had been reduced to just getting through each day, inching with trepidation towards that inevitable moment when I would have to declare defeat and medicate and lie down. Blaming myself for the state I'm in yet not knowing what I exactly did to get there, feeling guilty about not being whole and not knowing how to get out of it, all contributed to a very negative self image. By helping me understand how my body works, and what could most likely have gone wrong, and giving me hope and tools to start moving away from that negative zone, you have literally changed my life. 8 months later I'm not pain free, but I'm a lot better and by doing the exercises you've shown me I am managing to stay mobile and do the things I have to AND increasingly the things I WANT to as well, and I feel stronger physically and mentally. It's a long journey, and I still stumble, and sometimes fall, but I know how to get back up and not beat myself up mentally anymore. The chronic pain management course we did at the end of my sessions with you also helped to consolidate all I had learned from you. So, this long essay is really just to say thank you.


Book your slot now, or contact tanya@physiofanatics.com for more information.







World Physiotherapy Day

World Physiotherapy Day has been celebrated since 1951. It is a day where Physiotherapists around the world unite to promote a themed promotion. This year, obviously, that is Covid 19. Physiotherapy is important in your recovery after illness and is instrumental if full return to health.

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During this interesting times it is sometimes not possible or wise to travel, so Physiotherapist are using the internet and other alternative forms of communication to help with your rehabilitation. You can book online or contact us to book for a video consultation using zoom or whatsapp.

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Physio Fanatics wishes you a happy and healthy World Physiotherapy Day 2020.

Physiotherapy During Lockdown

I’m one of those people who doesn’t do change easily. I pretend I’m easy going and flexible (but that’s in the little things like supper and clothing). Big things like how I work? Not so much. So lock down was a big thing.

I’m a Physiotherapist- I have two hands and I use them (along with other modalities) to treat people. How do I treat people without touching them?

That was me 3 weeks ago.

Bear in mind that, for the past 6 months, I’ve been listening to podcasts and lectures from around the world of Physiotherapy urging a more “Patient Led” form of rehabilitation. The Physiotherapist assesses, does some treatment, creates a programme and then monitors progress. I’ve been following this with a degree of scepticism (or so I thought).

Then came lock down.

I find myself in a situation where I have to change my work methods in a big way. No more routine face-to-face appointments. Strict screening before any contact. Online video-link assessment, prescription and follow-up were the way forward.

And I’m loving it!

Yes, I miss the contact. I miss the general banter. I miss being able to “get my thumbs in there” and release that muscle or mobilise that stiff joint, or use a myriad of other hands-on treatments I have up my sleeve.

I’m loving the way that video assessments make me look at things from a different perspective. I have to diagnose and problem-solve so that You can fix it. I have to explain what’s going on so that You can make it better.

Is is quick? No. Is it as ‘nice’ as having that muscle released or that joint mobilised? Perhaps not.

Does it work? Oh yes…

This experience of ‘online physiotherapy’ has made me a better Physiotherapist. I have a broader view of things. I trust you as a patient to be more independent of me - more capable than I previously thought.

I have come to understand that slow-and-steady can win the race. The method may not be the same but the outcome - maybe.

Online Physiotherapy. Do I want to do it forever? No.

I like being hands-on. It’s satisfying and effective but, contrary to my old belief, it’s not the only way.

I’ve been pleasantly surprised to be happy with the results of the Online Therapy. In our current lockdown situation it’s been an absolute life-line to people who would otherwise had to go to the Doctor and take more tablets.

Just goes to show… change can be good.