Why We Sleep

Why We Sleep

Why We SleepSleep, a topic that thanks to the stress of the COVID-19 pandemic, has become all the more relevant. We have had an increasing number of clients in the practice reporting feelings of anxiety and being overwhelmed by many of the knock-on effects that this global pandemic has brought into our lives. While we can’t control the external factors of our environment, we are able to make an impact on our internal factors, such as the quality of our sleep. Even prior to COVID-19, sleep has been a key consideration in the management of pain and injuries. If you think that your sleep, or lack thereof, could be feeding your levels of anxiety or vice versa then read on…

As always knowledge is power and we hope to empower you by bringing awareness to this topic and giving you tools for you to help yourself, to match your own unique needs. We promise to keep the scientific jargon to a minimum (bit challenging with research articles- but for you we will do our best) and to peak your curiosity. This is such a rich topic that to write a blog is to merely scratch the surface. Our content has largely been drawn from Matthew Walker’s book, an international bestseller (it’s not just us that are obsessed with these nerdy books), “Why We Sleep”.

His novel starts off with the below:

“Do you think you got enough sleep this past week? Can you recall the last time you woke up without an alarm clock feeling refreshed, not needing caffeine? If the answer to either of these questions is “no,” you are not alone. Two-thirds of adults throughout all developed nations fail to obtain the recommended eight hours of nightly sleep.” YIKES! If this doesn’t ring alarm bells for you, then keep reading to see what the consequences are of not obtaining enough sleep.

The very simple question “why we sleep?” used to be accompanied by a very simple answer – we sleep to cure sleepiness. As you can imagine with the growing interest in sleep being linked to our health and well-being, we now have a far more detailed response. To keep this relatively surface level – we sleep to aid the mind and to assist the vast processes in the body to function optimally. This is essential for us to function (even at a sub-optimal level) on a daily basis. Sleep is our life support system, its mother nature’s best effort at immortality and it has been referred to as the swiss army knife of our health. With that in mind, who wouldn’t want to prioritise sleep.

Now let’s talk about the sleep cycles and different stages of our sleep. Human beings have two types of sleep – we have REM (rapid eye movement sleep) and non-REM sleep. REM sleep is our dream state of sleep, while non-REM sleep has four different stages to it. With each stage, the depth of sleep increases and the final third and fourth stages are our most restorative stages of sleep. This concept becomes increasingly important as we dive into lifestyle factors associated with sleep.

To make this knowledge more practical, let’s discuss these stages in terms of when your head hits the pillow. Once you’ve jumped into bed, lights out and head on the pillow, you’ll start off with light non-REM (stages one and two) sleep and continue down the stages. About 60 – 70 minutes later you’ll pop up into a short REM sleep period. Every 90 minutes or so you’ll cycle back between going down into non-REM and up into REM sleep, with the time spent in non-REM sleep decreasing and the time spent in REM sleep increasing as you shift into the second half of the night. So essentially, the first half of the night you’ll have deep dreamless sleep (as the ratio of non-REM dominates) and the second half of the night you’ll have REM dream sleep. Each of these stages has a hugely beneficial function.

Even though we need this type of pattern fully engaged to sleep properly, over the last 100 years it has been recorded that we sleep less than we need. In the U.K. it has been recorded that an adult gets on average 6 hours and 49 minutes of sleep each night. This total has shifted significantly, decreasing 15-20% from what was previously recorded. There is also research linking this lack of sleep with cancer and Alzheimer’s disease. Sleeping works closely with the brain and is effectively working as a “sewage system” to clear out metabolic toxic proteins. So alarmingly if you aren’t managing to get enough shut eye each night, you’re not giving your brain a chance to recover from any build up and this increases your risk of disease.

You may be wondering, if 6 hours and 49 minutes is not enough, then what is a good amount of sleep? The range is between 7 – 9 hours with a “sweet spot” of 8 hours. However, if there are any additional stressors placed on your mind or body you may need more. This shift will continue as you go through life and encounter changes. To figure out if you’re getting enough sleep, Matthew Walker suggests noting if you could sleep past your alarm clock going off. If yes, then you’re probably not getting enough sleep.

