First4Therapy Blog | Therapeutic Information and Guidance

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29/Nov/2024

Sciatica is a condition characterised by pain that radiates along the sciatic nerve, typically affecting one side of the body. This can cause discomfort from the lower back, through the hips, and down the leg. It can also cause numbness, tingling or weakness in the buttock or foot.

At First4Therapy, we specialise in assessing and treating sciatica using a range of proven therapies, including:

Joint Mobilisation

Joint mobilisation, particularly in the lumbar spine, can help reduce stiffness, improve mobility and ease pressure on the sciatic nerve. Research based NICE guidelines, recommend manual therapy, including joint mobilisation, as an effective method for addressing the spinal issues that often contribute to sciatica

Neurodynamics

Sciatica is often caused by nerve irritation or compression. Neurodynamic techniques, which focus on improving the mobility of the nerves, are highly effective in managing this condition. According to the Manipulation Association of Chartered Physiotherapists (MACP), these techniques help restore normal movement along the sciatic nerve, reducing nerve sensitivity and inflammation of the sciatic nerve, which can result in lasting relief from sciatica pain.

Soft Tissue Treatment

Nerve irritation often causes a protective muscle spasm that can increase pain. Soft tissue therapy like deep tissue massage, helps to relieve muscle tension in the surrounding areas, particularly the lower back and glutes. Studies have demonstrated the benefits of soft tissue treatment in reducing muscle stiffness and improving overall mobility, which can ease sciatic pain.

Electrotherapy

Electrotherapy, including TENS (Transcutaneous Electrical Nerve Stimulation), is commonly used to manage sciatica pain. By delivering electrical impulses to the affected area, TENS therapy can help to block pain signals and stimulate endorphin release. There is a significant evidence base to support its use in the management of acute and chronic sciatica. It is a non-invasive treatment that provides an additional layer of pain relief. Local ultrasound therapy and low level laser therapy reduce local inflammation and can reduce pain.

Exercise Therapy

Regular, targeted exercise can significantly improve symptoms of sciatica. NICE emphasises the use of exercise therapy that helps to strengthen core muscles, improving posture and reducing pressure on the sciatic nerve. Specific exercises that focus on stretching the muscles in the lower back, hips, and legs can alleviate nerve compression, helping to reduce pain and improve function over time.

Acupuncture

Acupuncture is another effective method for managing sciatica, especially for those with chronic pain. The Acupuncture Association of Chartered Physiotherapists (AACP) supports its use for reducing nerve pain and promoting relaxation, often providing long-term relief for individuals suffering from sciatica. Acupuncture may affect nerve pathways that reduce nerve sensitivity and inflammatory response, leading to pain relief.

Why Choose First4Therapy?

At First4Therapy, we take a holistic approach to treating sciatica. Our expert physiotherapists will assess your condition and develop a tailored treatment plan, incorporating a combination of therapies such as exercise, joint mobilisation, neurodynamics, and acupuncture to address the root cause of your pain. By focusing on long-term recovery and prevention, we aim to help you get back to living pain-free.

If you’re experiencing symptoms of sciatica, don’t wait for the pain to worsen. Book an appointment with First4Therapy today and let us help you on your road to recovery.

admin

25/Oct/2024

More than 90% of people experience a headache at some point in their lives. Physiotherapists most commonly treat migraines, tension- type headaches and cervicogenic headaches (caused by problems with the neck). Some headaches may be secondary to an underlying cause and will need further investigations. While many people treat headaches with medication, physiotherapy offers an effective alternative, especially for those experiencing tension headaches, migraines, or headaches caused by neck issues (cervicogenic headaches).

Common treatable causes of headaches are:

Poor motor (movement) control
Tightness of cervical/neck muscles
Reduced muscle size
Hypomobility (stiffness in upper neck joints)
Pain when conducting an examination by touching it with the fingers or hands, of the upper neck
Myofascial trigger points (pain caused by muscular irritation)

At First4Therapy, we offer a range of treatments to help manage and reduce headaches.

Here’s how some of our specialist therapies work:

Exercise Therapy

Exercise therapy focuses on improving posture, strength, and mobility. Poor motor (movement) control and weak deep neck muscles can contribute to headaches. According to the Chartered Society of Physiotherapy (CSP), regular exercise can alleviate tension in muscles that contribute to headaches, particularly around the neck and shoulders. Strengthening exercises also support long-term prevention by addressing posture and muscle imbalances that often trigger headaches.

