After COVID disruptions to sports and fitness training and competition, the prospect of returning to peak form and performance can pose the temptation of training harder, longer and more often. However, to make your workout, sport or other fitness regimen sustainable, it’s important to factor in your body’s physiology to optimise progress towards your goals and minimise injury risk. A key component is recovery. While preparation including your warm-up is important, recovery is the most influential component of any exercise program. Why?
Recovery perks (why bother)
Best recovery practices
Research reveals a number of simple practices that promote optimal recovery.
If you’re keen to optimise performance and minimise injury risk, a Soaring Health physiotherapist can devise a personalised plan to help you to achieve your fitness goals.
Blurred boundaries between work and home life can cause stress to ‘leak’, causing a sense of overwhelm and even anxiety. Reset your stress with these boundary-setting tips.
Working from home and home schooling have blurred the boundaries between work and home life. No longer do you have the end-of-day commute to unwind and transition back to your private self or family life. The work day no longer provides a reprieve from the demands of domestic life. It can feel like one big, chaotic, 24-7 blizzard of work emails, homework, washing, meal preparation and ironing a top for impromptu Zoom meetings.It’s no wonder demand for psychological assistance with stress and anxiety have sky-rocketed during COVID lockdowns. But why are those of us who previously coped with similar demands now feeling overwhelmed?
The stress leak
A key reason for feeling overwhelmed by stress is the lack of division between parts of our lives that were previously somewhat separate. Where before, our brains could compartmentalise or partition areas of demand and we could follow routines to feel a sense of control and order, now demands from each part of life run free. The boundaries that once seemed solid are now permeable. Stress from one part of your life is able to escape into another rather than waiting for its turn, which creates a kind of stress snowball. It makes sense, then, that creating mental boundaries between work and life can help us to cope with work-related pressures, reduce stress and restore balance.
According to research at the University of Illinois, workers with greater boundary control over their work and personal lives are better at creating a stress buffer to prevent them from mood disturbance and negative rumination (or getting trapped in a negative, self-perpetuating thought loop). Research has also found that switching off devices such as tablets, laptops and phones in the evening can promote better sleep, which is a known factor in our ability to cope with daytime demands.
Practical tips to plug the leak
Feeling overwhelmed? Protect your wellbeing with these simple tips.
If you frequently feel overwhelmed by work or experience symptoms of chronic stress or anxiety such as fatigue, headaches or low or erratic mood, consider consulting a psychologist who can help you to gain skills and techniques to manage stress while maintaining personal wellbeing.
Has working from home at a makeshift desk left you stiff and rusty? These chiro-approved sitting tips could help to relieve back and neck pain and restore free movement.
Fact: few of us sit in a way that maintains good posture and spinal health. Most of us automatically sit in a ‘C’ shape (shoulders rolled forward and pelvis tucked under), which compromises spine health and can lead to dreaded back pain often seen by our physios and chiropractors. The good news is that, like all habits, this C-sitting or other suboptimal seating positions can be unlearned by repeatedly performing a replacement behaviour. With practice, these good sitting habits will become your default.
First, untuck your pelvis. When you sit, bend at the hips and imagine you have a piece of string from your tailbone out behind you with someone gently pulling it. Your large leg muscles should relax and allow the tailbone to naturally untuck. Be careful not to forcefully arch your back and stick your tailbone out as this will strain low back muscles.
Uncurl your shoulders without either sticking your chest forward or arching your back to ‘push’ back your shoulders. It should be a ‘relaxing’ rather than a forceful effort. It’s a good lesson to teach the kids for school too.
EXTRA TIP: Activities such as yoga and Pilates and therapeutic yoga and clinical Pilates can help retrain the body towards optimal seated posture.
If you are experiencing persistent pain, tightness or stiffness in your back, neck or hips, consider consulting a chiropractor for a spinal health assessment and targeted interventions to relieve pain for good.
Reduce fall risk with these home safety, exercise, self-care and nutrition tips from our OTs, physios and dietitians.
For people living with disability and those whose mobility and balance are limited by the physical and/or cognitive effects of ageing, the risk of falling is often greatly increased. This risk is often especially high for those living independently due to the absence of risk assessments, checks and precautions that are in place in assisted or supported living environments. Even for those whose home environments have been assessed and even modified, many household items such as electrical cords, rugs and doormats can become major hazards.
While the obvious and very real danger of heightened fall risk is injury, from cuts and abrasions to sprains and strains and fractures and head injury, fall risk can also compromise vulnerable people by undermining their confidence in independently performing daily living tasks or engaging in activities. It is not uncommon for those who have previously had a fall to report living in fear of reoccurrence and in turn limiting activities in a bid to prevent another fall. Indeed, a fall within the last year is a significant predictor of another fall. So what can be done to mitigate both fall risk and confidence issues associated with fall risk?
There are many simple checks and precautions that can be taken by an individual or by a carer or visiting allied health practitioner such as an occupational therapist (OT) to reduce fall risk. These include simple precautions around the home as well as self-care measures including dietary patterns and timings. Exercises tailored to reducing fall risk can also be prescribed by a physiotherapist.
