Blog Articles

Benefits of Physiotherapy During Pregnancy Part 1

Going through a pregnancy presents significant physical and biochemical challenges to your body. Fatigue, joint pain, weight gain and depressed mood are just some of the symptoms you’ll experience. Working with your physiotherapist in the following areas can help you manage these symptoms and make your pregnancy more comfortable and enjoyab;e.

Medical Exercise Therapy

Exercise is important during pregnancy. It helps to maintain cardiovascular fitness and retain a degree of muscle strength & flexibility, all of which are beneficial during labour, in the postnatal period (after birth) and have positive effects on your newborn. Exercise can also help to reduce the amount of back and pelvic pain experienced, as well as improve breathing awareness and control.

Due to the increased demands placed on the cardiovascular system by the body during pregnancy, women with particular issues in their medical history should consider medical exercise intervention during pregnancy. The main aim of this is to achieve the benefits of exercise while ensuring safety of mother and baby. Women with the following issues before pregnancy should consider medical exercise therapy:

  • Women with Diabetes (type 1 or type 2)
  • History of Hypertension / High Blood Pressure
  • Women who are significantly overweight or obese
  • Women with heart or lung disease

At our clinic, Medical Exercise means to engage in exercise prescribed and supervised by a chartered, experienced physiotherapist. We monitor your heart rate constantly throughout the session so you complete a sufficient amount of exercise to gain benefits while not putting yourself or your baby at risk. We also repeatedly check your oxygen levels throughout and review your blood pressure at the beginning and end of sessions. Medical Exercise is a safe and sure way of getting the exercise you and your baby need to be as healthy as possible.

Treatment for Aches & Pains

Increased weight and hormonal changes, which occur naturally during pregnancy, lead to increased ligament laxity, which in turn causes joint hypermobility. Ligaments are tough, tight bands of fibrous tissue which give your joints stability and restrict movement that might be harmful to your joints. When these ligaments loosen, aches and pains in the joint and surrounding muscle is an inevitable side effect.

Therapeutic massage from a physiotherapist can benefit you in a number of ways. The release of endorphins result in an improvement in mood and reduced feelings of depression. You should experience reduced back pain and increased flexibility. The night after you might experience improved sleep and in general feel more relaxed. You should feel decreased anxiety and stress, and may receive relief from headaches caused by muscle tension around the shoulders.

It is important to note that I recommend AGAINST seeking professional prolonged massage therapy during the first trimester, due to the risk of miscarriage in the first trimester. I also advise AGAINST seeking deep massage techniques in the legs, particularly in people with low activity levels, as this can cause the release of a blood clot.

Next Time

In my next pregnancy article I’ll be talking about how physiotherapy can help you after receiving a Cesarean Section during labour, and what strengthening exercises you can do at home to best prepare your body for pregnancy and delivery.

Book an Appointment

If you’re interested in booking a consultation with me (Sean Flynn), a chartered physiotherapist, then don’t hesitate to give me a call, text or email (contact details below).

PH: 0861546175

Email: info@flynnmedicalexercise.com

—–

Seán Flynn

Chartered Physiotherapist

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4 Tips to Help you Exercise More

“Exercise is medicine, take if everyday!”

This is something I’m always telling my patients in the clinic. It’s vital that we start thinking of exercise as something that we have to do everyday, rather than something that’s purely fun and/or weather dependent and/or only for people who want to compete in sports or athletics. Have you ever set out on a new exercise frenzy, wanting to become super-fit, only to have your regime fall apart after a few short days or weeks? Its ok, you’re only human and none of us are robots! Implementing these tips the next time you start a new exercise regime will help you stick with it longer and enjoy it more as well.

