Why regular physio check-ups are an essential for remote and hybrid teams
It might be bizarre to hear that musculoskeletal conditions like neck and back pain are one of the top expenses associated with employee health care. But reports by organizations like OSHA (Organizational Safety and Health Administration) in the UK and NHS in the UK confirm that it is. According to OSHA, in USA these conditions account for over a third of the employee healthcare benefits. Likewise in UK, back pain accounts for 40% of sick leaves of employees.
To mitigate the expenses associated with these conditions it is important for employers to invest in employee wellness programs like regular physio check-ups, yoga, etc. These wellness programs not only enhance employee health but also their overall experience with the organization. Employees feel more engaged, relaxed, and committed to the organization.
However, physio check-ups are not the most popular wellness activity. The impact of Physio programs is often underestimated and considered as nominal. If regularly conducted Physio check-ups help in preventing chronic pain, stress, and improves overall strength. Other benefits of Physiotherapy include improved sleep, mobility, and mental health. It can reduce costs related to musculoskeletal conditions significantly while also helping employees feel better.
Physio check-ups are also more essential today than ever as corporate world has evolved into remote and hybrid teams. With employees also reporting that work life balance has been blurred in the world of remote work, activities like Physiotherapy are much needed.
In remote work, employees are more prone to chronic pains because there is less movement and interactions. Likewise, for hybrid teams Physio activities help in establishing a positive connect with their employers while working from offices.
Organizing activities like Physio and health check-ups in a post pandemic world also improves trust and empathy among employees. As the pandemic has proven that employee health and wellness are of utmost importance, employees are no longer interested in organizations where empathy and employee wellness are not prioritized. Surveys have also indicated that employees are looking to move towards roles that are more flexible, ensure holistic wellness, and a better work-life balance are preferred over those that do not.
Remote and hybrid teams also suffer from poor mental health because of less interpersonal interactions. They tend to develop conditions like anxiety, stress, and loneliness. Physiotherapy also aids in improving mental health. When the body is relaxed and stress free, individuals feel more empowered mentally too. The potence of Physio in treating mental health is not widely known. This can be pivotal to remote and hybrid teams and in helping them adapt in a post-pandemic world. It can also be a great team bonding activity. Physio when combined with Yoga sessions can be a highly engaging and motivating retreat for remote teams. When teams are engaged and relaxed, they also communicate and collaborate better.
To conclude, regular wellness activities like physio and yoga are an investment into the overall employee experience and organizational culture. Regardless of whether your employees are coming back to offices or have evolved into remote teams, wellness activities establish a connect between your teams and the organization.
How Well Do You Know Physiotherapy?
World Physiotherapy Day falls on 8 September every year and is an opportunity for us to raise awareness about the contribution our profession makes to keep people well, mobile and independent. While the demand for physiotherapists continues to rise and many patients are experiencing the transformative effects of physiotherapy, some misconceptions still persist today. Let us share and debunk the top 5 common myths about physiotherapy.
Myth: I need a doctor's referral to see a physiotherapist.
Fact: Patients can seek treatment from a physiotherapist without a doctor's prior referral.
Myth: Physiotherapy is painful.
Fact: Physiotherapists seek to minimise pain and discomfort — even if it is chronic or long-term. They work within your pain threshold to help you heal, and restore movement and function.
Myth: Physiotherapy is only for injuries and accidents.
Fact: Physiotherapists do a lot more than just stretch or strengthen weak muscles after an injury or surgery. As experts in the way the body moves, they are skilled at evaluating and diagnosing potential problems before they lead to more serious injuries or disabling conditions. Physiotherapists help people of all ages and abilities reduce pain, improve or restore mobility, and stay active and fit throughout life.
Myth: Physiotherapy isn't covered by insurance.
Fact: Most insurance policies cover some form of physiotherapy. Beyond insurance coverage, physiotherapy has shown to reduce costs by helping people avoid unnecessary imaging scans, surgery, prescription drugs. Physiotherapy can also lower costs by helping patients avoid falls or by addressing conditions before they become chronic.
Myth: Surgery is my only option.