All of this plays a pivotal role in your ability to heal. So you decide to come to Physiotherapy after your knee surgery, or you’ve been experiencing lower back pain and we ask you how you’re sleeping. The initial link may not seem very obvious, but if you’re not giving your body a chance to heal and recover, the next steps of physical rehabilitation could be lost or reduce your potential progress. To get into some of the science around this – your body has Natural Killer Cells. These are our immune cells and are needed to assist with keeping us healthy. They are also referred to as the secret service agents of our immune system. If you’re not getting enough sleep, you could be experiencing a 70% drop in cell function. Which means you could be doing all the right exercises but with a lack of sleep, you’re not able to recover optimally. There are a number of other processes that would also not be fully supporting your recovery and ability to heal.

Some of the other topics we could chat through during our sessions include your stress levels, what your diet is like, and what exercise you’re incorporating. All of these lifestyle factors play a part in your ability to acquire your necessary amount of sleep. To start off, let’s think about physical activity.  Regular exercise has been proven to help get you into the deep restorative sleep stages. It has also been proven to assist with better quality of sleep. And we know from the research that if you’ve had a good night of sleep, you’ll feel more motivated to exercise, you’ll be able to exercise more intensely and you’ll reduce the risk of injury. So exercise is good for sleep and sleep is good for exercise. It has also been said to be the greatest legal performance enhancing drug (why not give it a try…). Having said that, if you feel tired and know your body needs to prioritise rest, the research suggests not waking up to exercise but rather sleeping in.

Technology (specifically in the bedroom and before sleep) is another factor you have to control to ensure you’re best set up for a good night’s rest. This is linked with your body’s need to produce Melatonin. The light from your tablet directly impacts your body’s ability to produce this hormone and therefore your ability to feel sleepy building up to bedtime. There is a whole whack of information on this and some really great advice on how to manage this. I can highly recommend reading the book or even googling (but not in bed tonight) some of the best ways to promote healthy interaction with technology and sleep hygiene.

Sleep has a direct impact on mental health and we cannot dissociate our mental health from our physical health. Specifically, dream sleep has been said to be our emotional first aid and the best “nocturnal soothing balm.” If you don’t manage to get a good night’s rest, your anxiety levels may be heightened the next day. Due to your anxiety being heightened, you may struggle to fall asleep the following evening. And so the vicious cycle continues.

So as we’ve learnt, sleep is the single most effective thing we can do to reset our brain and body health each day. Below are some tips to get your best sleep yet:

  1. Regularity (make sure you’re in bed at night and out of bed in the morning at a similar time each day).
  2. Darkness (switch off bright lights one hour before bedtime).
  3. Keep it cool (18-18.5 Celsius for your room temperature).
  4. Walk it out (If you can’t fall asleep after 20 minutes, take a walk around or go to another room).
  5. Alcohol and Caffeine (monitor your intake and times you’re consuming).

We hope you’re feeling more equipped to get longer, deeper sleep.

Sleep well!

Stress

Stress – The Good, the Bad and the Ugly!!!

Stressed person

I’d say it is safe to say that most people have experienced stress in their lives. The very act of being born is stressful for both mom and baby, no matter the circumstances.

Take a look at the Oxford Dictionary’s definition of stress (as a noun):

  • Pressure or tension exerted on a material object
  • A state of mental or emotional strain or tension resulting from adverse or demanding circumstances

Can you see how being born for both mom and baby tick both boxes of the definition of stress? Which is why stress is something everyone can relate to. It is something we all have in common, we have all been, and all are, exposed to stress on a daily basis. “Adverse or demanding circumstances” certainly has a negative undertone to it, and a very current ring to it.  Thanks COVID!! So can we assume from these definitions, particularly the second one, that all stress is bad? Thankfully the answer is no (hopefully you picked that clue up from the title of the blog). Sometimes stress is even more than good for us, it is critical for our survival. Like much in life there is not a simple answer as to whether stress is good or bad, it all depends on the context, the duration, the amount etc. So read on dear readers to see which kinds of stresses are the heroes and which are the villains in our daily lives. And more importantly what can we do to manage our stress (note I said manage, we can never eradicate stress from our lives).

Let’s start with definition number 1) and explore how it relates to the body, which is a material object.

