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‘The Mild Head Injury’ – don’t be misled by the title.

By: Garry Dillon – Physiotherapist

I feel foggy in my brain – I just can’t concentrate like I used to’; ‘I’m so frustrated and this isn’t like me’; ‘These headaches are the worst’. While these experiences could be caused by many things, they are among the most common themes I hear when people describe the impact of a concussion on their everyday life.

Concussion is classified as an acute head injury and occurs when a significant amount of force is experienced through the brain tissue, resulting in a disruption to normal brain function.  Although we are most familiar with it through our passion for sporting endeavours, this type of accident can occur in many different situations and scenarios such as motor vehicle accidents, assault or slips and falls at home. The term ‘mild head injury’ tends to mislead people’s understanding on the potential impact a concussion or recurrent concussions can have on their everyday life.

Each individual experiences a concussion as a ‘unique event’ and does not necessarily have to lose consciousness at the time of injury. Although symptoms post-concussion can be similar, their impact can vary from person to person. Some of the most common symptoms reported post-concussion can include headache, dizziness, nausea, light-sensitivity, fatigue, poor concentration and irritability. This cluster of symptoms can significantly impact on one’s overall wellbeing and ability to engage in work, school and family life.

If you are concerned you may have experienced a concussion, it is important that you first seek medical attention by a qualified professional. The best advice is to get a review with your local GP, who will be able to confirm an accurate diagnosis for you.   Physiotherapists also play a role in post-concussion management and rehabilitation.  Their clinical skills are well-suited to carry out relevant assessments around headaches, balance and dizziness; provide sound management advice around pacing of return to normal activities; whilst closely monitoring and advising on appropriate return to sport guidelines.

Does time heal all wounds?

By: Nicholas Hohepa – Physiotherapist

Time, the great healer, is a key ingredient in recovery for all ailments. We use it for rest, we use it to take a break from the things that may be hindering our recovery, may it be work, sport, or any of a number of activities that we find ourselves needing a break from when we aren’t 100%. As therapists, we find time is a key ingredient in a rehabilitation plan, for tracking the changes we would expect someone to make, and allows us to work alongside your body’s own mechanism’s for healing. This being said however, time is but one of many ingredients required to get you Back In Action, excuse the plug!

Like all ingredients, it needs to be measured and applied in the correct way when you are baking the soufflé of injury recovery.

I see many new people come in 6 weeks or more after an injury, where they have hit a plateau of recovery where the “she’ll be right” method hasn’t quite worked out. I myself have used a bit of “she’ll be right” on a number of occasions, and at times it has served me well, and has I’m sure helped many of you. But in saying that, I have a job because “she’ll be right” only works some of the time.

So when thinking about this, there are a few things to consider regarding if she, will in fact be right:

– Your body is a great healer, your tissues will, to a degree, heal by themselves under the right circumstances

– Your body is a great adapter, if something hurts, you will find a way to work around it, it will learn a new patterns of movement, or ways of doing something

– Your body is not a great re-setter, once you have learned a new pattern, you will generally continue with your adapted pattern

Your body will not in the long run enjoy being out of symmetry. Walking with a 60-40 weight distribution will help for a few days, but a few weeks of this and you will start to feel it. If you do an average of 5000 – 10000 steps a day like this, you are doing 5000 – 10000 of something wrong every day, so your body will get upset. This is where we start to develop a bad side.

So with this in mind, I want you to put your hand up if you have a “good” anything, and if you do, you should know what I mean. This may be your good knee, hip, foot, and if you did follow my instructions before, which I am hoping you did for pure entertainment, you may have your good arm raised right now.

Usually you will have a good, because you had a bad, and you kept a good, because you still have a bad, so let’s go through a typical injury scenario that may result in a good and a bad.

You were stepping out the door onto the deck to head to the BBQ, it’s a new deck, and she’s not quite to code. There’s a bit of step down that you forgot about, and as you stepped down your knee gave way because you were focused on the plate of sausages in your hand. At this point, you have a good and a bad leg. Naturally, you are going to unload this side, it feels more comfortable. You have a sore leg for a few days, perhaps a week, and it starts to get better: your body is healing! You have a bit of a limp, but it is getting better. There are a few things that you usually do, like walking the dog, using the stairs at work, kicking off this side when you play football, but you adapt. This adaptation might be avoiding that hill on your walk; walking with a limp; taking the elevator instead of the steps; or just kicking off your good foot. You have adapted, and at this stage when trying progress back to your normal activities, or way of doing things, you are simply unable. This is a scenario where you have a structure that has healed to a degree, but something is not quite right, and when you start trying to get back into those regular things, your “bad” just says no.

You may be noticing your good leg is playing up a bit too, it has of course been doing more than it’s fair share. Like a good mate, it’s been there for the bad side, but now it has burnt out… And you have gotten the wrong kind of 2 for 1 deal. This is what we call a secondary issue, or even a secondary injury. Your injury is now an onion, and it has layers.

What I would like you to get from this, is understanding when,”she’ll be right” will be right. If you are unsure about what is going on and want to find out what it is, what you can do, and what to expect, we, or another qualified professional can help.

If you have a bad, that is not turning back into a good, we can help.

If you have a good, that is turning into a bad, you need help, and we can help.

Finally if “she’ll be right” is not getting where you need to get to, we can help.

Thanks Katie and welcome Zoe!

It was a busy end to 2016 for Katie Conway completing her studies at Wairarapa College and launching into fulltime employment at Back In Action Masterton.  Katie took it all in her stride though stepping up to the plate until a full-time position was filled.  Katie heads to Wellington to commence a Bachelor of Health studies (Muscular and Neuromuscular Therapy). She will continue to be a familiar face on the front desk filling in in holiday periods.

In Early January we appointed Zoe Dodd as full time receptionist at our Masterton clinic at The Hubb.
Zoe is originally from the Wairarapa and has most recently been working in Queenstown. We’re thrilled to have Zoe on the team and look forward to you all meeting her.

The case for sport: Low impact for life.

By: Ryan Monastra (Senior Physiotherapist/ Director)

A recent British study of more than 80,000 adults concluded that participation in specific sports may keep us alive longer and have a positive impact on public health. The study showed that participation in swimming, cycling, racquet sports and aerobics lowered death rates from all causes, while lowering cardiovascular mortality was observed more in swimming, racquet sports and aerobics. While I’m not going to jump up and down about the specifics, the trend I’m seeing in this (and other literature in the field more recently) is a tilt towards low impact exercise as beneficial. This study found no long term reduction in death rates for running or football. Which is gutting for me as someone who enjoys running and has been actively encouraging my kids towards football.

There’s probably lots of reasons why we see this. But here’s one that I think shines a light on a possible reason for the study findings… Any idea what sports carry the highest injury risk? The general rule is: the higher the impact, the higher the risk. I’d argue that the reason these studies are finding the benefits in lower impact sports like cycling and swimming is because the injury rates in these sports are generally low, and even when injured, in most cases people can still participate. (As an aside, while cycling injury rates are low the severity of those injuries is often high – when you come off at high speed there’s a LOT of impact!) When it comes to long term health benefits, it would appear that consistency is critical. As the Mainland ad’s suggest “good things, take time” and the good to be found in sports is good at a physical level, and a social level and at a psychological level, but it does take time. A flash in the pan 6 week course won’t cut it I’m afraid. So if you’ve made it a resolution to move more and be more active in 2017, make sure your chosen activities are within a range that’s doable for you in the long term. Cheers to your good health!