Fact: In many cases, physiotherapy has been shown to be as effective as surgery in treating a wide range of conditions - from rotator cuff tears and degenerative disk disease to meniscal tears and some forms of knee osteoarthritis. The study found that people who recently have seen a physiotherapist know this to be true, with 79% believing that physiotherapy can be a viable alternative to surgery.
"Commonly held misconceptions about physical therapy can become barriers to people seeking the potentially life-changing care of a physical therapist. We hope that by challenging these myths with facts, consumers will recognise that physical therapists can help them optimise their movement and greatly improve their quality of life."
- APTA member Joseph Brence, PT, DPT, FAAOMPT, COMT, DAC
Source: American Physical Therapy Association.
SILVER Winner for Expat Living Readers’ Choice Awards 2020
The results are in for the ExpatLiving Readers’ Choice Awards 2020 and we’re delighted to share that PhysioActive has been voted as a SILVER Winner for the Best Physiotherapist, under the Health & Medical category!
Over 7,300 respondents took part in voting for the best businesses in Singapore across 149 categories last year, and we were chosen as one of their favourites.
We'd like to take a moment to say a big THANK YOU to all who voted for us! We sincerely appreciate your confidence and trust in us and will continue to work hard to bring good health and cheer to our patients! We are humbled to receive this award.
PhysioActive is available in Orchard, Raffles, East Coast, Jurong & Novena!
Do Massages Really Have a Hand in Physiotherapy?
Physiotherapy aims to rehabilitate, improve or maintain health status and prevent injuries. By medically assessing the condition of one’s body, physiotherapists are able to use various modes of therapy to attend to its needs. The more commonly known method is exercise, where clients undergo a programmed exercise routine to rebuild or maintain muscle functionality. But aside from exercises, physiotherapists sometimes utilise massages to aid in faster recovery.
How Do Massages Help in Rehabilitation?
There are various forms of massages, and most of them employed by physiotherapists aid in blood circulation. Our blood carries oxygen and all sorts of nutrients needed by the body to function and repair itself. This is especially important for injured sites where more resources are needed for the body to mend that area.
Not only does it improve blood circulation, the exertion and release of pressure in a massage creates a better flow for the lymph fluid to circulate. The lymphatic system is responsible for removing toxins, unwanted fluids and wastes from the body through the lymph fluid. The lymph fluid holds white-blood cells that defends the body from infections thus during recovery, the lymph fluid is essential in helping to clear the injury site off foreign entities. But if the circulation is hindered, the fluid will accumulate and the body part swells as a result. The swollen tissues impede blood circulation which further delays recovery. Thus, it is important to keep both blood and lymph fluids well-circulated during an injury.
Massages are also sometimes paired with exercises to increase mobility needed for exercise or after exercises to reduce stiffness. During exercise, the muscles contract and retract. This motion is generated by the sliding of muscle fibres across one another: towards to contract and away to retract.
However, when the muscles are stiff, the contraction and retraction is not executed along the full length of the muscle fibre; This produces a shorter range of motion. Stretching helps to relieve the stiffness to a certain extent, but applying a good amount of pressure on the fibres helps to work the fibres apart better at a deep tissue level. Massage helps physiotherapists relax the muscle fibres that cannot be reached through stretching, to release muscle tension and provide greater mobility before or after exercises. This allows the client to better perform the exercises and prevents exercise-related injuries by ensuring the muscles are not overly stressed.
When appropriately paired, massage can be a great tool to work in conjunction with physiotherapy-led exercises. By knowing when to utilise each method, healing takes a more efficient path and the road to recovery can be expedited.
To Stand or Not to Stand
We have at some point heard complaints from people who have stood for long hours or have ourselves, been that person complaining. Standing for too long may induce leg cramps or backaches, especially with unsuitable footwear. Mothers who are expecting or those with health complications might have detrimental effects associated with standing for long hours too. While it is true that standing for long hours can cause some negative effects on your body, there are plenty of positive effects from standing as well.
