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    topical.jpg
    Lisa Bywaters
    10/Aug/2022
    Health InformationMSK articles

    Therein lies the rub… topical pain relievers

    Creams, sprays, liniments, ointments, patches, rubs & gels

    If you open most medicine cabinets or bathroom cupboards, you’ll more than likely find a tube or jar of a pain-relieving rub. With varying degrees of smelliness!!😱

    Many of us turn to these products when we wake up with a stiff neck or overdo it in the garden. The soothing ointments, creams, sprays, liniments, patches, rubs and gels that we apply directly to our skin (topically).

    But what are they? How do they work? Are they effective? And are they safe?

    First, there’s a vast array of topical products available in many forms and using different ingredients. Many are available to buy over-the-counter from your chemist or supermarket. However, some require a prescription.

    Let’s look at some of the more common varieties.

    Counterirritants

    These products use ingredients such as menthol, methyl salicylate, eucalyptus oil and camphor. They’re called counterirritants because they create a burning, cooling or ‘tingling’ sensation in the area where they’re applied that distracts you from your pain.

    Medicated products

    Many topical products contain non-steroidal anti-inflammatory drugs (or NSAIDs) such as ibuprofen, diclofenac or piroxicam. NSAIDs block the action of specific enzymes (cyclooxygenase or COX) that are involved in inflammation.

    Topical NSAIDs may be an option for you if you can’t take oral NSAIDs due to other health issues (e.g. high blood pressure) or the risk of complications (e.g. stomach problems), as less medication is absorbed into the bloodstream.

    If you’re using a topical NSAID, you should avoid taking NSAIDs orally (pills or tablets) unless you’ve discussed this with your doctor. Although the amount of medicine that enters your body through the skin is less than when taking them orally, there’s still the risk of getting too much when using both forms.

    Corticosteroids, or steroids, simulate the naturally occurring hormone cortisol. One of the many functions of cortisol is to suppress or reduce inflammation. Steroid creams come in varying strengths. They rarely have serious side effects if used correctly, so it’s essential that you follow the instructions carefully. If you have any concerns, discuss these with your doctor or pharmacist.

    Capsaicin

    Capsaicin is the substance found in chilli peppers that gives them their heat and spicy kick, making your mouth tingle and burn. Applied to the skin as a cream, it works by interfering with the pain signals between your nerve endings and brain.

    Benefits of using topicals

    Most topicals, when used correctly, provide quick, temporary pain relief and have fewer potential side effects than oral pain-relieving medicines.

    They may be a good option if you only have pain in a few joints or muscles, as they work in the immediate area you apply it to, rather than affecting your whole body.

    Topicals also provide the soothing benefit of a mini-massage when you apply them to your skin. Seriously, how good does it feel when you rub the cream into your sore neck, and you feel the muscles loosening? Or when you apply a warm gel to your stiff, aching knee? Bliss. 😊

    Another benefit of topicals is that they’re very portable; you can have some at home, in your drawer at work, in your handbag or gym locker, and use them as needed.

    Do they work?

    Many people swear by these products for quick pain relief. And there’s solid evidence that they can provide pain relief for acute pain, such as strains and sprains. However, research shows only modest benefits for chronic pain. But, if you feel better when using these products, and you’ve discussed it with your doctor, they’re safe to use and are better tolerated than oral medicines.

    Potential side effects

    Topicals, both medicated and non-medicated varieties, can cause side effects. They include skin irritation, redness, rash, or a burning, stinging or itchy sensation in the area it’s been applied.

    Very rarely, some people may experience nausea, breathlessness, indigestion or an allergic reaction to the topical. If you experience any of these symptoms, stop using the topical and talk with your doctor or pharmacist for advice.