Diary Make an Appointment

1. Plan your Weekly Regime

People who plan to do something are more likely to do it. Planning doesn’t just involve thinking about something, you also need to write it down somewhere you’re going to see it – be that in your phone calendar, in your diary or on a piece of paper stuck to your fridge! What you write down shouldn’t be that long or detailed, just a brief synopsis of what you’ll be doing to exercise. You also need to write down when you’re going to do the exercise. Example: ‘Monday: Walk the park before work’, ‘Tuesday: Run to the shop and back after dropping the kids to school’, or ‘Wednesday: Cycle to Jane’s house and back after dinner’. When you plan like this, the subconscious part of the brain processes your plan in advance, so you’re more mentally prepared when you go to do your exercise.

2. Variety is the Spice of Life!

Particularly when it comes to exercising (and also healthy eating), variety is crucial in maintaining your regime long-term. Repeating the same exercise session over and over is boring, and it doesn’t have to be! Switching between different types of exercise not only makes your sessions more interesting, it also challenges different areas of the body, and you’re less likely to get injured. For these reasons, even the most focused of athletes need to vary their exercise sessions.

3. Entertainment During your Exercise

If you’re entertained during your exercise session, you’ll exercise for longer and enjoy it more, I guarantee it. Entertainment can take many forms, it’s a case of choosing whatever works for you. Exercising with a friend, spouse or offspring is one example; the conversation and company helps pass the time. You can also exercise either while listening to podcasts, music playlists or watching your favourite TV show(s). I personally like to exercise while watching/listening to rugby matches! This is one of the reasons why exercising outdoors is better than exercising indoors on a machine, because there’s entertainment everywhere you look outdoors!

4. Start Slow, Small Increments

  • How hard is too hard? 

When (re)starting a new regime, of course you want to push yourself as hard as you can, primarily to see results as quickly as possible. STOP, don’t do it, this is a mistake! In order to gain the medical benefits of regular exercise, you need to be pushing yourself only so hard that you’re moderately out of breath i.e. so you have to breath through your mouth. It’s at that point that you’re challenging your cardiovascular system sufficiently for your fitness to improve.

  • How long is too long?

It’s also important not to push yourself too far into discomfort – remember that exercising for 5 minutes per day is better than no exercise at all. I recommend that you keep going until you’re really not enjoying the session anymore, and then try and hang on for another 2-3 minutes. Exercising for 5-10 minutes every day is better for your health than exercising for 40 minutes one day each week, because you’re challenging your cardiovascular system every day. You’re also more likely to keep it up long term!

health is priceless poster

5. Appropriate Clothing & Gear

If you’re like me and live in Ireland, then you’re used to wet weather. Often when you go to exercise outdoors, it’ll either be raining already or there’s a good chance it could start at any moment. Wearing comfortable, waterproof clothing can make exercising in the rain actually enjoyable, as opposed to sheer misery. Getting yourself a good pair of appropriate footwear is also highly advised. Getting welts or blisters will end your new exercise regime pretty quickly, so I advise investing in a good pair of Asics running shoes. You can find some good deals online for these types of things if you shop around!

That’s all for today, but if you live in the Dublin 18 area, why not get your exercise needs taken care of at Flynn Medical Exercise? I’ve got a variety of exercise classes and groups running 5 days each week. You’ll be tutored by a professional and meet like-minded people at the same time! Get in contact with me for more information! And remember…

“Exercise is medicine, take if everyday!”

Sean Flynn

Chartered Physiotherapist

 

What is the Role of your Community Physiotherapist? Part 1

Physiotherapy is a Health Care Profession, and in keeping with that we play a vital and varied role within Ireland’s Health Service (public and private). Most people have seen physiotherapists treating injuries and assisting sports teams, but what about the other, less obvious roles we fill, specifically with regard to Health Promotion and Hospital Discharge? I’ve written this article so that when you next get sick, you know how my colleagues and I can better assist you in getting better and staying better.

Assess Your Fitness, Flexibility & Posture

If you’ve got any problem, no matter what it is, getting a comprehensive assessment is a crucially important step towards solving the problem. As a physiotherapist, I have assessment expertise in the areas of both Posture and Fitness. 