We have already given the example of the birth process where large pressure changes and tensions are exerted on both mom and baby. But to keep this blog appropriate for all parties, let’s use the daily examples of gravity and a very common injury such as an ankle sprain.

“Our bodies and minds respond to the stress and pressure they are exposed to. Without stress and pressure there is no robustness or resilience.” Sadly I can’t remember where I read this- somewhere on Instagram no doubt (if it was you please claim it so we can give credit) but this spurred my action into writing this post. That and the recent bout of ankle sprains I have seen the last few weeks as everyone hits those wet, wintery trails.

Ankle sprains and stress: Good, bad or ugly

When we were at school/varsity we were taught this acronym for treating ankle sprains: RICE (Rest, Ice, Compression, Elevation). Thankfully as science progresses and is more accurately able to study the ingeniousness of our human bodies, they have realized that too much rest is in fact detrimental to our healing. Why? Well there are many reasons, I could write a whole blog just on the healing process and another on ankle sprains, but let’s just look at it in terms of stress being applied to the tissue.  One of our phases of healing is the ‘remodelling’ phase- this is where the new collagen is laid down to repair the fibres that were torn. Movement and stress helps the new fibres to align in the direction of the stress, which helps improve the resilience. Without this stress/input the body would just lay these fibres down haphazardly, which can result in scar tissue and would actually reduce the resilience of the ‘new’ fibres, leaving your ankle vulnerable to a resprain. Which explains why the new acronym for management of ankles sprains is POLICE (Protect, Optimal Loading, Ice, Compression, Elevation). The loading is key to successfully rehabilitating an ankle. Not only in the beginning of healing but also end stage. Your ankle needs to be able to respond to the stresses that your lifestyle will place on it. A more sedentary person needs very different kinds of strength to say a keen trail runner/surfer/dancer etc. Which is why we recommend that you see a Physiotherapist– they can assess the extent of your injury and educate you on how the POLICE management applies to your unique ankle sprain. Most importantly though- through a combination of manual techniques and a graded exercise programme- they will ‘stress’ your ankle in all the ways required to help prevent further injury.

Another example that most of us take for granted is the very good stress that gravity places on us (if only we could choose which parts of our body gravity had an effect on!).  Look at the very bad effects that a zero gravity environment has on humans, astronaut humans that is..

  • Loss of muscle mass is ± 20% in just 5-11 days
  • Lose bone mass at a rate of 1.5% in one month vs the 3% per decade (not including bone disease such as osteoporosis)

(Figures taken from: The dangers of zero gravity: Davidson Institute of Science. Feb: 2017)

So while you may not be keen on the sagging skin, be very thankful for the muscle mass and bone density that you have from just being on earth!!

While that is all fascinating, I am sure many of you are reading this with more interest in the 2nd definition.

This is the more commonly spoken of the definition of stress. The quick answer is that in this case acute/short bouts of stress can be really good for us. It is the long term/chronic stress where we head into the bad and even the ugly. To understand the difference we need to quickly give you some anatomy and physiology, which I will try to do in layman’s terms.

Our nervous system is divided into two parts the Central Nervous System(CNS) and the Peripheral Nervous System (PNS). Central is brain and spinal cord, and Peripheral is the nerves outside of the CNS. The PNS is further divided into the Somatic/Voluntary and the Autonomic Nervous System (ANS). The ANS can be further divided (stay with me, we are nearly there) into the Sympathetic and the Parasympathetic nervous systems. The ANS is always activated and its ideal state would be to be balanced between the sympathetic and parasympathetic. The ANS is for the most part not under our control, breathing is the only action controlled by our ANS that we can alter using our voluntary control.

Here it is in a practical example. You are walking through the Lowveld and a lion appears. Now you need to decide if you are going to stay and fight this lion, or if you are going to take flight/run away. Either way, you need your Sympathetic system(often called “fight/flight’’) to come to the party, and quickly.

Let’s say you wisely choose option b and you take flight. When you get back to the safety of your camp, your Parasympathetic (often called the ‘’rest and digest’’) will kick in. And hopefully your ANS will come back to the desired homeostasis of being in balance.