Neurodynamics

Neurodynamics is especially beneficial for individuals whose headaches are linked to nerve sensitivity or entrapment. The Manipulation Association of Chartered Physiotherapists (MACP) highlights the effectiveness of neurodynamic techniques in reducing neural tension, which can often alleviate headache-related symptoms by enhancing nerve mobility and reducing pain.

Joint Mobilisation

Misalignment or stiffness in the upper cervical spine is a frequent contributor to cervicogenic headaches. Joint mobilisation can help restore proper movement in the joints, reducing headache frequency and intensity. Studies from the National Institute of Health show that manual therapy, including joint mobilisation, is an effective treatment for cervicogenic headaches.

Soft Tissue Treatment

Soft tissue treatment, such as massage, can help relieve muscle tightness, especially around the upper back, neck, and scalp. Evidence from the Chartered Society of Physiotherapy (CSP) supports the use of manual therapy for tension-type headaches, particularly when used in conjunction with exercise.

Acupuncture

Acupuncture is another effective tool for managing headaches, particularly chronic tension headaches and migraines. NICE includes acupuncture treatment in its guidelines for the management of chronic tension type headache and migraine. The acupuncture needles relax the muscles locally and also stimulate the production of naturally occurring substances that give pain relief.

How Can First4Therapy Help?

At First4Therapy, we tailor our headache treatments to suit each individual’s needs, ensuring we target the underlying causes of your headaches rather than just the symptoms. Whether it’s through exercise, joint mobilisation, acupuncture, or soft tissue treatment, our team is committed to providing you with lasting relief.

For more information on how we can help you manage your headaches, or to book a consultation or give us a call today.

admin

04/Apr/2022

One of the more common types of injuries faced by runners and those who exercise primarily on their feet affect the Achilles Tendon at the back of the leg.

Did You Know?

The Achilles Tendon is the largest and strongest tendon in the body. When the calf muscles flex, the Achilles tendon pulls on the heel. This movement allows us to stand on our toes when walking, running, or jumping.

There are three more common types of injury that can affect the Achilles tendon, all of which can be assisted by a trained Physiotherapist.

What is Achilles Tendinopathy?

Achilles tendinopathy presents as pain, stiffness or swelling in the tendon that runs down the back of the leg to your heel. It usually occurs in stages and if the early warning signs such as pain during or after a run are ignored. It can progress to swelling and daily tendon pain whilst going up and down stairs. Squeezing the tendon will also be painful.

What is Tibialis Posterior Tendinopathy?

Tibialis posterior tendinopathy presents as pain and swelling on the inside of the ankle, close to the Achilles tendon. It can occur when the posterior tibial tendon becomes inflamed or torn and may not be able to provide support for the arch of the foot.

What is Peroneal Tendinopathy?

Peroneal Tendinopathy is not as common and presents as pain and swelling on the outside of the ankle, mainly occurring after ankle sprains. The muscles and tendons involved in this type of injury move the foot in an outward direction and help point the foot and ankle downward.

How can you prevent these injuries?

Training errors account for as much as 60-80% of runners with tendon problems. Rapid increases in distance or speed, change of running terrain and not enough rest between training are quite often the cause.

To ensure you prevent yourself from stressing these areas, watch how much and how often you load the tendon. If you are planning on increasing your exercise safely then try to follow these guidelines:

• Only increase your weekly running mileage incrementally (by adding 10%).

• Work on either speed or distance, but not both together.

• Make sure to have rest days between runs.

About the Calf Muscles

Your calves are made from two muscles – the Gastrocnemius (the larger muscle) and the Soleus which is a flat muscle which sits underneath it. The two muscles work together to give you the push-off needed when running.

The Soleus muscle which runs from your calf to your heel is important for endurance running and posture while the larger Gastrocnemius is perfect for sprinting and speed.

Strengthening the calf muscles with these exercises is a good way to prepare your tendons for running and reduce the chance of injury

Exercises You Can Do At Home

To target the soleus muscle:

Seated heel raises with both legs

Seated single heel raise. You can progress this by doing it with a weight on the knee.

For calf muscle strength

Isometric Calf Raise

1. Start by going up on your toes and then holding at the top position
2. You can hold at the top for 45 seconds then take a 2 minute break and repeat up to 5 reps 2x daily

Short hold of less than 6 seconds, 5 reps 3-4 sets helps with force production

3. Increase load gradually by either doing them single-leg or wearing a backpack with weight

Heel Raise Wall Squat

1. Start with your back against a wall and your feet about a foot away, feet shoulder width apart.
2. Bend your knees until your thighs are parallel to the ground with your knees positioned over your toes
3. Raise your heels while maintaining this position.

Plie Calf Raises ( works your glutes as well!)