Posture: From the top of your head right down to your feet, I can assess your posture and identify structures (muscles, bones, joints etc.) that are out of place, however slightly. Issues that might seem small, like fallen arches or forward shoulders, can nonetheless cause you big problems down the line, like Shin Splints or Frozen Shoulder. Posture assessments also includes assessing your flexibility, because tight muscles and joints inevitably lead to bad posture. After assessing you, I’ll  prescribe exercises and strategies to help you achieve and maintain good posture.

Poor Posture

Fitness: The health of your cardiopulmonary system (heart and lungs) is crucially important to your overall body health. Poor fitness can contribute to heart disease, lung disease or obesity, and generally makes everyday tasks that much harder to perform. Our physiotherapy degree includes comprehensive study of heart and lung biology, and physiotherapists play a central role in Cardiac and Pulmonary Rehabilitation programmes in hospitals. I can assess your fitness and prescribe you exercise at a precise level for your age and ability.

Exercise Test Image

Both of these important areas come under the idea of Health Promotion. As experts on the mechanics of your body, physiotherapists have a duty to teach and help people like you maintain a fit and healthy body and that is exactly what I aim to do everyday in my Flynn Medical Exercise clinic.

Encourage and Facilitate You in Exercise

As physiotherapists, we can’t just prescribe you exercises and hope that you do them. It is my firm belief that we should also provide you with easy, sustainable ways of getting those exercises done. I’ve put that belief into practice in my clinic by offering regular Group Exercise Classes which my patients can access as much as they require. Offering my patients regular, cost-effective ways to maintain your flexibility, improve your posture and increase your fitness is the most important service I offer to my patients.

Aerobic Theraband Setup

Of course, not every patient is suitable for group classes. Some patients have complex heart, lung or weight issues and require individual attention. That is why I also offer Individual Exercise Therapy sessions of which all my patients can avail. Getting time to exercise individually with your physiotherapist is an essential part of any rehabilitation programme, because we can target the exercises to your specific goals.

To Be Continued…

Be sure to keep an eye out for my next Community Physiotherapy Article to read about physiotherapy’s role in facilitating Early Hospital Discharge and Achieving Functional Independence. Until then, all the best!

Seán Flynn

Senior Physiotherapist

PH: 0861546175

EMAIL: info@flynnmedicalexercise.com

Principles on Weight Reduction and How I Apply them to my Patients

Everywhere you look there’s theories, fads and quick solutions regarding the quickest and most effective ways to lose weight. It can be extremely difficult to wade through all of it and come up with a weight loss programme for yourself, especially if you’re not a health care professional. As an experienced chartered physiotherapist, weight management falls directly into my area of expertise. I’ve been researching and applying my knowledge about weight loss since the days of my college thesis, and I’m going to tell you how I approach my patients who need to lose weight.

Postural Muscle Strengthening

If you’re carrying extra weight, chances are that you’ve experienced some associated lower back pain and/or knee pain. The primary benefit of strengthening your postural muscles is that it will reduce this pain.  When I say postural muscles, I’m mainly talking about your abdominal muscles, the muscles at the back of your hips, your thigh muscles and the muscles around your shoulder blades. Stronger muscles are able to bear more weight and consequently your joints have less weight to bear. You’ll feel less aches and pains which in turn will make it easier to exercise. It’s a win win.

4 pt core Opposite

The secondary benefit of strengthening these postural muscles is that there will be an increase in your Basal Metabolic Rate (BMR). BMR refers to the amount of calories that your body is spending every day to maintain the muscle you already have. The bigger your muscles are, the more calories that will be spent in this way. Therefore postural muscle strengthening will help you burn more calories and thus lose weight

Bridging

Exercise Intensity Determined by Heart Rate

In the absence of any severe heart conditions, your heart rate is the most accurate indication of how hard your body is working to perform a particular exercise. When designing and leading individual weight management sessions, I lead patients to work at 80% of their Estimated Maximum Heart Rate (EMHR) for short periods of time: roughly 20 minutes. If you’re reaching that heart rate goal, then you’re burning enough calories to lose weight, and exercising for 20 minutes is psychologically much easier than exercising for 60 minutes. It’s also much easier to fit into your daily schedule, which is a big factor as well.