That would be an acute state of stress and you can see how it would be necessary for your survival. In the fight/flight state adrenalin is released which increases heart and breathing rate, and shunts blood to areas like muscles while reducing flow to your digestive organs- digesting breakfast takes a back seat to maximizing your lung and muscle capacity when faced with a lion or other life threatening situation. The huge surges of adrenalin often allow for almost superhuman feats, it is common to hear stories of people climbing impossibly high walls or lifting extremely heavy objects when their lives or lives of loved ones depend on it.

While thankfully many of us are not out walking in the Lowveld, we encounter our own “lions” in our daily urban lives- constant exposure to crime, work deadlines, school drop offs, illness, loss of loved ones etc. This relentless exposure to stress requires our body to not only release adrenalin, like it does for an acute episode, but it also starts to release the hormone cortisol to help booster the body. Short term effects of cortisol, like adrenalin are our heroes, helping bolster us through the tough times. But if our cortisol levels remain high for a prolonged period of time it is often associated with digestive issues, weight gain, disrupted sleep, immune-suppression and decreased ability to concentrate/focus, to name just a few.

There is so much information on this topic that to really do it justice you need to read a book and not a blog. Thankfully, Richard Sutton has done just that. He is the author of The Stress Code, and even better he is South African, so by buying his book you are supporting local (I promise I am not getting any commission from him, I just really rate his book). He has taken thousands and thousands of scientific papers/studies and put it all into an amazingly easy to read (think summaries at the end of every chapter) book which I personally think should be prescribed reading material for anyone experiencing stress……

Here is his list (taken from chapter 3 summary) as to how to increase vagal activation and tone:

(Quick side note: The Vagus nerve (often called the wandering nerve as it appears to wander nearly all over the body) is best known for it’s role in calming the body following the fight-or-flight state induced by adrenalin. This should happen on an automatic feedback loop in the body, however the longer we have been exposed to stress/in a chronic state of stress the longer it takes for this feedback loop to kick in. By treating the vagal nerve we can undo/prevent some of the ugly symptoms related to chronic stress.)

  • Visceral manipulation
  • Massage therapy
  • Controlled breathing exercises
  • Swimming
  • Facial immersion
  • Yoga
  • Meditation
  • Music

I would love to go into more detail on each of these but they literally could each have their own blog. Lucky for you, I already have a video on a controlled breathing technique, which you can go check out on our Instagram/Facebook pages- if you want more details on that. Plus I’m hoping to post a video on “What is Visceral Manipulation” in the next few weeks so follow us on Instagram/Facebook if you interested in seeing that one. Take home message from this post. Acute stress is really good for us, especially if you perceive it as such. It is good to be challenged and to test our boundaries, and it is often needed as part of our healing process. So embrace those situations. Long term stress- is detrimental to our healing/health but sadly it is also often unavoidable in today’s fast paced life. So be sure to manage your stress by implementing some, if not all, of the tools listed above.

As always thanks for reading to the end.

Pilates vs Yoga

The difference between Pilates and yoga

Pilates vs Yoga

The short answer?

They are both INCREDIBLE forms of exercise that help a person to better understand and connect with their bodies.

Pilates helps you to stabilise using the correct muscles and is therefore very good for people with hypermobility or an excess of flexibility (these are the people who have always been able to flop forward and touch their toes without blinking an eye).

Yoga includes postures or positions that actively work on flexibility. It is therefore very good for stiff people or those with high tone (people who feel like their eyeball will pop out if they even think about touching their toes).

On the physical level:

Pilates does this by strengthening the core muscles of the body. When I say ‘core’ here, I mean so much more than the crunches and clams that people normally think of when someone says Pilates. It teaches you where the core is, what it does and how to correctly engage it. It also teaches you where the neutral positions are – in the spine and the rest of the body.

Yoga allows you to connect with your body in various postures, encouraging you to understand for yourself what is happening in your own body. A yoga class will involve several postures (these are also called asana) that you either hold or fluidly move through.

Both of these forms of exercises can be done in a more relaxing or a more challenging way.

Used with Physiotherapy:

As a physio, I started my movement training with Pilates. Pilates complements physiotherapy beautifully and it helped me to better use exercises to help patients in the rehabilitation process. Movement is incredibly important in the healing process. It usually does return after an injury, but it can return very slowly and there are always compensations and weaknesses that develop in the process.  I often use Pilates to overcome these compensations and weaknesses and get people moving WELL after an injury.  This is why many people will have experienced Pilates as a ‘rehab’ type of exercise.