A study from 2015 on Standing, Obesity, and Metabolic Syndrome by Shuval, Barlow, Finley, Gabriel, Schmidt and DeFina concludes that standing for at least 6 hours a day reduces the risk of obesity. Compared to sitting, your body’s metabolic rate is higher when standing which aids in countering obesity.
Another study in 2015 by Healy have shown that standing increases the High-density lipoprotein (HDL) cholesterol in your bloodstream and reduces the low-density lipoprotein (LDL) cholesterol. This bodes well for those with high blood pressure or high cholesterol because levels of LDL cholesterol that clogs up your arteries is lowered, and levels of HDL that help to further remove LDL cholesterol from your body is elevated.
Levels of blood in the sugar is shown to decrease with standing as well! Even though standing stationary may seem pretty much like sitting, the results of sitting for as short a time as 2 hours actually reveal an increase in blood sugar levels and LDL cholesterol. So if you have a seated desk-bound job and are at risk of high blood sugar content, researchers recommend standing up or taking a short 5 minutes walk to decrease the sugar levels in your blood by as much as 34%!
Standing has also been noted to enhance productivity levels during work. Compared to sitting, standing employees show significant growth in productivity as well as stimulation in creativity. Standing employees stated lower levels of stress and lethargy as compared to their seated counterparts. Their mood was also reported to show improvement, aiding in better work-place relations/cooperation.
Having said that, it is important to wear proper footwear if you intend to stand for long hours. If you find yourself over-straining or forcefully exerting strength just to stand, a rest is needed to prevent muscle fatigue and stress. To lessen the stress on your back and feet, choosing the right shoes to stand in is essential.
If you are pregnant, standing for long hours is also not recommended as some studies have shown long hours of standing to be correlated to the delay in fetal development. Therefore, please consult a specialist before engaging in any strenuous activity that you are not used to.
Is It Really That Dangerous to Drink & Run?
'Do not drink and drive' - a common line with a universal understanding and fairly warned so according to the devastating effects intoxication is known to have on driving. But what about drinking and running? What effects could there be physiologically when one drinks and runs?
With more and more booze-based runs emerging in the scene, it is important for us to share what could be in for you.
Alcohol Dehydrates You
Firstly, alcohol dehydrates you because it is a diuretic. This means that it aids in the expulsion of water and sodium through urination. While this may be a helpful function for people with high blood pressure or swollen tissues, ridding your body of sodium and hydration before a run is definitely disadvantageous.
Muscles are more likely to cramp up with reduced levels of electrolytes, and along with the decreased efficiency of your muscles, chances of pulls and strains are elevated. If you do want to keep electrolytes and hydration levels up between runs, a sports drink is a great alternative.
Other Physical Effects
Secondly, the same interference one experiences while drinking and driving influences running as well. This includes slower reaction time, lowered physical coordination skills, increase in heart rate and issues with balancing. Such influences can affect a runner’s safety and/or accelerate fatigue.
Metabolism Is Impeded
Thirdly, metabolism of fats or carbohydrates is impeded. This happens because your liver focuses on breaking down alcohol therefore other functions such as breaking down glycogen slows down. With unregulated levels of glucose in your blood stream, the steady supply of energy from glucose can run low, making it tougher to continue running.
Does this mean one should never drink and run?
Drinking and running is as counterintuitive as it sounds, but it is always healthier to exercise than to drink without exercising at all. Still, based on all the immediate negative effects drinking has on running, it is inadvisable to drink before you run. But if you absolutely have to for a social event or fun run, remember to hydrate yourself adequately and drink with consumption of food!
Are the Formula One Races a Physical Sport?
In the recent Formula One (F1) Singapore Grand Prix, racers came in from all over world to participate in a contest of speed. Perhaps unlike sprinting or cycling, one may be tempted to view F1 racing as a non-physical sport: the speed produced is after all completely dependent on the car, or is it not?
Let’s break it down
F1 cars connote loud screams of engines that power the impressive speed capable of lifting a car off the ground. What stabilises the cars and keep their wheels on the ground lies in the design of the car. Instead of generating lifting force on the car, F1 cars are designed to produce downforce on the car when it speeds through the air. However, this means that the same downward force that keeps the car grounded is also acting on the driver inside the car. The faster the car, the more downforce is needed to hold the car down and the more pressure is experienced by the driver!