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Exercise Test Image.jpg

Direct, Physiotherapy-Led Sessions

One of the hardest things to do when you’re trying to lose weight is to choose your exercises. If you’re on your own or searching online, chances are you’ll end up with a repetitive regime of exercises, and even the most effective exercise can get boring after a couple of sessions. To combat that, I lead my patients directly through each session, so all they have to do is show up. I monitor their heart rate continuously, and modify the exercises as needed to increase or decrease intensity. I individually design each exercise programme tailored to that patient’s history of aches and pains as well as their physical ability. So all my patients have to do is follow my lead.

No Shortcuts

If you want to lose weight and keep it off, then there are no shortcuts. The most natural way to lose that weight is to burn those calories off. If you want to become a patient of mine, give me a call, text or email. You can come for a no-obligation fitness assessment where you’ll meet me, do a simple exercise test and talk about what my Weight Management Approach could do for you. I give every 6th individual weight loss session free, and I charge €50 per session. No gimmicks, just hard work and well earned results. Are you ready?

Seán Flynn

Senior Physiotherapist

PH: 0861546175

Email: info@flynnmedicalexercise.com

So What is Medical Exercise & Why is it Important For Me?

We all know we need to exercise more, but everyone has different ideas about what actually counts as exercise. Most of us don’t know how to exercise effectively, in a way that we’re actually improving our fitness or losing weight. I’m hoping this article will begin to explain the idea of ‘Medical Exercise’ and how it can improve the efficiency of your exercise.

What Counts as Exercise?

Before we start talking about exercise, we need to speak briefly about Physical Activity. Physical activity includes all the bodily movements you perform throughout your day like walking to your car or lifting the groceries. Some people perform a lot of physical activity in their day whereas others perform very little.

Exercise, on the other hand, is just one form of physical activity. Exercise is planned, structured and repetitive (Public Health Reports, 1985). You do exercise deliberately, not by accident. Going out for a walk, playing a sport or lifting weights all count as exercise. Walking up the stairs to get your phone, however tired you might feel afterward, doesn’t count.

health is priceless poster.jpg

How is Exercise a Medicine?

Exercise is a medicine because it can treat and prevent illness, injury or disease. Exercises which involve repetitive contact with the ground (like running, walking, step-ups and jumping) can help prevent Osteoporosis – a disease in which your bones become fragile and weakened. Performing regular exercises that stretch your shoulder joint can help prevent Frozen Shoulder, which is a painful injury characterised by gradually decreasing range of motion in your shoulder joint.

Performing exercise with your whole body challenges your cardiovascular system to supply enough blood (which is carrying energy, oxygen and water among other things) to your entire body. Improving your fitness means that your body gets better at delivering these nutrients to your working muscles, and that your muscles get more efficient at using them to do work. Exercises that work your whole body include swimming, running, cross-trainers and my Aerobic Theraband Exercise classes. A fitter, more efficient cardiovascular system is less likely to experience a cardiac event, like a heart attack.

4 pt core Opposite.JPG

What’s the Correct Dosage of this Exercise Medicine?

As with almost all forms of medication, different people require different dosages to experience the positive benefits. Our weight, muscle strength, exercise history, diet and metabolism all play a role in determining how much exercise you individually need to improve fitness and prevent illness, injury or disease. When deciding how much exercise you need, we need to consider two factors:

  1. How long (time) you should exercise.
  2. How hard (intensity) you should exercise.

Time is easily measured with a stopwatch. Intensity, however, is more difficult to measure. In my Individual Exercise Sessions, I measure exercise intensity by constantly monitoring my patient’s heart rate. I then steadily increase the intensity of the exercise until my patient’s heart rate reaches the agreed target amount, usually around 80% of their Estimated Maximum Heart Rate. Then we sustain that intensity for 25-30 minutes.

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Exercise Test Image.jpg

Where can I get My Own Exercise Prescription?