In terms of yoga, I was drawn to it because of the holistic approach to movement and the focus on the mind-body connection. The asana, or exercise, is only one small part of yoga. Yoga encourages a person to look at all aspects of their life and to find balance. This is also essential to consider when your hope is to help someone heal.

All of that being said, I believe that finding the right teacher and class is as important as deciding what exercise to do. If the teacher has valuable knowledge that they are able to communicate with you, in an environment where you feel guided and supported, then it doesn’t really matter what kind of movement you do.

I love both of these forms of exercise and, as with many things to do with the body, there isn’t a straightforward answer when it comes to which one a person should or shouldn’t do. I would say you don’t have to pick one, do both.

What Is Dry Needling

What is dry needling?

What Is Dry Needling

At Tamsin Hodgson Physiotherapy we aim to provide a magnitude of different treatment techniques that we believe will best support our patients journey to more efficient and effective ways of movement. Dry needling has been one of the brilliant techniques we choose, together with our patients, to assist with pain management. So let’s get into the detail around it all.

Dry needling is one of the many techniques Physiotherapists can use to alleviate pain. A thin needle is inserted into your muscle(s) to hit and deactivate trigger points (muscle knots). The term “dry” simply refers to the needle not injecting anything into your body eg.medication.

The next question, and one we receive a few times a day at the practice is…

What is the difference between dry needling and acupuncture?

There can be similarity in what the needles may look like as well as the techniques used however, “it’s the philosophies and applications that make them different.”

“While it’s been around for centuries, dry needling uses modern neuro-anatomy, musculoskeletal anatomy, and Western medicine’s concepts to affect the way your muscles move and function, locally, whereas acupuncture is a holistic medicine-type approach that uses the philosophy of energy systems, meridians, and qi flows,” Matt Briggs, PhD, A Physical Therapist at the Ohio State Wexner Medical Center says. This centre is a leading researcher in pelvic pain and well as dry needling for knee injuries.

So in essence and what you will experience at the practice is a Western medicine concept. The Physio will palpate/identify a taut band within your tissue. This point is often where the needle is inserted. For many of you who have experienced needling with us before, this is the time when you’d typically feel that muscle twitch (and possibly think out a few swear words). From a more academic sense, this is referred to as a Local Twitch Response. The therapeutic intent for dry needling then is to correct underlying biochemical and biomechanical imbalances, where as acupuncture’s intent is to balance Qi/energy.

Hopefully that makes sense!

What is the needle doing?

Once the needle has been inserted into your muscle, there is an interruption within your neural response. That is, the message being relayed between your brain and your spinal cord. As a result, this positive boost can shift how your muscle is able to move and therefore perform its range of functions. Due to your brain receiving different messages, there can also be a change in how you perceive pain. Research has also shown needling changes muscle stimulation, triggering greater blood flow, healing, and improved movement.

Is dry needling helpful for new injuries?

Needling can relieve pain from acute or chronic problems. With the body providing compensatory patterns, areas that aren’t necessarily directly affected by an injury, can impact the pain you’re experiencing. So while it wouldn’t feel entirely comfortable if you’d just sprained your ankle, and you had a needle jabbed into it, we could needle your calf muscle which may be feeling tight from walking in a different pattern in an attempt to offload your ankle. This type of needling would aim to relax your calf muscle, creating a pain-relieving response. In turn, you’d experience increased blood flow to assist with healing.

With chronic injuries, and pain you’ve been experiencing long-term, dry needling can be used in combination with other treatments to reinforce different patterns. “These type of injuries can restrict movement in an effort to protect your body and, over time, if that’s not resolved it can create compensation as different parts of your body become overloaded. A lot of times you have pain and that causes muscle spasms and muscle tightness, which causes more pain,” Briggs says. “We use dry needling to break that cycle.”

How many sessions would we incorporate dry needling?

Often, as you start strengthening different muscles, it is normal to experience muscle discomfort. Dry needling could assist with changing the spasm pattern, while you concurrently follow the programme we’ve shared with you to strengthen and improve your range.

While this may be beneficial, if you’ve been needled in your previous session and had nightmares about returning for your next Physio treatment – we wouldn’t suggest needling again just to stick with the course.