How much force is acting on the body?
Considering the average weight of a driver as 67kg, the head being roughly 7% of the body weight (4.69kg), and the helmet (1.2kg) worn by the driver, a 230N of force (23.45kg) is acting on the head!
This implies 2 things:
1. The neck needs to be strong enough to counter that gravitational force (g force) just to keep the head upright and to prevent neck injuries.
The spine is just as much susceptible to injury from the sudden changes in movement while making a corner.
2. If the car goes faster, the body needs to be better conditioned to withstand the physical demands.
F1 cars have indeed gotten faster since its plateau from 2004, and the drivers are having to overcome more gravitational force than ever.
This means that even though technically the car generates the speed, without an appropriately conditioned driver, that speed can never be achieved in an F1 race.
How do the drivers handle the speed then?
Like any other contact sports that are high-impact (ice-hockey, rugby, etc.), an F1 racer has to build adequate muscles on their necks, chest and back to prevent injuries. This is often overseen by a group of professional physiotherapists.
Physiotherapists put drivers through training intended to build specific muscles to withstand the cornering forces and to last the full distance of the race. Screenings and musculoskeletal assessments are also conducted to track the drivers’ health. According to the results, personalised training can be implemented to better improve the adaptability of the driver to his car.
As technology increases the speed of cars, the F1 is a sport like no other. The competition is now not just against other drivers, but also a race against the advancement of technology by conditioning the body enough to handle the physical demands of newer and faster cars.
Sever's Disease Explained
Sever’s Disease is a condition caused by the overloading of Achilles Tendon near the heel, and the growth plate in the area.
It is common in physically active boys between 10 to 12 years old and active girls aged 8 to 11 years old. Usual signs and symptoms experienced by the child are:
Redness and/or swelling in the heel
Heel pain during running or jumping that usually goes away after some rest
Difficulty walking or running
Most parents get highly worried about the pain that their child is experiencing and at times, they may feel helpless on what to do. Here are 3 most common questions asked by parents who come through our physiotherapy clinic:
Can my child continue his/her physical activity?
Yes, he/she can continue with physical activity provided that the pain does not occur.
Will the pain go away?
Yes, the pain should go away. However after knowing this fact, parents should not push their child to continue with pain during physical activities. Avoiding the pain is very important.
Is there anything my child can do to recover faster?
An appointment with a physiotherapist is highly recommended. A professional can assess your child’s flexibility, strength, muscle control and biomechanics. From the assessment, we can then prescribe your child with a specific rehabilitation program which will consist of stretches and strengthening exercises.
Most of the times, we also find that children who suffer from Sever’s disease lack strength in their hip muscles, which is important for activities such as running and jumping. Knowing and working on the right exercises that will build strength in your child’s hip is crucial in the treatment of Sever’s disease.
Remember, do not force your child to continue with pain during his/her physical activity. Even though your child may grow out of the pain, it is important to exercise within pain free limits!
Ankle sprains can be painful and make it hard for you to carry out daily activities. However, many people can’t quite identify the difference between an ankle “sprain” and “strain”. These two terms are often used interchangeably to describe over-stretching or tearing of soft tissues in and around your joints.
Classifications of Ankle Sprains
There are two basic classifications of ankle sprains: Anatomic (the severity of damage to tissues in the ankle) and functional (the level of which an injury affects the patient’s ability to walk or put weight).
Grade I ankle sprain – where the lateral ligaments are strained (overstretched) but the patient is still able to fully bear weight and walk.
Grade II ankle sprain – where there is partial tearing of one or several ligaments and the patient walks with a noticeable limp.
Grade III ankle sprain – where there is a complete rupture (tear) in one or more lateral ligaments and the patient is unable to walk.
These grading systems are commonly used to estimate timelines for recovery, which can range from 1 to 2 weeks (Grade I) to 6 to 12 weeks (Grade III). Recovery is also often dependent on the specific injury, the type of rehabilitation, and the therapy goal, e.g. return to sports.