Poor balance and impaired gait are known risk factors for falls. Key indicators may include inability to walk in a straight line or at a steady speed; requiring support in order to walk; inability to stand on one leg or to sit down in a controlled manner. Exercise can significantly mitigate fall risk by strengthening physical deficits that contribute to fall risk. Ideally, these exercises are prescribed by a physiotherapist based on your unique physiology. You can also help to decrease your fall risk by remaining physically active to maintain strength and agility. Consider these exercise types:
Few people consider food types or meal timing as risk factors for falls, but the effects of irregular food intake or unbalanced meal composition and dehydration can contribute to fall risk. This can be mitigated by adhering to a schedule of snacks and meals, planning snacks and meals that will sustain energy and maintain stable blood sugar and getting into a routine of drinking water throughout the day.
Many health conditions including hypotension or hypertension and diabetes can, without proper medical management, increase fall risk. Conditions affecting vision, hearing and balance can also increase one's risk of falling. Maintaining general healthcare and adherence to medical advice are important measures in fall prevention. Consider this checklist.
If you or someone in your care is concerned about fall risk, consider a home assessment by an occupational therapist, who can provide a comprehensive assessment of the home environment and recommend modifications and measures to maximise safety and confidence. If you experience dizziness or light-headedness due to a medical condition or unknown cause, bring it to the attention of your primary healthcare practitioner and other healthcare providers.
Make play time work double duty with these play-based activities that target key areas of kids' physical, mental, emotional, and social development.
If you notice that your child is having difficulties with certain skills or competencies expected for their age or are concerned about whether your child’s development is normal, consider consulting a children’s occupational therapist, speech pathologist, physiotherapist or psychologist, depending on the area of concern.
From reducing pain to improving mobility and even enhancing body image, these ability-tailored exercises can have far-reaching benefits.
If you have a disability, severe weight problem, chronic health condition such as arthritis or diabetes or a severe injury, you may assume that your ability to perform meaningful exercise is limited - if not ruled out completely. The truth is, regardless of your current physical condition, age and whether you’ve previously exercised, there are many ways to access the physical and mental benefits of exercise. In addition to global benefits such as managing body weight, decreasing cardiovascular disease risk and releasing feelgood brain chemicals (endorphins), for people with disability, exercise may even help to alleviate pain and degenerative symptoms and help to build areas such as muscle strength and power, balance, agility and flexibility - which can effectively help to improve mobility. Certain types of exercise can also support bone density, in turn reducing the risk of major damage such as fractures from a fall or knock. As a bonus, regular exercise can incidentally improve body image. Exercise has been shown to improve people’s feelings about their bodies regardless of changes in weight or perceived flaws or imperfections. The effects of exercise can be life-changing!
Finding your fit
The key point when considering exercise is considering it within the context of your individual strengths and limitations. A good way to identify exercises that target specific goals (e.g. upper body strength) and accommodate your current needs and incremental progress is to involve your physiotherapist, occupational therapist or both in your exercise planning. They have detailed knowledge of your condition and health history and can tailor a plan to develop areas required to safely perform certain exercise (for instance, if you want to start swimming and have limited lower limb use, you may need to first develop the upper body strength to propel yourself through water, which may involve a preliminary training program). Consultation is especially important if you suffer from a condition that directly affects your muscles (such as cerebral palsy or multiple sclerosis) as exercises may need to be modified.
As you look through these exercise ideas, the appropriateness of each for your situation will probably be obvious. However, if you are considering incorporating any of these moves into your routine, it may be a good idea to print these out and discuss them with your healthcare provider (e.g. physio or OT), who can help to tailor them to your goals and help you to practise safe, effective technique.
These workouts are appropriate for those without upper-body or upper-limb injuries or limitations and can be done while sitting on a chair, wheelchair or bed. These exercises use a resistance band (an inexpensive, stretchy band that causes resistance against your effortful movements).
For these exercises, the amount of weight used (dumbbells are the most common weight type) and number of sets and reps will depend on your physical condition and fitness level. Seek advice from a physio or OT to optimise these variables.
Generally, leg exercises are appropriate for people who have some mobility. Check with your physio or other healthcare provider before performing any new exercise. This simple, isometric lower-body/leg exercise is targeted to building muscle tension without stretching the muscle.
Chair Leg Extension
In a regular chair or wheelchair, sit up straight. Holding the armrests, keep one foot on the footrest or floor and slowly raise the other foot upward with your foot flexed towards your shin to create muscle tension. At the top of the movement, your leg will be stretched out in front of you with your foot flexed. Hold for a few seconds and slowly, with control, lower your foot back down to the footrest or floor. Repeat with other leg. Repeat for recommended number of reps.