“Dry needling is just an adjunct to other treatments; it’s not meant to be the sole treatment,” Briggs explains. “It’s used to get over the hump of why performance is being restricted, or to help rehab you from injury.”

Who can be dry needled?

At the practice, we conduct a thorough assessment looking at a wide range of variables before we decide to offer needling. It’s important, through assessment techniques, to understand where your pain or muscle imbalance may be coming from.

We wouldn’t needle anyone with a bleeding disorder, signs of infection, active cancer or anyone who’s pregnant. There are also other conditions we’ll take into account before offering to use dry needling. And it should go without saying that if you feel like you want to faint at the thought/sight of a needle, then we wouldn’t suggest this for you either.

Your safely is our first priority.

What does it feel like?

Mmmm, how to answer this without totally scaring you off…

Simply put, it’s not a feeling you can control. You don’t normally feel much when the needle is being tapped into your muscle. It is when the needle gets closer to the dysfunctional area that you can experience some tightness or slight deep aching.

It can also feel a bit odd when the muscle twitches, and again you don’t have any control over how big the response will be. Sometimes it can take patients by surprise when there is a noticeable “ jump” sign. Other times the response is less noticeable. The good news is we haven’t had anyone fall off a plinth or jump through the roof, so chances are you’ll manage.

That “jump” sign can also feel sensitive when there is a release in tension. Each person is different, so sensations will vary.

Due to the fact that the needle is increasing blood flow to the area, it is common to experience muscle soreness and tenderness after needling. Bruising is also common and a bit of heat goes a long way to help manage the discomfort around this. We will offer you a heat pack that you can use while you’re still at the practice.

What are the most commonly treated areas?

At the practice we most commonly use dry needling for the glutes, quads and calves as well as shoulders, jaws and necks.

How can I tell if the Physiotherapist I want to see has been trained in dry needling?

As dry needling is not taught within our undergraduate training, Physiotherapists can choose to receive postgraduate dry needling certifications. Often Physiotherapy websites will demonstrate their areas of practice, however if you’re after dry needling specifically it’s a good idea to call and ask before your appointment.

All our Physiotherapists at Tamsin Hodgson Physiotherapy are certified in dry needling, and you’re welcome to read up about each Physiotherapist on our website to see who you’d prefer to book an appointment with.

Should you be thinking this may be a great way to exempt you from household/kid duties afterwards, no, we don’t write “sick” notes to partners.

We hope this shed some light on the benefits of dry needling.

When Should I See A Physio

When should I see a Physiotherapist?

When Should I See A Physiotherapist Medicine Ball

Most people who sustain an injury or experience muscle/joint pain will seek treatment in the hope of resolving their issue. Often they are not sure who to see, or when to seek treatment. In our first blog post, we aim to shed some light on when to seek treatment and with whom. We get asked a lot about what the difference is between Physiotherapists and Biokineticists (don’t worry there are a lot of medical people who don’t know the difference either), as well as the difference between Physiotherapists and Chiropractors. What is the difference between Physiotherapists and Massage Therapists? Do you know whether you need to see a GP before you can see a Physio? Keep reading if you want to know the answers….

Are there different kinds of Physio?

There are lots of different fields of Physiotherapy. Most people are only aware of Physios working in private practices or on the side of the sports fields. However, Physio is a very diverse field. The undergraduate training for Physio includes: Chest physiotherapy both for adults and children treating conditions such as bronchitis, pneumonia, intubated patients and post- cardiac surgery; Neurodevelopmental training for treating children and adults with disorders of the neural system such as stroke or Cerebral Palsy; Orthopaedics which is focused on the recovery of fractures or trauma to the bones and surrounding structures; Women’s Health Physio for pre and post-natal care; and Neuro-musculo-skeletal  (NMS) which is what Physios are most commonly known for, this includes spinal pain and sports injuries. Physios are closely aligned with the other medical fraternities through this exposure to the medical training in their undergraduate level. Some Physios continue to work within a hospital or medical team setting once they are qualified. This is something that differentiates the Physios from the Chiros; the Chiros are not as closely aligned with the medical/in-hospital services. (It also has to do with the bureaucracy of governing bodies, Physios fall under the Health Professions Council of South Africa (HPCSA) while Chiros do not).