    Cautions

    As with any medication, there are things you need to be aware of to prevent any problems from occurring:

    • Taking oral and topical medicines containing the same ingredients (e.g. NSAIDs) at the same time may increase the risk of side effects. Talk with your doctor about this risk.
    • Always read the consumer medicine information carefully and follow the instructions. Take note of how to apply the topical, how often and how much. Don’t go overboard and slather it on. You can get too much of a good thing!!
    • Wash your hands thoroughly after applying.
    • Be careful to avoid contact with your eyes or other sensitive areas 😖.
    • Don’t use these products on wounds or damaged skin.
    • Don’t use with heat packs as this may cause burns.
    • Only use one topical medicine at a time.
    • Check the use-by-date and discard any out-of-date products.

    Contact our free national Help Line

    Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

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    happy.jpg
    Lisa Bywaters
    21/Jul/2022
    MSK articles

    Embracing happiness

    COVID numbers are up and masks are back. The stupid virus and its many variants just keep on giving 😥.

    We’ve dealt with isolations, lockdowns, and massive life changes in the past few years. We’ve made sourdough bread, completed countless jigsaws, consumed gallons of quarantinis (or was that just me? 😉🍸) and given online yoga a go.

    But now what? Yoga has become a source of calm and relaxation, but we’re sick of sourdough, can’t bear to see another jigsaw, and for the sake of our livers, we’ve moved on to non-alcoholic mocktails (again, maybe just me? 🍹).

    It’s time to cast aside the things that make us unhappy or trigger feelings of lockdown anxiety. It’s time to embrace the things we love, that make us fulfilled and satisfied. The things that feed our curiosity and creativity. And the things that support self-care.

    Here are some simple things you can add to your routine to boost your happiness. Hopefully, one or two of them will strike a chord with you 😊.

    Give thanks

    Sometimes we can be consumed with what we don’t have or what others have… money, good health, the latest gadget, a great job, travel opportunities… Unfortunately, all this does is create feelings of envy or dissatisfaction – and that’s no way to live.

    When I find these feelings creeping in, I stop myself. I think of three things I love about my life and make me grateful for the life I’m living. And there’s so much to choose from! My partner, the absolute love of my life 😍. Having a nice place to live in the green outer suburbs. A fabulous collection of shoes that I’m rediscovering after years of lockdown slippers and runners 😁 Psychotic balls of fluff (aka two cats) that rule my home and make me laugh. The fact that I live in a country where I can attend a non-violent protest for women’s rights. The chilli plant I bought as a small seedling that now produces deliciously hot chillies 🌶🌶 A library within walking distance. Without even breaking a sweat, that’s seven things I could list in a few short minutes!

    We have lots to be thankful for in our lives – we just need to take a moment to think about and value them.

    Learn new things

    Nerd alert! For me, there’s nothing like watching a documentary, learning a new skill, attending a webinar/seminar/class, reading an article or talking with someone with unique experiences and knowledge. It always inspires me to discover more and delve deeper into a subject.

    Learning new things challenges us and fires our curiosity and imagination. And that’s not only good for our mental health and satisfaction with life in general, but it’s also excellent for our brain health. I’m currently messing around with learning to play the guitar. I’m not sure if you could call the sound I create music, but it’s a lot of fun! If there’s something you’ve been wanting to learn, don’t put it off any longer. Book that class, take that online course, speak with people in the know – you won’t be disappointed!

    Enjoy the company of friends and family

    Seeing our important people face-to-face is all the sweeter when we remember the restrictions we endured in 2020 and 2021. It’s hard to imagine that there were periods when we could only connect via phone or video. So cherish the time you have together.

    Do things for others

    I find being useful and helping others a rewarding experience.

    It doesn’t matter if it’s something small, e.g. letting a car into traffic in front of me, or something big, e.g. helping an aunt move into a retirement village, then out of a retirement village, and later relocate 500 kilometres away in the space of 18 months (true story 😝). To me, if it helps make someone’s life a little easier, it’s worth it.

    There are many ways you can help out or do things for others, including volunteer work, mowing your neighbour’s nature strip, being kind to your barista, cooking a meal for a sick friend. Whatever you do, you’re sure to feel warm and fuzzy inside, and make your corner of the world that much brighter.