Sit to Stand (if you are able to stand safely)
This exercise is as simple as it sounds. Start in a sitting position in a firm chair with support (do not use a soft, cushioned armchair or lounge chair). Holding the armrests for support, push up to a standing position. You may place a mobility aid or walking frame in front of the chair for support upon standing. From there, return to a sitting position, again using the armrests for support if needed. Try to lower your body with control rather than ‘falling’ back into the chair.
Whether your goal is to improve your muscle strength and/or in turn, mobility, reduce pain or boost your mental health (or all three), speak to your physio or OT about which exercises are best for you and how to perform them with safe, effective technique.
Whether you aspire to the freedom of independently preparing meals or wish to unleash your inner ‘Masterchef’ with greater freedom in the kitchen, we provide tips for safe kitchen practices, simple kitchen tweaks and low-cost, cooking-specific assistive technology.
When it comes to independence, being able to prepare your own meals is a worthy priority. Not only does having resources to match your capacities and limitations allow you the freedom to choose your own meals and provide flexibility, but being able to nourish your body with the nutrition it needs is an important and satisfying part of self-care. Whether you or someone in your care is working towards greater independence or wishes to pursue a passion for cooking as a leisure activity, here are some practical tips to get started.
For people with limited mobility, functional difficulties that affect use of regular kitchen equipment or low vision, kitchen configuration can either enable or prohibit successful and safe cooking. If you’re living alone or in a shared environment without ongoing assistance, this will likely be a key consideration during a home assessment by an occupational therapist, who may make recommendations for modifications and/or assistive technology to enable maximum independence in a safe environment. However, in many cases, major expensive modifications are not required. Inexpensive items such as mobile cutting benches and storage trolleys and height-adjustable wall-mount racks and shelves can greatly enhance accessibility and manoeuvrability around the kitchen. Low-cost cooking-specific assistive technology can also positively transform your experience of cooking and enable you to harness your capacities. Here are some ideas for setting up a kitchen that’s right for you (they’re rental property friendly):
2. Plan meals and shopping
If your mobility is limited and shopping is difficult or requires the assistance of a carer or support worker, or you have groceries home delivered (with a delivery fee for each order), it makes sense to limit shopping trips. However, doing this while ensuring that you have everything you need requires planning and discipline. If you’re not used to following a structured meal planning and shopping regimen, it may take time and additional support to set up a workable structure. Here are some possibilities to consider:
3. Prioritise safety
The kitchen is full of potential hazards - for anyone - and avoiding accidents requires consistent attention to safety details (as we become more proficient in the kitchen, it can be easy to get complacent). Consider printing a list (using words and/or pictures) of key safety checks and sticking it on the fridge or in a prominent place on a kitchen wall as a reminder and make a habit of checking off each one every time you cook. Here are some items to put on your list:
4. Use your NDIS funding
If your goals for development towards greater independence include learning to cook or being able to independently execute daily living tasks at home, you may be able to purchase certain kitchen assistive technology using your NDIS funding. Expensive modifications such as moving benches or changing bench height aside, many kitchen-specific assistive technology items qualify for the low cost assistive technology category. This means that if your need for them is reasonable and necessary and you have funding for assistive technology in your NDIS plan, you should be able to purchase items up to a value of $1,500 without a quote. Similarly, you may be able to use your funding to enlist a support worker to help you learn how to plan, prepare and cook meals or an occupational therapist to help you to gain access to relevant assistive technology and develop physical attributes such as strength and coordination to enable you to achieve your independent cooking goals. Here are a few low-cost assistive technology items that can greatly enhance independence in the kitchen.
If your goals or those of someone in your care include cooking independently for the first time, improving your ability to fulfill your nutrition requirements independently or becoming more independent in executing daily living tasks at home, speak to your existing NDIS team or occupational therapist. If you or someone in your care isn’t currently engaged with an occupational therapist or is seeking an all-in-one multidisciplinary NDIS-registered provider with collaborative occupational therapy, physiotherapy, psychology, speech pathology and dietetics services, please contact our dedicated community division on (03) 9013 5987. We’d be glad to help!
Dynamic stretches are stretches you do while a joint is moving through its full range of motion. An example of this is standing on one leg while swinging the other leg from full extension to full flexion. Dynamic stretches are great for improving flexibility and are most effective when done in the mornings.
2. Static stretches
3. Regular massage
Elite athletes receive at least two 45-minute massages a week for a good reason. It loosens up the muscles fibres, reduces the formation of scar tissue during muscle repair and helps with lymphatic drainage. Recreational athletes should endeavour to get a remedial or myotherapy massage every fortnight.
4. Magnesium Supplements
Found in a variety of foods including legumes, whole grains, green leafy vegetables, seeds, and nuts is magnesium. However, one in four Australians fails to meet the recommended daily intake of magnesium. There are many magnesium supplements to available, but there are only two we recommend. They have the highest level of magnesium absorption and retention in the body. They are BioCeuticals-UltraMuscleEze oral powder (kept in stock at Soaring Health) and Metagenics CalmX 270g oral powder.
