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Melanie Potgieter on Physiotherapy

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How can physiotherapy help with everything from sports injuries to back pain and mastitis? Melanie Potgieter of Island Health Family Practice explains.

What does physiotherapy involve?

There are a wide range of techniques, ranging from manual mobilisation of the joints, massage, stretching, and exercising with Pilates or weights to electrotherapy. Some therapists also make use of dry needling or acupuncture to help with muscle release.

Is it all about rehabilitation?

Physiotherapists help patients with neurological problems either caused by disease, strokes or trauma, teaching them to move normally. We use chest physiotherapy on patients with severe chest ailments or lung congestion. This type of physiotherapy is also used with patients on ventilators who are unable to cough by themselves. Physiotherapy helps geriatric patients keep fit and strong, and can assist children with development delay. It teaches pregnant women how to regain abdominal strength, helping to relieve any pain caused during and after pregnancy. It can also help with post-natal mastitis and stress incontinency.

Which ailments do you most commonly treat?

Physiotherapy is used to get movement back after bone fractures, joint replacements, sprains, dislocations of the joints and after surgery. We see a lot of musculoskeletal problems, particularly backache. A sedentary lifestyle in front of the desk or computer for long hours without stretching or strengthening the back and abdominal muscles results in back pain, as does carrying heavy shopping, laptops and children’s pushchairs up and down stairs. Physiotherapy is often used to rehabilitate patients who have had sport or spinal injuries, like torn or sprained muscles.

How can we relieve post-exercise muscle pain at home?

Pain after exercise is mostly caused by micro-trauma in the muscles. By having a cold bath or using an ice pack, you stop all the secondary inflammation by constricting the blood vessels, and limiting the collection of waste products in the muscles. Ice is best used immediately after exercise or trauma – for 24 to 72 hours. If there is any swelling or inflammation, or if a joint is painful continue icing.

And what if the muscles have gone into spasm?

In this case it is better to use heat – electric heat packs or hot-water bottles. Heat helps to increase the circulation and it also relaxes the muscles. Back pain is generally caused by muscle spasm, so usually heat treatment is beneficial. Alternating heat and cold (in the form of ‘contrast baths’) works well as it increases circulation to body parts that have circulatory problems or to areas of swelling.

How can Pilates help with sports injuries?

Pilates focuses on muscle stability and body balance. It can be especially helpful with back, shoulder and hip injuries. Strengthening inner core muscles helps the body work more efficiently. When the body tries to compensate for muscle imbalance, energy is often lost. With the lower back, abdominal and gut muscles strengthened, balance is restored. A strengthened core particularly helps distance runners and sprinters by preventing the muscular imbalance which causes injuries from overused muscles.

How important is exercise after an injury?

After any injury your body is very good at compensating so that it can function as normal. Different muscles take over the function of the injured muscle. Once the original injury has healed, the muscles that have been affected need to be strengthen to take over the work once again. If this does not happen, then a chronic imbalance of the muscles can lead to later problems. If joints have been restricted in movement during an injury and they are not exercised, joint contractures may even occur. Muscles and tendons need to be strengthened to prevent re-injury. Light resistance bands make exercises easy to do at home.

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