    Laugh

    Having a good laugh, chuckle or giggle is the best 😂😆🤣. Everything seems so much better, you feel happier, and you can’t wait to do it again.

    Laughter releases the ‘feel-good’ hormones – endorphins, serotonin and dopamine. They boost your mood and make you feel more positive. And endorphins are your body’s natural pain reliever and can reduce your feelings of pain. Yay!

    So next time you feel a little down, or you’re in pain, watch funny cat/dog/panda videos (I’ve heard there are a couple on the internet 😉), talk with a friend about a silly experience you had together, watch a comedy, listen to an entertaining podcast. Do whatever makes you laugh and enjoy those happy vibes.

    Get out into nature

    Whether it’s the local park, a walk on the beach or bushwalking through the hills, just getting out into nature makes me feel happy 🍁🍂. We’re surrounded by so much beauty.

    When you head outdoors, keep your phone in your pocket and look around. Listen to the birds in the trees, notice how the trees sway in the wind, enjoy the dogs playing in the park, and appreciate the scenery around you. Take the time to pay attention and be mindful, and you’ll immediately feel a boost in your mood.

    Discover new places

    This often goes hand in hand with the previous one. And it’s something that kept me sane during lockdowns. I’d look at maps of my local area and the radius in which I was allowed to travel. I’d then look for all the green spaces – and it’s amazing how many parks, reserves, playgrounds, and abandoned golf courses I could find. When I visited them, I’d discover new, interesting things – a pretty creek alongside the path, a group of goats brought in to deal with the weeds, a flock of cockies gathered in a tree throwing seedpods at the people walking below 😆. Discovering new places brings out the intrepid explorer in me and I feel like I’m seeing so much more of the world.

    Stay active

    Activities that exercise your body and mind in challenging, new ways are great for your physical, mental and emotional wellbeing. And choosing activities that you enjoy will ensure you do them regularly.

    For example, I’ve recently rejoined the gym because my strength and stamina have declined due to my sedentary COVID life. So I’m combining my usual walking and hiking with strength training, yoga and Pilates to increase my fitness, take some weight off my joints and help me sleep better. It’s early days, but I’ve already noticed a difference.

    Like millions of others, I’ve also been enjoying the daily mental challenge of Wordle. It stimulates the brain and provides social competitiveness as we compare our wins and losses 😃. And I’m trying to learn to do cryptic crossword puzzles, though that’s proving more difficult!

    The important thing is that I’m engaging both body and mind in demanding activities. They’re pushing me out of my comfortable status quo and making me grow.

    Hug your people

    Physical distancing and being unable to get close to others for fear of germs is a lonely experience. And it can leave us feeling sad at the lack of closeness. So the people I can touch, I touch a lot! Not in a creepy, unwelcome way 😄 but in a caring, loving way.

    Being able to touch or hug others reduces stress, anxiety, and depression and makes us feel good. And here’s a tip from me to you: don’t save your hugs for when you’re feeling down. Hug each other when you feel happy, excited, or just because it’s Thursday.

    Clean and declutter

    Ooh, I did a lot of this during the first few lockdowns. And I know many of you did the same. Op shops were bursting at the seams with our discarded books, clothes, jigsaws and appliances. There’s nothing like decluttering and cleaning your home and work spaces to make you feel satisfied and in control. And your new tidy rooms will hopefully have the added benefits of preventing falls as trip hazards are moved or given away. Just be careful while doing your big clean not to overdo it physically. Take your time and pace yourself.

    Try new recipes and new ingredients

    Full disclosure, I’m a terrible cook. But I’ve been trying a new recipe and/or ingredient at least once a week. It gets me out of my ‘Tuesday night stir-fry’ rut. It helps to have tasty recipes from our talented volunteers, Lauren and Kitty. I’m also blessed that my partner is a great cook and has introduced me to spices and condiments I’ve never used before. There have been many, many disasters in the kitchen (and a trip to the hospital for a deep cut from slicing capsicums 😫), but there have also been successes. And that’s incredibly satisfying.