As a medical exercise therapist (and a qualified physiotherapist), I specialise in offering fitness testing services to my patients. Depending on your physical ability, we carry out either a walking or a running fitness test on the treadmill with constant heart rate and oxygen level monitoring. I then assess the results, go through them with you step-by-step, and show you how hard you should be exercising to see the results you want, whatever those might be. This test is a great way to see a snapshot of your fitness level right now as well as measure your progress in improving your fitness over time. You can find out more information by calling me on PH: 0861546175 or emailing me on: info@flynnmedicalexercise.com. I take appointments Monday to Saturday in my Blackglen Clinic, and I look forward to helping you feel better soon.

Seán Flynn

Senior Physiotherapist

My Sharp Elbow Pain – Preventing & Treating Tennis & Golfer’s Elbow

Common Symptoms

  • Are you getting either a dull or sharp pain on the inside or outside of your elbow when playing tennis or golf?
  • Are you getting pain when turning a doorknob or using a computer mouse?
  • Are you occasionally feeling weakness around your elbow and wrist, especially after engaging in a lot of activity with your arm?
  • Are you noticing that regions of your elbow are swollen, hot to touch, or inflamed (red in colour)?
  • Are you over 35 and have not previously experienced symptoms in your wrist or elbow area?

If you have some or all of these symptoms, it’s likely you have Tennis/Golfer’s Elbow, which is known medically as Elbow Tendinitis.

General Information – why does this injury occur?

Tennis (or Golfer’s) elbow accounts for approximately 7% of all sports injuries, so if you’re suffering with it, it’s safe to say that you’re not alone! This injury is primarily a tendon injury and is caused by excessive, repetitive forces going through your forearm, like when you strike a ball in tennis or golf. There are a significant number of muscles in your forearm, and many of their tendons join together & anchor themselves on the outside or inside of your elbow. It’s this tendon junction (a.k.a. Common Extensor/Flexor Origin – these muscles either extend or flex your wrist) that gets irritated and inflamed by the repetitive high forces.

Your tendons get less durable as you get older, which is why people over 35 are more prone to this type of injury. During your backswing before striking either a tennis or golf ball, the muscles that extend your wrist are in a stretched position, which is a vulnerable position for this muscle/tendon. Therefore when you strike the ball, your forearm muscles are in a vulnerable position and are likely to suffer a micro (tiny) injury. When you play the sport for an extended period (18 holes of golf or 2-3 sets of tennis) these micro injuries get bigger, more inflamed and subsequently more painful.

Typical Treatment – how will you cure my Elbow Tendinitis Injury?

Assessment: The first important step is to confirm that you do indeed have Elbow Tendinitis. We need to rule out other possible injuries like Carpal Tunnel Syndrome or other causes of pain like a nerve problem. Once we’ve confirmed the diagnosis, we can commence treatment and management.

Rest: A break from the sport or activity which likely caused your injury is essential. We need to prevent the tendon from undergoing those repetitive micro-injuries which prolong the inflammation process and prevent healing.
Ice: Many people find icing this type of injury helpful. In general, if the ice feels soothing and comfortable on your injury, then it is providing a benefit. Apply ice for 10 minutes at a time with a 45-50 minute gap between applications.

Manual Therapy: This is the most important part of managing this injury. I’ll need to carry out a type of therapy called Friction Massage on the affected tendons. This type of therapy is quite uncomfortable and will leave your forearm feeling limp for 2-3 days, but it is extremely quick and effective at curing this type of tendon injury.

Strengthening: Once your pain, swelling and inflammation have gone down, we’ll start strengthening exercises on your wrist muscles. In order for those injured tendons to heal strong, we need to be putting them through their paces. These exercises also help to prevent this injury from (re)occuring. See the pictures below for a demonstration.

Wrist Extension Strengthening

Wrist Flexion Strengthening

Stretching: Last but certainly not least, stretching before sports is crucially important to keep your muscles loose and flexible. There’s just one simple stretch required in this instance and that’s wrist extension stretching. See the picture below for a demonstration.