5. Salt baths
Salt baths work because the warm water and the salt are absorbed directly by the muscles help reduce tightness. The two most commonly used salts are 100% pure Epsom salts and Radox Bath Soak. They’re inexpensive and with the right brands, very effective. Also remember they’re ineffective if the water isn’t warm enough and if you don’t put the recommended amount.
6. Self-massage tools
Self massage tools include spiky massage balls, foam rollers, massage sticks and trigger point triangles. Foam rollers are the most commonly used tools by athletes while massage balls are considered the most useful. Their use is easy and straightforward; use your body weight to press on a trigger point over the spiky massage ball. Trigger points release after 30 to 60 seconds when done correctly. This will help to alleviate the muscle tightness.
The best thing is that you don’t need to do all of these to get results; sometimes implementing just a couple could alleviate your reccurring or niggling muscle tension. Try it this month and leave us some feedback on how it went.
Disability sports are booming, but how do you find the best sport for you and what does it take to become an athlete? We explore how to get started.
In recent years, disability sports have enjoyed a seismic rise in attention and popularity. Paralympians and elite disabled athletes are being celebrated on a global stage, with athletes such as wheelchair tennis champion Dylan Alcott becoming celebrities and further elevating the profile of sports adapted for participants with disabilities. Simultaneously, sporting organisations including Tennis Australia, Surfing Australia and others have created dedicated competitions, divisions and development pathways that enable greater participation in disability sports and provide opportunities for people with disabilities to aspire to athletic performance at all levels, from amateur to elite. There has never been a better time to get involved in disability sports!
Yet while this progress is exciting, the idea of becoming involved in disability sports may still be daunting or overwhelming. Where do you start? What sports are suitable for your individual limitations and strengths? And which sports have eligibility criteria that match your physical abilities? The practitioners from our dedicated community division have compiled some tips to start making it happen.
Consider your strengths and limitations
Broadly, it’s a good idea to consider sports that allow suitable adaptations to accommodate your physical capacities and limitations and leverage your physical strengths or strengths you may be able to develop. For instance, wheelchair tennis accommodates limitations in lower limb function yet demands a great deal of upper body and arm strength and power, which may be developed through targeted training and goal-specific work with a physiotherapist. Swimming may be another suitable option to leverage upper body strength. Other sports offer various adaptations to suit individuals’ physical limitations and strengths. For instance, for adaptive surfing participants to compete, eligibility simply requires a physical or visual impairment, although eligibility and classification to compete have different criteria for different divisions such as ‘open stand/kneel (upper limb amputees, BK amputees) and open (visually impaired).
Review eligibility criteria
While practical considerations generally lead people to appropriate sports, there are also formal eligibility criteria for competitive participation in particular sports. For instance, to compete in wheelchair tennis, a participant must meet impairment type criteria, which broadly include being medically diagnosed with a permanent, mobility-related physical disability resulting in a substantial loss of function in one or both lower extremities. There are also classification criteria related to functional ability for participation in ‘open’ and ‘quad’ class divisions (open division athletes have no impairment to upper body function whereas quad division players have impairment to one or both arms). Eligibility and classification are administered by individual sporting bodies such as Tennis Australia. They are available to view by sport type on the Disability Sports Australia website.
Involve your healthcare team
Along with your own appraisal of your physical strengths and limitations or those of someone in your care, it is a good idea to discuss your sporting aspirations with members of your healthcare team. This includes medical specialists and your GP, who can determine whether you can safely participate in a given sport (e.g. for certain injuries and conditions, certain sports may present an undue risk of further injury or fracture). For NDIS participants working with a physiotherapist and/or occupational therapist, it can also be helpful to glean their recommendations. A physiotherapist can provide a realistic appraisal of suitability based on evaluation of your potential for required physical development while an occupational therapist can evaluate potential eligibility for funding of equipment (e.g. a specific wheelchair type) as well as providing guidance in pathways to participation.
Tap into social media
Many high-profile disabled athletes have thriving social media pages. These can give you a glimpse into their experience, including training, competition and challenges and considerations associated with their sports participation. Athletes may also provide helpful tips or learnings as well as inspiration and motivation. Louise Sauvage, Kurt Fearnley, Ellie Cole and Dylan Alcott are just a few of athletes you may wish to follow (by following these athletes, you should receive recommendations for other related accounts). If you don’t know the names of specific athletes, try starting with the Instagram accounts of Disability Sports Australia, Tennis Australia, Disabled Surfers’ Association, etc. Following these accounts is also a great way to connect with like-minded people and to become a part of the disability sports community and conversation.
Once you’ve narrowed down possible sport types, it’s time to get specific. To progress from contemplation to action, you’ll need to make contact with a local organisation to establish steps to get involved. If you still have questions about your suitability or eligibility for certain sports, you may wish to contact a few organisations representing your preferred sports to further refine your options. You may also have a list of questions about things such as availability of coaching or lessons and whether there are any programs or provisions for equipment funding, grants or loans. To find a local sporting body offering a specialised disability sports program, visit the Disability Sports Australia website, select a sport and visit the ‘Where to play’ tab, which will lead you to relevant phone numbers by state or area. This will enable you to locate your nearest club or facility and factor proximity and transportation into your considerations.