1. Start in a sumo squat position with your feet in a wide stance and toes pointing out to the sides, thighs parallel to the floor.
2. Raise your heels off the floor
3. Lower your heels and repeat until you complete the set
Walking a set distance with your shoulder back and your back straight carrying weights (Farmer walk)
Or walking a set distance on your toes with your feet turned out is also a good way to strengthen your calves and core and improve your balance.

Maintain Flexibility
Compare your ankle movement moving your feet up/down, in and out. Work on doing calf stretches in your post run cool down. Hold each stretch for 30 seconds.

Calf stretches

Gastrocnemius: This link demonstrates the correct way to do a gastrocnemius stretch
https://www.youtube.com/watch?v=y01ri_43G50

Soleus: This link demonstrates the correct way to do a Soleus stretch
https://www.youtube.com/watch?v=kNm6qFnOiIw

The next instalment in this series will cover shin splints – and how to avoid them!

admin

12/Jan/2022

Getting fit and losing weight are usually high on the list of New Year’s resolutions.

While exercising to get fit is fantastic, it should not be a cause for injury!

As a Physiotherapist I would always say that an ounce of prevention is worth a pound of cure. The last thing I want is for anybody to find themselves in pain when they could have simply avoided it.

Avoiding Common Sports Injuries

Different sports make different demands on the body so there is no one size fits all when it comes to prevention. A key factor to consider is the part of the body which is being used and what role proper preparation for exercise can have on your ability to do it for longer periods without experiencing discomfort.

Warming up muscles before exercise can seem time consuming but the role of proper warm ups cannot be overstated, especially in cold weather or if you have had previous muscle injuries. It serves many benefits including increasing circulation around the body and ensuring that the muscles themselves are not under as much strain when you do start exercising.

If you are looking to discuss what specific exercises and warm-ups would be good to do in order to avoid injuries in different sports, you can always email me at admin@first4therapy.com and I will be happy to help.

Running is usually a popular choice in January – there is nothing better than putting on a pair of trainers and hitting the road on a crisp winter’s morning. It is also a leading cause of small-scale aches and pains for this very reason.

What is Plantar Fasciitis?

(Planta – Fash-ee-ahy-tis) usually presents as heel pain sometimes radiating to the arch of the foot. Studies have found that reduced calf flexibility as well as foot muscle weakness correlates with plantar fasciitis.

To avoid this all too common pain – first, make sure you have the correct footwear when you go exercising. This doesn’t mean going to buy the most expensive trainers on the market, but make sure they are light, comfortable, the right size and done up correctly to support your feet (not too tight though!).

You should also be aware that flat feet/ high arched feet are more predisposed to Plantar Fasciitis.

Exercises You Can Do At Home

There are some simple and fun exercises you can do to strengthen the small muscles of the foot. This should help you prevent common injuries such as Plantar Fasciitis and make sure you can go for longer without sustaining any uneccessary aches and pains.

1. Begin by sitting and scrunch a towel with both feet.

Progress to standing scrunches with both feet, then to scrunches standing on one foot. 

Sets of 10 reps.

2. Pick up a small object – for example a cotton ball – with one foot and place it into a small cup on the floor.

Begin in sitting and progress to standing – sets of 10 reps.

Aim to do these exercises x 3 times per week, this will mean you stand a much better chance of avoiding Plantar Fasciitis.

Runner’s World shops also do a slow motion video assessment of your feet whilst running, assess abnormalities and suggest footwear.

Find out more about this here: http://www.runnersworld.ltd.uk/acatalog/Gait-Analysis

Alternatively it may be a good idea to see a musculoskeletal podiatrist and have your feet assessed for insoles. This is a great way to make sure that you can keep up a sustainable exercise regime which will provide the long term benefits you are looking for.

admin

30/Mar/2020

The Coronavirus epidemic is closing in. We are all practising social distancing, hand washing, wearing masks and gloves. What else can we do to prepare ourselves?

We can improve our health before an anticipated massive stress to the body so that it can deal with it better.

This is not a new concept, it was used by the British Army during WWII in order to be able to enlist as many soldiers as possible.

How do we prepare ourselves, just in case?

Physical conditioning and exercise build muscle mass and improve heart and lung function.

Eating a protein rich diet, breathing exercises and psychological strengthening improve nutrition and mental health. We keep hearing about underlying health issues causing complications. These can be diabetes (so keeping a tight control on it becomes important) and giving up or at least reducing smoking does too.

