Recently, Barry Nguyen has been selected to participate as a Treating Physiotherapist in a Randomised Control Trial involving Physiotherapy Treatment Approaches for Knee Osteoarthritis Sufferers, led my Professor Kim Benell, from the Centre for Health, Exercise, & Sports Medicine, School of Physiotherapy (University of Melbourne).

The following is the research project outline:

“Knee osteoarthritis (OA) is a major public health problem causing pain and impaired physical and psychological functioning. There is no cure for knee OA and the traditional approach to treatment focuses on biomedical disease aspects (i.e., exercise, drugs and surgery). Although effective, these methods of treatment do not directly address psychological responses to the disease, such as pain catastrophising, leading to depression and anxiety which are commonly reported by individuals with knee OA. In light of a rapidly ageing population, yet limited resources, there is the need for treatments that enhance pain self-management skills. There is also interest in exploring new models of health service delivery that include changes to traditional health provider roles whilst still respecting the expertise of different disciplines. As Cognitive Behavioural Therapy (CBT) is traditionally the domain of psychologists, however people with knee OA generally do not access psychologists. Research has shown that non-psychologists can successfully deliver CBT following training by a psychologist. Hence, we aim to conduct the first randomised controlled trial to compare the efficacy of exercise alone, CBT (emphasising pain coping skills training) alone, and exercise combined with CBT all delivered by specially trained physiotherapists in people with knee OA.” – Professor Kim Benell

The Australian Medical Association President Dr Pesce supports Physiotherapy Services within community Medical Centres

Push for merger of GP practices

MICHELLE GRATTAN

April 27, 2010

A BIG health package in next month’s budget is expected to encourage GP practices to

merge, either actually or ”virtually”, allowing patients better one-stop access to related

services. The fresh funds are likely to run into hundreds of millions of dollars over four

years.

This would be on top of the more than $5.4 billion over four years that the government

promised last week to encourage premiers to sign up to its hospitals reform measures.

That package left primary healthcare mostly to be dealt with later. Primary healthcare is

solely the responsibility of the Commonwealth so the funds did not have to be

announced to the states. The package would also allow the government to have health

at the heart of the budget, continuing a theme it wants to reinforce in the run-up to the

election.

Australian Medical Association president Andrew Pesce said the AMA wanted the

government to help GPs make the transition from small-scale practices to adopting

economies of scale and improving access for patients to related health services. Where

feasible, the allied services – such as practice nurses, physiotherapists, dietitians,

podiatrists and diabetes educators – should be located in the same place as the GPs, he

said. Help could include assistance for capital investment, such as extra rooms, or for

electronic linkages between separate practices. The AMA would prefer encouragement

for existing practices to consolidate rather than the creation of what Dr Pesce described

as ”huge hospital-like superclinics”.

The government previously promised 36 superclinics: two are operating, eight are

offering interim services and 15 are being built. The ”kitchen cabinet” of Kevin Rudd,

Julia Gillard, Wayne Swan and Lindsay Tanner will review the budget preparations today.

Mr Swan returns from the US this morning after attending the meetings of the G20

finance ministers and the International Monetary Fund. The government’s National

Health and Hospitals Reform Commission urged the establishment of ”comprehensive

primary healthcare centres and services”, describing this as a ”one-stop-shop” approach

that gave patients access to an expanded range of services, better co-ordinated referrals

and expanded opening hours. The report said: ”Comprehensive primary healthcare is

likely to include both ‘physical’ centres and ‘virtual’ services. ”Existing primary

healthcare service providers could combine and evolve into these larger groups, while

the Commonwealth government might also target the development of new

comprehensive primary healthcare centres and services in areas where there is now

limited access to these services.”

Adapted from The Age, Online (http://www.theage.com.au/national/push-for-merger-of-

gp-practices-20100426-tncl.html)

1. We do not believe in “quick fixes”.

Our treatment plans aim to deliver long-term sustainable results, reducing the dependence and financial expense of ongoing treatment.

2. Generally, Same Day Appointments.

3. Value for Money.

We strive to improve community accessibility to receive high quality physiotherapy services. Hence, we charge industry competitive market rates for private clientele. In addition, we do not charge a gap fee for those clients under the Medicare Enhanced Primary Care plan approved by their GPs, for sufferers of Chronic & Complex Medical Conditions.

4. We love to Listen to your Problems!

5. We are Passionate about being Physiotherapists!

If you are not 100% satisfied with our service, inform our central office and we will return the paid fee for that unsatisfactory consultation. Just fill in the customer feedback form we will send you, send it back to us and we’ll mail you a cheque.