Even within the private practice setting in the NMS section of Physio you can have a spectrum of Physios. Many of the skills and training that set Physios apart happens after the undergraduate training. In SA there are two main schools of post graduate training in the orthopaedic/musculoskeletal field, the Sports course (SPT) and the Orthopaedic Manipulative Therapy (OMT). Both courses run the duration of a year and require the successful completion of examinations to receive a diploma. The training in these courses vastly improves a Physiotherapist’s ability to complete a thorough assessment and to undergo a clinical reasoning process to ensure an accurate diagnosis or an appropriate referral.

What is the difference between a Physio and Biokineticist?

Physios are recognised as having first line practitioner status which is defined by the HPCSA as the following: A first line status practitioner has the autonomy to make an independent diagnosis and treat such a condition, provided it falls within his/her scope of practice. It is therefore legally and ethically acceptable for a patient to approach a physio for treatment without the intervention of another health care practitioner. In simple terms this means that you do not require a referral letter to see a Physio and that Physios are able to refer you for basic diagnostic tests such as an X-ray and/or an Ultrasound. So if you have a sprained ankle, sore back, headache etc. you do not need to see your GP first, you can come straight to the Physio.

A Bio is not recognised as a first line practitioner. A Bios scope of practice is defined by the HPCSA as final stage rehabilitation through exercise prescription. In other words they use exercise, and only exercise to assist you in recovering from an injury and improving your wellbeing. It is therefore out of their scope of practice to perform any hands on techniques such as myofascial release, joint mobilisation/manipulation, massage or dry needling.

Here is a practical example of when you would see a Physio or a Bio: If you were post knee surgery the Orthopaedic surgeon should refer you to the Physio for some hands on treatment and basic exercises. These will be aimed at reducing pain and swelling, and increasing your mobility. If you are still on crutches the Physios will assist you with how to use them correctly. Very often you will see a Physio in the hospital prior to being discharged. As your range increases and your pain decreases the Physio will increase your exercises. If your Physio is trained in rehabilitation and has the correct facilities they can take you all the way to your end stage of rehab and return to sport. If not, this is when they would refer you to see a Bio.

What is difference between a Physio and a Chiropractor?

Physios and Chiros both share the honour of having first line practitioner status, in other words you do not need to be referred to make an appointment, and they are able to refer you for X-rays and musculoskeletal ultrasounds. A Chiropractor is a health care professional focused on the diagnosis and treatment of neuromuscular disorders, with an emphasis on treatment through manual adjustment and/or manipulation of the spine. They often have fairly short treatment sessions that may require repeat visits to maintain the ‘alignment/adjustment’. Physiotherapists are also able to manipulate the spine if they have completed a diploma in Orthopaedic Manipulative Therapy (OMT). So if you are only interested in spinal manipulation as a treatment technique and want to be ‘clicked’ into place, then traditionally the Chiro would be better suited to your needs. Traditionally Physios use more of a combination of joint mobilisation/manipulation, soft tissue mobilisation, dry needling and exercise in their treatment approach. An example of when to see a Physio vs a Chiro: If you have a sprained ankle you would be better off seeing a Physio with an interest in sport injuries/rehabilitation than a Chiro who specialises in spinal manipulation.

What is difference between a Physio and Massage therapist?

Massage is very useful for therapeutic or relaxation purposes. Massage therapy can take several different forms for example lymph drainage, sports massage, Thai massage- etc. Massage therapists are certified by their institute of learning, and are not in any way educated in diagnosis or rehabilitation. For example, if you have completed a race and you have general overall body stiffness then a massage would be beneficial. If you have completed a race and you have a pain in your knee or back then it might be worth seeing a Physio. The Physio will be able to assess your problem area, as well as the rest of your body, to be able to make an accurate diagnosis. The Physio can then use massage as well as other techniques such as taping/needling/joint mobilisations to treat the immediate problem but also to look at trying to prevent the problem from reoccurring.

When Should I See A Physiotherapist

Things to remember when seeking treatment

The approach of the healthcare practitioner is often determined by the level of skill and training of that practitioner, and their particular field of interest. As with any profession you get the good and the bad, so just make sure that you do your research or get a ‘word of mouth’ referral before seeing a new practitioner. Google reviews and social media are also great with helping to get a sense of the practice/practitioner.