Exercise

Not becoming a couch potato is important. We can watch all the box sets and netflix series we like but we must keep moving. Jogging on the spot, dancing to music, short bursts of high intensity exercise are all good. Use cans of food instead of weights and do a few arm raises. Use a sock filled with gravel and tie it around your legs as a weight… there are lots of imaginative ways to make weights and of course, you can always use Amazon.

Breathing Exercises

These involve taking a deep breath and holding it for a few seconds before breathing out. In order to expand the upper lobes of your lungs, place your hands on either side of your chest, in the front just beneath your collar bones, for the middle lobes place them at the level of your arm pits and for the lower lobes place them at the level of your diaphragm.

Mental well-being

I’m not qualified to talk about psychological wellbeing but I’ve compiled a small list of free apps for mental well being like Elefriends, Silvercloud, Catch it, Stay Alive, SAM from MIND charity. Take a look at them and see what you like.

Free Video Consultation from First4Therapy

With a view to helping people stay fit in my area, I am offering to do telephone and video consultations for free for those that are not insured. The major insurance companies are paying for video consultations. I will assess you and provide a plan of self- management including simple ways to relieve pain and exercises to deal with the problem.

Please ring 01277 841118 or e-mail admin@first4therapy.com for more details.

Vinita Sood

06/Mar/2019

You are not alone! Almost 80% of adults have suffered it at some point. Most of the time it is short term and lasts for a few days to a few weeks.

So what should you do if you have an acute episode ? Treatments have changed drastically over the past 30 years that I have been practising as a physiotherapist- Bed rest and traction was the norm for treating low back pain in the past.

But now, keeping active is the new mantra! Treat your back like you would an acutely sprained ankle- keep moving but gingerly avoid too much of any movement that hurts.
Take painkillers like Paracetamol- they don’t speed up your recovery but combined with activity will help a return to normal movement. Over the counter Ibuprofen, an anti-inflammatory also helps but you must check with your pharmacist to rule out any contra-indications to taking it.

Hot or Cold – what is best ?

Some people prefer cold packs in the acute stage- never applied directly but with a wet flannel between the ice and the body – this helps in the first 2- 3 days to reduce inflammation. You can apply it for 20 minutes at a time 2 to 3 times a day. Cold packs work better if you have nerve pain or sciatica.

If you have a lot of muscle spasm then you will find that heat helps to relax your muscles and if there is underlying wear and tear of the spinal joints, heat will improve local circulation and be more effective. Moist heat works better than dry heat but heat patches can be kept on for long periods and have been found to be effective.

I’m going to do a series of posts on low back pain. Feel free to ask questions and I will try and answer them to the best of my ability

admin

15/Jun/2018

Dealing with pain and arthritis everyday can wear you down, and have a major impact on your life.

We want to show you that you don’t have to live life this way!

Our Chief Physiotherapist, Vinita Sood, will explore:

What is arthritis?
Better ways of coping with it to make your life easier
Exercise, diet, and joint protection, so you can live life to the full again

Join us at

10.30am – 12.30pm | Sunday 1st July 2018

The Reading Rooms
73 High St, Billericay
CM12 9AS

Whether you want to learn more to improve the quality of your own life, or find out more to help your family or friends, we’d love to see you there!

The event is free to attend and places are limited.

To book your place call First 4 Therapy on 01277 841118.

We look forward to seeing you!

admin

14/Jun/2018

A new study published in Frontiers in Neuroscience has shown that one surprising way to maintain good neurological health is through exercising your legs, as the signals sent by leg muscles to the brain are equally as important as the directives from the brain to the muscles themselves.The new research which provides a new look for scientists into the nervous health system and the brain also potentially provides an explanation for a decline in some patients with diseases such as motor neuron disease, multiple sclerosis and spinal muscular atrophy.

Dr. Raffaella Adami from the Università degli Studi di Milano, Italy said: “Our study supports the notion that people who are unable to do load-bearing exercises — such as patients who are bed-ridden, or even astronauts on extended travel — not only lose muscle mass, but their body chemistry is altered at the cellular level and even their nervous system is adversely impacted.”

The study was conducted using mice and restricting their hind-leg use over 28 days. While the mice continued to eat, groom and did not demonstrate signs of stress, at the trials end a study of a section of their brain responsible in many mammals for maintaining nerve cell health showed a decline in stem cells of 70%. This was compared to a control group of mice without any leg restrictions that did not experience this decrease.

The research showed that exercising the legs, especially through weight-building exercises send vital signs to the brain which aid the production of healthy neural cells and are essential for the nervous system and brain. Adami says: “It is no accident that we are meant to be active: to walk, run, crouch to sit, and use our leg muscles to lift things,” adding that “Neurological health is not a one-way street with the brain telling the muscles ‘lift,’ ‘walk,’ and so on.”