When Should I Seek Medical Attention?
While ankle sprains are among the most common injuries and are typically perceived as mild problems that can heal by themselves, here are some indications that you might require medical attention:
There is severe swelling and/or bruising of the ankle.
You cannot walk or bear weight on the injured foot.
A crack or pop sound was heard during the accident/injury.
There is an obvious deformity of the ankle.
The injury does not seem to be improving over time (prolonged pain, bruising, etc.)
It is advisable to see a physiotherapist for an assessment to determine the severity of the trauma. Sometimes, a patient may need to see a doctor for further examination and in some cases, a surgery might be indicated.
The RICE Method for Injuries
The RICE (Rest, Ice, Compression, and Elevation) method is often recommended for mild, acute injuries. This simple self-care technique helps reduce swelling, eases pain, and speeds up healing.
While an ankle sprain can clear up on its own, you may have a greater chance for an ankle sprain if you have had one before. Be sure to get sufficient rest before returning to (intense) sporting activities, especially for grade III injuries. Bracing or taping the ankle can also decrease the frequency and severity of ankle sprains among athletes.
Patients with recurrent ankle sprains can also benefit from physiotherapy, e.g. strengthening and stability training for the ankle.
Remember, early appropriate treatment may prevent unnecessary pain and a delayed recovery!
More often than not, the most random things end up going viral online and leave people pulling their hair out over absolutely nothing – no we are not going to ask if you see a blue or gold dress!
One particular campaign caught our attention in recent months. The #Stand4Strength test initiated by the Abbott Family challenges you to take the 'stand-up test' to check if you are at risk of not being able to walk in your 70's & beyond.
Are You Strong Enough? Take the Test!
Take the stand-up test now to see if you are at risk. This simple test was created to help healthy adults check if in the future they are at risk of not being able to walk, and to help adults, especially aged 40-60, take the necessary precautions.
Find a chair (that is 40cm from the ground) and sit down.
Bend your knees slightly.
Cross your arms and place them in front of your chest.
Stand up from a seated position on one leg.
Maintain that position for 3 seconds.
Be careful not to injure yourself.
Do the test under supervision of a family or friend that can support you.
Do not lean back to gain momentum or you may fall backwards.
Stop the challenge immediately if your knees start to hurt.
Do not try the test if you had a recent fall or injury.
How Does It Work?
Our muscles gradually get weaker as we get older, thus making it more difficult for us to undertake daily activities from buying groceries to playing sports. In fact, research has shown that adults aged 40 and above could begin to lose up to 8% of muscle mass every decade!
Loss of muscle mass can lead to a vicious cycle of increased inactivity which leads to more muscle loss. This could expose older people to an increased risk of falls, loss of independence and even premature death.
In Singapore, about 1/3 of older people aged 60 and above has fallen more than once.
While declining muscle mass is a natural process of ageing, it should not be seen as a normal part of ageing.
Let’s start off by asking yourself 2 questions:
Are you strong “enough”?
Do you have confidence in activities of daily living?
Not all is lost if you had difficulty performing the test. Lifestyle and nutritional changes for instance, can help to improve muscle and overall health.
Working with a physiotherapist on your strength, balance, and motor skills can also help you to increase confidence and remain independent.
Blood Clots & Flying: What You Need To Know This Summer
It's finally the summer holidays!
This well-deserved break calls for a vacation but do you know that travelling on flights that extend beyond 4 hours can be associated with serious health threats?
Blood clots, also known as deep vein thrombosis (DVT), can form in the deep veins of your legs during travel because you are sitting still in a confined space for a prolonged period. The longer you are immobile, the greater your risk of developing a blood clot.
The problem comes when a part of the blood clot breaks off and travels to the lungs, causing a blockage. This leads to a condition called pulmonary embolism, and it may be fatal.
Good news is, many times, the blood clot will dissolve on its own. There are also actions that you can take to reduce your risk of developing blood clots during a long-haul flight.