Punchline: Getting started as a participant in disability sports requires some research, but there are resources and supports available. Tap into every available resource, from sporting organisations to your healthcare team. With each action you take, you are closer to making it happen.
Even seasoned gym-goers make common workout form mistakes that undermine results and increase injury risk. Audit your technique with these physio tips.
When performing any exercise, correct form or technique is crucial both for getting results (e.g. increasing strength) and preventing injury. Not only do exercises become ineffective when incorrectly executed, but they can place undue strain on certain parts of the body, which become susceptible to injury. Unfortunately, many of us are unaware of deficits in our form. What’s more, the more familiar you are with an exercise, the less likely you are to question your technique, which is why common exercises such as lunges, squats and lat pulldowns are frequently implicated in injuries requiring physiotherapy treatment.
Even if you’re a seasoned gym-goer, put yourself in the mindset of being a beginner or novice and practise performing these moves in accordance with our experts’ recommendations. If you notice or suspect that your form is lacking, practise correcting it until correct form becomes habit.
The glitch: Your knees turn in or form a knock-kneed position while squatting, placing undue sideways or lateral stress on knees. Also known as ‘valgus’, this position can cause joint injury.
The fix: To keep the knees from turning, push your knees out to the sides so they’re above your feet throughout the movement. This helps to activate the medial glutes.
The glitch: An acute stance forces the front leg's knee too far past the toes, increasing stress on the knee and the injury-prone anterior cruciate ligament, or ACL. A short or narrow lunge stance also undermines activation of the glutes.
The fix: Step farther forward or backward as you lunge. As your foot lands, push your front heel into the floor as an anchor to stop your knee pushing excessively forward. For greater glute activation, widen your lunge stance.
The glitch: The most common mistake with push-ups is sagging or letting the body hang, with little or no core engagement. Other errors include dropping the head and shrugging the shoulders up towards the ears.
The fix: Ensure that your core is engaged and that there is tension throughout your body. Your body should form a straight line from your head to your heels. Work to pull shoulder blades down and together, away from your ears.
The glitch: Pulling down behind the neck misses the point of the ‘lat pull-down’ (which is supposed to work the latissimus dorsi, located in the middle and lower back). It also places shoulders in an unstable position and places undue stress on shoulder ligaments.
The fix: Pull the bar down towards your collarbones rather than forcing it down behind your neck. A 2009 study in the Journal of Strength and Conditioning Research showed that this in-front technique was just as effective for strengthening lats, with the added bonuses of working pectoral muscles and reducing strain on shoulders. When pulling the bar down, stop just below the collar bone. Pulling the bar further down can cause internal rotation of shoulders, potentially leading to strain and undermining effectiveness.
If you’re returning to working out after lockdowns and gym closures or you work out alone without a trainer to spot form slips, consider consulting a physiotherapist, personal trainer or exercise physiologist for a workout once-over to correct technique errors and optimise results and injury prevention.
How to tell whether your tooth or jaw pain is dental or chiropractic (plus DIY jaw and spine exercise solutions).
If you’re suffering from unexplained tooth pain or jaw pain, do you call a dentist or a chiropractor? It’s not a trick question. Tooth pain that can’t be explained by a cavity or structural issue such as a crack may in fact be referred from the jaw. Jaw pain, or pain in the sliding hinge-like ‘temporomandibular joint’ or TMJ (tem-puh-roe-man-dib-you-lur), is more common than you might think.
The temporomandibular joints (TMJ) are the joints which allow us to talk, chew and yawn. They are formed by the mandible or jaw bone, joining with the temporal bone of the skull, just below and in front of your ear. The position and movement of these joints are controlled by muscles that surround the joints, enabling you to move your jaw up and down, side to side, forward and back.
TMJ or TMD, also known as temporomandibular joint dysfunction or disorder, is a term given to a group of symptoms that occur when the jaw joints and associated muscles are disrupted. TMJ affects an estimated 20 to 30 per cent of adults and is more common in women and those aged 20 to 40.
Telltale signs of TMJ or related dysfunction can include:
What causes TMJ pain?
The causes of TMJ pain are many and varied. While it may result from habits such as teeth grinding or slouching (posture can contribute), it may, in some cases, indicate ‘temporomandibular dysfunction’ or TMD. Common causes or triggers may include:
Chiropractic diagnosis and treatment
A chiropractor can undertake a thorough assessment and diagnose the cause of pain or dysfunction and tailor treatment to your condition. Treatment of the TMJ joint focuses on relieving tension in the muscles around the joints, using trigger point therapy to alleviate the jaw pain associated with TMJ. If the cause is identified as being misalignment in your neck and/or upper back, treatment may include chiropractic adjustments of spinal joints around problematic areas. Other chiropractic techniques may also be used to alleviate mechanical causes and symptoms.