Additional research was done on individual cells which gave evidence that reducing exercise in this manner lowers oxygen in the body which affects metabolism and creates an anaerobic environment. This also seems to have an impact on two specific genes genes,with one, CDK5Rap1, being important for the health of mitochondria which release energy for the body to use. This information provides insight on other health issues such as cardio-vascular problems related to having a sedentary lifestyle and other conditions such as motor neuron disease.

The studies co-author, Dr. Daniele Bottai, also from the Università degli Studi di Milano said of these findings: “I have been interested in neurological diseases since 2004…”The question I asked myself was: is the outcome of these diseases due exclusively to the lesions that form on the spinal cord in the case of spinal cord injury and genetic mutation in the case of SMA, or is the lower capacity for movement the critical factor that exacerbates the disease?”

As well as providing more information for the general population on the benefits of leg exercise, there are also positive implications for astronauts who may be in space for months or years and experience the effect of gravity on exercising. Dr. Bottai concluded: “One could say our health is grounded on Earth in ways we are just beginning to understand.”

Always consult your physician before beginning any diet or exercise programme. This general information is not intended to diagnose any medical conditions or to replace your healthcare professional.

You should always consult with a GP, doctor, or other healthcare professional before embarking upon any diet, exercise, or supplementation programme, before taking any medical or nutritional supplement, or if you suspect you may have a health issue.

admin

13/Jun/2018

One of the most common health issues that people worry about increasingly as they age is having high blood pressure, with more than one in four UK adults falling into the high blood pressure bracket.Also known as hypertension, the condition places strain upon your blood vessels and organs such as the eyes, kidneys and brain, while long-term high blood pressure can increase your risk of heart disease, heart attacks or having a stroke.

So how can you reduce your risk of developing high blood pressure or minimise your current pressure?

One nutritionist believes he may have found a solution through eating more celery. Dr. Josh Axe claims that one of the many purported health benefits of the cheap vegetable is its ability to reduce inflammation through anti-hypertensive properties found within the seeds.

He said: “They contain hexanic, methanolic and aqueous-ethanolic extracts that improve circulation, lower inflammation and help control blood pressure. It’s believed that celery helps lower high blood pressure by acting as a smooth muscle relaxant and improving the flow of calcium and potassium into and out of cells,” and added that celery extract “helps blood vessels expand and contract, improve blood flow, and aid in overall heart health.”

His beliefs were supported by a study published in the Journal of Medicinal Food in which a group of rats were given celery seed extract over a seven week period. The results of the trial showed significant improvements in the blood pressure of the rats given the extract when compared with a second group fed the same diet minus the extract.

In addition to these heart healthy benefits, increasing your celery intake will boost your body in a variety of ways. Celery is packed full of anti-oxidants, is nutrient dense despite being very low in calories and can even help tackle urinary tract problems by helping to reduce uric acid and stimulate urine production.

First4Therapy

Understanding Sciatica: How Physiotherapy Can Help

Understanding Headaches: How Physiotherapy Can Help

Injury Prevention: The Achilles Tendon & Calf Muscles

One of the more common types of injuries faced by runners and those who exercise primarily on their feet affect the Achilles Tendon at the back of the leg.

Did You Know?

What is Achilles Tendinopathy?

What is Tibialis Posterior Tendinopathy?

What is Peroneal Tendinopathy?

How can you prevent these injuries?

About the Calf Muscles

Exercises You Can Do At Home

Making New Year Exercise Resolutions Sustainable

Getting fit and losing weight are usually high on the list of New Year’s resolutions.

While exercising to get fit is fantastic, it should not be a cause for injury!

As a Physiotherapist I would always say that an ounce of prevention is worth a pound of cure. The last thing I want is for anybody to find themselves in pain when they could have simply avoided it.

Avoiding Common Sports Injuries

What is Plantar Fasciitis?

Exercises You Can Do At Home

Prepare for COVID-19 with First4Therapy

How do we prepare ourselves, just in case?

Exercise

Breathing Exercises

Mental well-being

Free Video Consultation from First4Therapy

Suffering from Low Back Pain?

Hot or Cold – what is best ?

Join us for our next event: Managing Arthritis

Leg Exercises May Improve Your Brain and Nervous System Health

Could Celery Help High Blood Pressure?

Understanding Sciatica: How Physiotherapy Can Help

Understanding Headaches: How Physiotherapy Can Help

Injury Prevention: The Achilles Tendon & Calf Muscles

Making New Year Exercise Resolutions Sustainable

Prepare for COVID-19 with First4Therapy

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