Recognise the Symptoms
DVT occurs usually in the legs or arms, and are accompanied by these common symptoms:
Swelling of your leg or arm
Pain or tenderness that you cannot explain
Skin that is warm to the touch
Redness of the skin
Move Your Legs Frequently
If you have been sitting for a prolonged period, take a break to stretch your legs. Moving your legs and flexing your feet can help improve blood flow in your calves. The calf muscles assist in pumping blood from the legs back towards the heart. This prevents stagnation of blood in your veins.
Some airlines suggest pulling each knee up towards the chest and holding it there with your hands for 15 seconds.
Tip: Request for an aisle seat so you can get to enjoy a little more leg room. It will also be easier for you to get up and move around.
Not drinking enough fluids may cause your blood volume to decrease, and your blood to "thicken". Therefore, allowing yourself to get dehydrated could increase your risk for DVT during long-haul flights.
To prevent this, be sure to drink plenty of fluids while traveling.
Tip: Limit how much alcohol you drink because it can lead to dehydration.
Wear Compression Stockings
There are ‘flight socks’ designed to help improve blood flow in your legs. These special compression stockings provide graduated pressure that is strongest at the ankle and gradually decreases up to the knee or thigh.
Tip: Remember to wear loose-fitting outfits that do not constrict your waist or legs.
How PhysioActive Can Help
Our therapists can be an important part of a DVT patient’s recovery by:
Providing massages that are useful for stimulating better vascular response in affected areas.
Recommending specific exercises that can help to re-tone damaged muscles.
Utilising specialised compression techniques to help the body recover from the stresses of a DVT.
MRIs are considered the gold standard on identifying structures within the body. However, sometimes, there can be different perspectives to the same fact.
Case in Point by Physiotherapist - Jack Allen
John, a 40-year-old Caucasian patient came to me for a pre-op evaluation. He was a healthy male who frequently exercised outside of his working hours.
John also had a passion for gardening and it was during squatting while planting when he noticed a pulling sensation on the outside of his right thigh. This remained a constant issue for the next three weeks until he sought medical advice from an orthopaedic surgeon.
An MRI was performed which revealed disc bulges at L4/L5 and L5/S1 (lower back).
As bulging discs are often an incidental finding on the MRI (especially in patients over the age of 40), the surgeon recommended John to see a physiotherapist first. If his condition does not improve, surgery would then be an option.
The MRIs that John brought along in his initial appointment clearly showed presence of the disc bulges. As we continued to talk, John revealed that he did not have a history of back pain and currently did not experience any localised or radiating pain. John’s only symptom was the strong pulling sensation on the outside of his thigh whenever he squatted. To some people, this might appear as a minor problem but to John, it affected his passion.
During the physical examination, John was noted to have a good squatting form but subjectively could feel the pulling sensation. John also had a full range of movement in his lumbar spine although certain hip movements were limited secondary to tight lower limb musculature. We performed all the special tests to assess the integrity of his sciatic nerve which all turned out to be negative. On feeling the quality and movement of the different levels of his spine, nil pain or restrictions were noted.
So What Was Wrong?
However, what we did find was that John had pain on feeling his right IT Band (a strong, fibrous band that runs from the outside of the hip to the outside of the knee), TFL (a small muscle that connects the ITB to the pelvis) and his VL (the outside quadricep muscle). John was also found to have poor posterior chain strength (muscles along the back of the leg) in comparison to his lower limb anterior chain (muscles along the front of the leg).
I explained to John that I believed his squatting issue was unconnected to his spinal disc bulges. I demonstrated on an anatomy model how his overly tight musculature pulls on his ITB while squatting and how this produces the pulling sensation.
At the end of the session, we re-assessed and John found the pulling sensation to be halved. A home exercise program was devised and after two more sessions, John could squat freely and return to his passion.
What Do MRIs Say Then?
A famous study found that MRIs identified disc bulges in 30% of pain-free 20-year olds. This highlights that a person is never defined by his MRI!
In the above case in point, John's disc bulges (as seen in his MRI) could just represent normal wear & tear.
A combination of manual therapy and exercise was just as effective at solving his problem, which originated from his overly tight musculature.
This post was written by Jack Allen. The name, age and details of this patient were also changed for privacy reasons.