When would you seek treatment?

Common sense should prevail, and usually the sooner rather than later rule should be applied. Even with acute injuries there may be limited hands on treatment in the first few days, however the advice that we can give you could make a big difference in setting up the scene for a positive and speedy healing experience, for example giving you crutches if indicated or referring you for the correct bracing etc. Being well informed and accurately assessed is key to long term recovery.

So why see us??

At Tamsin Hodgson Physiotherapy we believe that finding the source of the problem is extremely important in resolving the issue and restoring optimal function. Hence all of our therapists are either SPT or OMT trained- in other words we have extra training to help us make a more accurate diagnosis. Our first sessions are always 45 minutes to an hour long so that we have enough time to listen to our clients, make an accurate diagnosis and create an individualised treatment plan. We strongly believe in rehabilitation which is why all our Physios are further trained as Pilates instructors. Some are even dual trained as Pilates and Yoga instructors, and Pilates and Gyrokinesis instructors. We also offer a variety of classes run on site, by our Physios, to help clients stick to their ‘home’ programmes and achieve their goals.  We love what we do and sharing our passion for our incredible bodies with our clients.

When should I see a Physiotherapist Cape Town

March Newsletter 2019

Well done to all of you who braved the windy conditions on Sunday and completed the Cape Town Cycle Tour (Argus). While you were testing your physical limits against the Cape of Storms some members of the practice were testing themselves in other areas.

Congratulations to Michelle, our newest team member, who got married on Saturday. Many of you have had the privilege of meeting Michelle and the feedback has, not surprisingly, been extremely positive. Wishing Michelle and Rory a lifetime of happiness together. We look forward to watching their relationship grow and having her back from honeymoon at the end of the month.

Tamsin was putting her mental capacity to the test with a weekend workshop in Stellenbosch called Be Activated. The course was developed by a South African Physio many years ago and is now taught internationally. It is unlike the conventional methods of Physio, so it does require a shift in paradigms. However, if the astounding results that were witnessed on the course can not only be replicated in our practice, but also maintained over a period of time, then this may be an extremely well-spent weekend of work!

Nicky’s return has filled the practice with her wonderful laugh and her unwavering dedication to giving her best to each client she takes on. It is such a privilege to have her back and to witness her applying her personal growth to the task at hand. We are extremely excited to now be able to offer Yoga alongside our other classes in the studio. Please get in touch with us if you are interested in doing Yoga with Nicky.

Although Jayne is no longer a member of team, sadly, we know that many of you would be thrilled to hear that she gave birth to a healthy baby boy at the end of January. Mom and baby are doing very well and we adore their social visits to the practice. Should any of you require a Physio in the Winelands area, Jayne will be working from there when her maternity leave ends in a few months’ time. Please don’t hesitate to get her contact details from us should you require them.

Only a few more weeks left before the Two Oceans is upon us. Don’t forget that we offer a lower limb rehab class on Thursday mornings. This is a perfect class for anyone wanting to improve their running. It also really helps to shape your glutes and thighs!! Should you have a niggle while running please don’t leave it to the week before race day to seek treatment. The sooner we can assess your movement pattern the more chance we have of reducing any overloaded areas. Not only can this prevent serious injury it can also help to make your run more pleasurable and perhaps even get you that much desired PB!!

As winter slowly creeps up on us keep those bodies moving to stay warm…

Latest Classes

We are now half way through the year – time flies when you are having fun, and what fun we are having at the practice!!

We have started a ‘Move of the Month’ post on our Facebook page. So follow us on FB if you want to access our ‘moves’ as well as the other interesting articles that we regularly post there.

March Update

Easter is just around the corner which means so is Two Oceans. It is a bit late for the last minute training, but it’s never too late to stretch and foam roll. If you need a foam roller please remember that we stock our own made-to-order, firm, 1m foam rollers for a very reasonable price of R300- which is half the price of the sports stores out there!

Foam rollers are excellent for helping with recovery between runs and in keeping your fascia mobile prior to and/or during a sporting event.

Happy Holidays

And so another year draws to a close… 2015 has been a jam-packed year for the team at Tamsin Hodgson Physiotherapy.