While DIY treatments are not a substitute for chiropractic treatment, for mild cases or between visits, these simple tips may help to lessen jaw tension.
It may be tempting to try to ‘loosen’ a tight jaw by creating an exaggerated chewing motion or by chewing gum, however, chewing regular solid meals and snacks is adequate activity for your jaw. Constant chewing can place extra strain on the jaw and worsen symptoms. If you chew gum after food or drink for dental protection, to stimulate saliva or freshen your breath, limit gum-chewing sessions to two to three minutes.
If you suffer from a painful or tight jaw, especially if you grind or clench your teeth, you may be able to feel that your masseter muscles (the ones just above your jawline on each side, below your cheekbone) feel firm and pronounced - like muscle knots. Gently massaging these points can help to encourage these muscles to relax and release tension, in turn providing relief from pain and discomfort.
For many people with jaw pain, clenching is an automatic, habitual practice during waking and sleeping hours. Make a point of checking in at regular intervals throughout the day and consciously unclenching if you find you’re holding tension. If this is done regularly, the relax and release action will also become a habit, which may help to resolve pain and discomfort. Are you clenching right now? At set times or whenever you notice tightness or pain, slightly lower your jaw until your teeth are no longer touching. You can do this with your mouth closed. If you’re holding your tongue against the roof of your mouth, let it gently fall back down.
Poor posture or spinal misalignment can contribute to TMJ pain or jaw tension. Optimal posture is when your ear is in line with your shoulder rather than your head pushing forward, which is common among people who work at computers. To assess your alignment, ask someone to take a photograph of you from the side while you’re standing up straight (or what feels like straight to you). If your ear is not above your shoulder, regularly practising this posture correction exercise can help. First, lie on the floor or on a mat or stand directly against a wall and tuck your chin to your chest. Relax and repeat. Complete this multiple times per session. With repetition, this exercise can help to strengthen muscles in your neck, in turn helping to relieve jaw pain.
If you are experiencing persistent jaw pain or dysfunction, or have unexplained symptoms such as tooth pain without dental causes, a chiropractor may be able to provide treatment to resolve both the cause and symptoms.
Increasingly, evidence is pointing to the power of psychological practices and therapies such as mindfulness and CBT to improve chronic pain. But how does it work and what should you look for?
If you suffer from chronic pain, you know too well that the physical discomfort and limitations are only part of the experience. These are often accompanied by psychological pain and distress, which can manifest as frustration and despair (and in some cases, clinical depression), anxiety and painful emotional responses to the loss of ability to participate in or enjoy activities you once did. Indeed, many sufferers experience grief. Mental wellbeing can be further undermined by effects of pain such as insomnia.
This holistic view of chronic pain has inspired a large volume of research and evidence for an integrative treatment approach to chronic pain. It is now widely recognised that a multidisciplinary approach combining medical treatment, allied health treatments such as physiotherapy and psychological therapies and practices such as mindfulness and cognitive behavioral therapy (CBT) can produce better outcomes than standalone physical interventions. What’s more, self-help practices such as mindfulness and cognitive exercises prescribed by a psychologist may empower sufferers to take control of their pain experience as they can be called upon at will. So what are the best psychological interventions for pain?
Mindfulness has become a buzzword in recent years. Based on ancient Buddhist principles and practices, it is now backed by a wealth of scientific evidence as an effective tool in managing conditions from depression and anxiety to the effects of severe and chronic pain. Recent research suggests that mindfulness meditation–based interventions improve pain symptoms across a span of pain-related disorders including fibromyalgia, migraine, chronic pelvic pain, irritable bowel syndrome (IBS) and other conditions. What’s more, it can work quickly. Even a brief introduction to mindfulness can help people to manage and cope with physical pain and associated negative emotions, according to a study published in the journal Social, Cognitive and Affective Neuroscience.
Changing the way the brain responds to pain
It sounds like a wild claim, but mindfulness practice has actually been found to change the way the brain responds to inputs such as painful or uncomfortable stimuli. In fact, in the aforementioned research, brain imaging scans showed that when those who had practised mindfulness were exposed to high heat on their forearm, their brains responded in the same way as if they were exposed to a normal temperature. In other words, their brain didn’t register the pain it would be expected to. Evidence suggests that even a few minutes a day can assist with pain management.
Mindfulness in practice
Mindfulness is essentially awareness and acceptance of a situation without judgment. During mindfulness practice, one focuses on the present moment and tunes in to bodily sensations and emotional responses without either ‘following’ them or judging them. In a simplistic sense, this may include noticing a twinge or ache in a particular body part without progressing to a judgment such as ‘this pain is bad’. Or if negative thoughts or difficult feelings about pain arise (e.g. ‘I can’t stand this pain any longer’, ‘I will never be free of this pain’ or ‘I feel so hopeless’), mindfulness practice advocates merely noticing those. Importantly, the practice doesn’t minimise of invalidate pain or invite one to block it out. Rather, it may deactivate cognitive and emotional factors that amplify or perpetuate pain, reduce the stress response and simultaneously cause the brain to operate in a way that improves the experience of pain.