There are many reasons why you may have pins and needles in your feet. Most commonly, it’s a drop in blood supply, particularly at night when you’re sleeping when your blood pressure tends to lower and blood rushes away from your periphery (hands and legs) and towards the thorax. This is normal and not to be worried about. Just remember to shake those legs!

However, pins and needles often accompanies back injuries, in which case, pins and needles, particularly if it’s unusual,  accompanied with pain starting from the back/pelvic area down to the legs and with weakness or difficulties walking.

In this case, you may have some sort of compromise of the nerve. If it’s in both legs (bilateral), it may be some compression on the spinal cord or cauda equina (the end of the spinal cord) and this may be serious. If it’s only on one side, or on one part of the foot, it may indicate spinal nerve compression or a pinched/compressed nerve.

The spinal cord or the spinal nerves can be pressed by a disc that is not its normal shape, old ligaments or bones that may be worn and sticking out (degenerative changes).

The usual scan to find out if you have something serious going on is a CT scan, which can detect disc bulges, or an MRI which is better at detecting pinched/compressed nerves.

Our physiotherapists can help, especially with compressed nerves, where manual techniques can assist with opening joint spaces to reduce nerve compression, or with exercises that help to restore the shape of the disc. Hydrotherapy services, massage, electrotherapy or spinal mobilisation are adjuncts to the correct exercises to improve nerve health and are provided by our physiotherapists.

However, surgery may be indicated in these cases. This should be the last option you turn to, so it’s good to make sure you try conservative treatment (physiotherapy) first before you jump for the knife.

Good luck!

What a ‘crack’ is when you do it (or when it is done to you), when the joint (where two bones meet), opens suddenly and an air bubble is formed then is pushed out. This creates that cracking sound. The technical term for this is a ‘cavitation’.

Interesting?

Even more interesting is that ‘cavitations’ (not cavities) causes the surrounding muscles to relax due to its effects on the local nervous system. This is why ‘cracking’ feels good, but doesn’t always last.

If you have a tendency to crack, it mainly means that the joint is stiff, and when it is forced, it separates easily rather than smoothly gliding on itself. The stiffness is made worse when your muscles are tight and aching.

If your muscles and joints are stiff, it’s usually associated with what you do during your day. It could be your sitting posture, work habits, that long game you played on the weekend, or some weight you’re carrying (but are thinking of getting rid of, am I correct?).

Talk to your physiotherapist if you’re concerned, and they can perform a postural screening process to determine where you lack mobility and need stretching. We don’t just crack backs, we find out what’s going on.

In the rare case, cracking in the back can be a sign of arthritis. But this is very rare. Most of the time, you’re just stiff. Give us a call!

1. Is this going to cause trouble?
2. If it is trouble, what is going on?
3. What led to this trouble?

So, if your shoulder cracks often, it might not cause you any harm or trouble, it could be just ‘your body’, in which case, don’t worry too much about it.

But if it’s becoming a problem (you have pain, you find it hard to move, you can’t sleep at night on the shoulder, reaching to pull up your pants or undo your bra is difficult etc.), it would be good to get it check out.

Below are the main reasons for a ‘cracking’ shoulder:

• Bursitis
• Abnormal joint mechanics (due to past injuries)
• Arthritis (you need to either have hurt it really bad in the past or be really old, so don’t stress!)
• Intra-articular pathology (labral tear, bony lesion, osteophyte)

Obviously, treatment differs for all of the above. Physiotherapists can help you every step of the way, although obviously we aren’t magicians and we can’t fix arthritis. We can still certainly help ease the pain, improve your movement and strengthening you shoulder.

Give us a call if you’re concerned the shoulder might cause your problems, even if it ends up being no problem, at least you know.

Physiotherapists are trained not only in anatomy (knowledge of muscles, bones and joints), but also in exercise physiology (knowing how train for fitness) and the neurosciences (knowing how to train following nerve and brain injuries). Some of us have further skills and training to make our skills more effective.

If you’re worried about your muscle weaknesses, please make an appointment with us and we’ll love to provide you some helpful advise and care.

You’ll need someone with the right training and knowledge of joint anatomy and pathology, which is where a physio can come in. You can’t risk having the wrong procedure done to your body.

Knowing what muscle to release, which direction to push and what exercise to do is part of our job, and you can feel assured we know what we’re doing with your body. Give us a call!