Wrist Extension Stretch.jpg

Make an Appointment

Remember, if you’ve got a wrist/forearm problem, or any other injury, why not get it assessed by a professional, before it gets worse. Call me on 0861546175 or send me an email on info@flynnmedicalexercise.com. You can see me in my Blackglen Clinic, Sandyford or we can organise a Home Appointment. I have weekend and evening appointments available as well, just give me a call for more information.

Thanks for reading!

Seán Flynn, Senior Physiotherapist

My Mysterious Knee Pain – Treating and Preventing Patellar Tracking Dysfunction

Common Symptoms – is my kneecap mal-tracking?

  • Do you have knee pain despite having no incident where you specifically injured it?
  • Has your knee pain been persistent for a number of weeks without getting better?
  • Have you recently increase in activities/exercises that put a lot of weight/stress through your legs OR are you recovering from another unrelated leg injury resulting in significantly less exercise for your legs?
  • Are you feeling pain primarily in the inside of your knee? Is this pain worse when walking down stairs, and sitting with your knee bent for long periods?

General Information – why does this injury occur?

Your kneecap, first and foremost, is a bone which we call your Patella. When straightening and bending your knee, your patella glides over the front of your knee. Your patella is pulled through this movement by your Quadriceps (thigh) muscles. As well as pulling your patella upwards, your quadriceps muscles also pull your knee cap inwards (i.e. towards your mid-line). There is a smooth track of bone in your Femur (thigh bone) in which your patella glides quite comfortably. When your patella deviates from this track (pulled to the left or right), these symptoms are caused.

The pull of your patella  towards your mid-line is primarily the responsibility of your Vastus Medialis Obliquus (VMO) muscle, one of your four quadriceps muscles. If this muscle is weak, your patella will instead slide outwards (away from your mid-line) and grind against parts of your femur (thigh bone). It’s likely that this it what’s causing your pain.

If you have fallen arches in your foot (also known as Excessive Ankle Pronation), then this could be causing your tibia (shin bone) to be rotated/tilted ever so slightly. This can cause your patella to be tilted/rotated ever so slightly, which in turn causes your patella to grind against the sides of it’s track in your femur (hip bone).

Typical Treatment – how will you cure my patellar mal-tracking injury?

  • Rest: Resting from activities where your knee is working for extended periods of time is important to prevent further trauma to the injured tissues. Avoiding activities like descending stairs and sitting with knees bent should be avoided even if they are no longer painful, as they are still damaging your knee.
  • Manual Therapy: Hands on physiotherapy is important to stretch the tight structures pulling your patella out of alignment. I will perform glides on your patella, pushing and stretching it towards your mid-line. Manual stretching of the Ilio-tibial Band (fibrous tissue stretching from your hip into your knee cap) is also essential if this structure is tight.
  • Strengthening: As mentioned, if one of your quadriceps muscles (Vastus Medialis Obliquus) is identified in the assessment as being weak, then strengthening and conditioning of this muscle is crucial. For sportsmen and women quadriceps will have to be strengthened to a high level and continuous leg strengthening will be required going forward to prevent reoccurring injury. If the below exercises are pain-free, you can start performing them straight away.
  • Stretching: It’s common with almost all knee injuries to see some tightness in the hamstring muscle group (back of the thigh). Therefore stretching of these muscles is almost always prescribed. Additionally, home stretching of your Ilio-tibial band is also important to maintain the gains achieved with manual therapy.
  • Taping: Lastly, taping can help to manage this pain in the knee in the short term, especially if spending lots of time walking/running is unavoidable in your daily life. I can show you how to tape this injury effectively so you can manage this aspect of the treatment yourself on a day to day basis.

SLS Squat

Make an Appointment

Remember, if you’ve got a knee problem, or any other injury, why not get it assessed by a professional, before it gets worse. Call me on 0861546175 or send me an email on info@flynnmedicalexercise.com. You can see me in my Blackglen Clinic, Sandyford or we can organise a Home Appointment. I have weekend and evening appointments available as well, just give me a call for more information.

Thanks for reading!

Seán Flynn, Senior Physiotherapist