How do you do it? A psychologist can help you to tailor mindfulness practice to your personal needs and circumstances. However, common methodologies include reciting a mantra (e.g. ‘I am safe and at peace’), paying full attention to the breath or performing a body scan, whereby you attend in turn to the sensations in each part of the body without labelling or judging them or letting your thoughts spiral or run away. This is often done in an upwards sequence, from feeling your feet connecting with the floor to noticing the feel of your breath and even noticing whether your eyebrows are tense or relaxed.
Talk therapy for chronic pain
While mindfulness is a powerful DIY practice for those experiencing chronic pain, it doesn’t address unhelpful beliefs or emotional responses to pain. These aspects have been identified as integral to the pain experience and are targeted using certain psychotherapeutic paradigms. The two talk therapy frameworks with the greatest wealth of evidence in the context of chronic pain are cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT), which is a variation on CBT.
Cognitive Behavioral Therapy (CBT)
CBT is an evidence-based technique often used in the context of psychological talk therapy or ‘psychotherapy’ to improve symptoms and underlying factors in conditions including depression, anxiety and stress. It is now widely supported as a powerful component in management of chronic pain. It works to identify negative thought patterns and beliefs that may cause or perpetuate psychological and emotional discomfort. For chronic pain, this may mean identifying and replacing negative thoughts and beliefs and replacing them with more helpful ones, which may in turn disrupt processes that compound the pain experience. In other words, it may make physical pain feel more tolerable and positively alter pain perception. There is no standard timeframe for CBT. Depending on your needs and progress, sessions may be limited to a few (e.g. three to six) or ongoing.
Acceptance and Commitment Therapy (ACT)
Like CBT, ACT is a type of behavioral therapy. As the name suggests, it is heavily focused on helping to foster acceptance of factors that may otherwise inspire a mindset of ‘fighting’ or ‘resistance’. Why? Often, the negative thoughts and feelings involved in fighting a situation over which we have little or no control actually makes the experience (e.g. pain) feel more severe or unbearable. Part of the methodology includes promoting flexible thinking and relinquishing rigid, entrenched, unhelpful ways of thinking and related emotional reactions and behaviours). ACT also encourages clients to clarify personal values and commit (the ‘C’ bit) to actions based on these values to enhance life satisfaction. In the context of chronic pain, ACT may help to alleviate pain-related stress and anxiety and manage their experience of pain on a daily basis.
If you are experiencing chronic pain, consider consulting a psychologist, who can guide you in strategies to help manage the physical, mental and emotional effects of pain and help you to return to greater wellbeing and life satisfaction.
If you sit for prolonged periods and suffer back pain, your hip flexors may be a hidden cause.
When it comes to back pain, it seems obvious to treat the source. Many of us, quite logically, apply a heat pack or book a shoulder and back massage. But often the obvious remedies fail to target the causes of pain. In fact, in many cases, the primary cause of pain is not the area where we feel pain at all. This is because pain is a complex process of messages from body parts to the brain and back (or to other body parts). For those of us experiencing pain, the messages we receive at the end (‘my knee hurts’) can be like the last word in Chinese Whispers: imprecise and even deceptive. This is why we often talk about ‘hidden causes’ of pain and recommend assessment and diagnosis by an allied health practitioner such as a physiotherapist or chiropractor rather than relying on guesswork.
A common example is back pain or movement limitations caused by shortened, tightened or weakened hip flexor muscles. This is common in those who sit for prolonged periods (e.g. desk work and driving). Because one hip flexor muscle, the psoas, is attached to the lumbar vertebrae, stretching out hip flexor muscles can help to alleviate a range of movement and pain issues including back pain and stiffness. A chiropractor can facilitate lengthening and strengthening of hip flexors using various hands-on techniques including PNF stretching in conjunction with targeted lifestyle recommendations and at-home exercises.
Can I DIY my flexors?
If you are not currently suffering pain, stiffness or movement limitations and do qualify as high-risk for shortened hip flexors due to prolonged sitting or a sedentary lifestyle, there are DIY exercises that may help to prevent deterioration and knock-on symptoms. Here is a basic at-home primer.
HIP FLEXOR STRETCH
KNEELING ADDUCTOR STRETCH
SEATED ADDUCTOR STRETCH
If you are experiencing persistent pain in your back, neck or hips, consider booking a FREE 30-minute chiropractic spinal health check, which can reveal hidden causes of pain. To book, call 9013 5987 (available until May 19, 2021). For more information, click here.
Could you really find relief from long-term or severe pain in a single session with a physiotherapist? Science says ‘yes’.
If you're living with a disability or severe injury, it may sound flippant (or even ridiculous) to suggest that manual therapy with a healthcare professional such as a physiotherapist could quickly result in a reduction in your level or pain or experience of pain. After all, your pain is a complex puzzle of tissue and/or nerve damage, brain signals and chemicals, memories and beliefs and their emotional effects and other factors.
However, it is not so far-fetched to suggest that your pain level or experience may be reduced within one or two sessions with a practitioner using tailored, targeted, evidence-based manual therapeutic techniques. How can that be?
While each hands-on therapy is tailored by highly-trained health practitioners to treat specific complaints, which undoubtedly may require sustained treatment to promote improvement, manual therapy brings with it the healing benefits of touch itself.
If it sounds a bit woo-woo, consider everyday benefits of touch. For instance, a hug promotes the release of bonding hormone oxytocin and makes us feel safe, close and connected. When you’re suffering emotional pain, a hug can make a world of difference. Then there’s massage, which has been shown to help regulate physiological factors such as blood pressure. But how can touch itself help with pain? Read on for a brief overview of the science.
How does touch promote healing?
The mechanisms through which touch can both promote the body’s own healing capacities and improve the pain experience are complex and not fully understood. However, neuroscience research solidly supports a number of powerful ‘analgesic’ mechanisms and pathways. For instance, a leading Swedish touch neuroscience research has identified special fibres in the body known as C-tactile afferent fibres, which register and convey to the brain the emotional meaning of different types of touch. We automatically detect, interpret and respond to these signals without even being aware of it. In another neat twist, these fibres also happen to respond optimally to the temperature of a human hand! (Interestingly, the word 'chiropractic' literally means 'done by hand' (from the Greek 'cheir' or hand and 'praxis' or action). So what?
In effect, the constellation of effects activated by therapeutic touch can help to relieve pain and the anxiety that can both result from, and perpetuate, the pain experience. Research shows that gentle, consensual physical contact delivered by a trusted health practitioner can relieve the anxiety that often accompanies pain and confer emotional support, camaraderie and confidence in obtaining relief (rather than fearing that it will last forever). Touch has even been shown to reduce levels of stress hormone cortisol and promote the release of feelgood hormone serotonin. This can help to reduce the perception of pain. Serotonin is the neurotransmitter that is often deficient in depression, which is common among those experiencing chronic pain and can compound both the physical and mental experience of pain. These factors can make pain feel more tolerable, even before the underlying or condition heals or improves from specific types of manual therapies. This may explain why clients often report less distress and discomfort after a single session with a chiropractor, physiotherapist or remedial massage therapist.
Do you really need a professional?
If touch itself can relieve pain or alter pain perception, does it matter which type of hands-on therapy you receive? And do you really need to pay a health professional at all? In a word, yes. While pain is a complex interplay of brain signals, physical factors and emotional responses, it usually stems from a specific physical injury, condition or compensation (e.g. joint or ligament injury, arthritis or muscle imbalance). Identifying these factors and administering targeted treatment are key to correcting the causes of pain. Diagnosis and targeted hands-on treatment by an allied health professional such as a chiropractor or physiotherapist, combined with recommended self-management strategies, can help to deliver relief from the physical and mental effects of pain while promoting healing or correction of underlying causes of pain.
If you’d like to be free of pain and are not sure which treatment type you or someone in your care needs, our knowledgeable client services team can help you to get the best possible treatment and advise on applicable programs and schemes.
If you’re too busy to tend to your own self-care, try these simple tips.
In the era of wellness coaches, yoga retreats and meditation apps, we all know about the importance of self-care. We may even encourage others to work less and rest and play more. Yet when it comes to the crunch, many of us either feel guilty for looking after our own needs or avoid ‘me time’ altogether. Sound familiar?
The cruel irony is that, by neglecting to prioritise our own needs - including needs such as rest, play and social interaction - we in turn undermine what we’re able to give to others. According to Soaring Health psychologist Prishni, if you’re fatigued or burnt out, the care and help you can afford your children or parents or friends is compromised. (You’ve heard the adage, ‘Fit your own oxygen mask first’). What’s more, people who actively practise self-care are better able to contribute productively and meaningfully to work and relationships, creating a positive ripple effect.
Self-care v ‘me time’
It can be tempting to think of ‘self care’ as selfish or indulgent. You may wonder how you can justify dedicating time to fulfilling your own needs. However, ‘self care’ is not a luxury. Many areas of self care have flow-on effects for your family members. For instance, self care includes practical considerations such as career planning and financial management, which directly benefit others by providing security. If you’re not sure where to start, consider choosing one of these areas of self-care as a focus and set a SMART goal related to it.
Ideas for ‘time out’ when you don’t have time
What if the idea of self-care only exacerbates your stress and overwhelm? In considering self-care, it’s important to resist the trap of feeling obligated or pressured to do it ‘perfectly’. Self-care practices that leave you frazzled defeat the purpose! If you are overwhelmed, set aside just five to 10 minutes per day, which may be while you’re lying in bed first thing in the morning or before going to sleep. For five to 10 minutes, dedicate your focus to one of these self-care activities.
If you’re struggling to find balance between work and life, work and family or all three, consider consulting a psychologist, who can help you to clarify your values and priorities and assist with adjustments to improve your life satisfaction and wellbeing.