    Acknowledge it’s been hard

    So far, the things I’ve listed have been light and happy. But we should acknowledge that there have been dark, traumatic times without fun, joy or happiness. There have been tears, arguments, and moments of intense anxiety and stress. And before this pandemic is done, we’ll likely experience more of these moments. So it’s important to remember that we’re not going through this alone. We have people who love and care for us. We also have access to professional support if we need it to get through. We just need to ask.

    The COVID-19 pandemic will pass. It’ll take some more time, but we can adapt. We’ve been doing it for years, and even though we’re weary, we can continue to do it. And finding the things that make you feel happy, strong, and in control of your world will help you get through.

    Contact our free national Help Line

    Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    Contact Lifeline Australia

    13 11 14 for 24 hour crisis support and suicide prevention.

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    self-care-tips.jpg
    Lisa Bywaters
    21/Jul/2022
    Health InformationMSK articles

    Self-care tips

    Looking for ways to put more ‘care’ into your self-care game? We’ve got 21 tips to help you!

    1. There’s no perfect or right way to practise self-care

    The first tip, and I can’t stress this enough, is there’s no perfect or right way to practise self-care. Sure, we can talk about the International Self-Care Foundation’s seven pillars, and we can push exercise, healthy eating and hand washing until the cows come home 🐄 🐄 🐄. But, if those things don’t resonate with you, or you have other pressing issues vying for your attention (e.g. dealing with a case of painsomnia), you’re not going to care about our messaging on those topics. Or, at least not at the moment.

    2. Choose your own adventure

    This leads us to tip number two. Self-care is like a ‘choose your own adventure’ story. It’s unique to you, your life, your specific set of circumstances and your choices.

    3. Create your toolbox

    Knowing the basic elements or tools of self-care (see the seven pillars) means you can choose what you need to help you manage at specific times. It’s like having a trusty toolbox filled to the brim with info about exercise, smoking cessation, healthy recipes, pain management strategies, guided imagery scripts and massage oil. You can pick and choose what you want or need. The key is knowing what’s available and how they can help you.

    So far, we’ve been talking broadly about self-care. Now let’s look at some more specific tips our consumers and staff recommend.

    4. Drink water

    It lubricates and cushions your joints, aids digestion, prevents constipation, keeps your temperature normal and helps maintain your blood pressure. The amount of water you need varies from person to person and from day to day. There’s no ‘one size fits all’, but “as a general rule, men need about 10 cups of fluids every day and women need about 8 cups (add another cup a day if you are pregnant or breastfeeding)”. (1)

    5. Plan your menu

    You can take a lot of the stress out of your day if you sit and plan your week’s meals and snacks. Check what ingredients you have in your pantry, fridge and freezer, work out what you need to buy, and write it all down. Then all you hopefully need is one trip to the shops, and you’re sorted! No more – ‘what’s for dinner’ angst. 😐 Eatforhealth.gov.au has some info on meal planning and sample plans for men, women and children.

    6. Get excited about exercise

    Mix up your exercise routine with something fun and enjoyable to get you out of your exercise rut. Try Zumba, cardio, low-impact exercises, tennis, dancing, skipping, cycling, or trampolining. Head to your local fitness centre or gym, try an online class or download an app like Get Active Victoria. There’s something for everyone!

    7. Just breathe

    Our breathing can become shallow when we feel stressed, anxious, upset or in pain. This, in turn, can elevate blood pressure and increase the heart rate. It can also cause more tension. When you notice this happening, take some time to decompress. Relax your body. Focus on your breathing. Slowly take a deep breath in. Fill your lungs to a capacity that’s comfortable for you. Then slowly release this breath. Don’t release it in a sudden exhale, but control it, so it’s slow and smooth. Continue this deep breathing, and you’ll feel your muscles relax, and your mind calm.

    8. Write it down

    Write about the things that make you happy and grateful. Write about the things that went well in your day.

    And write about the bad things. Not so you’ll continue to obsess about them, but so you can process your feelings and actions. This reflection allows you to devise strategies to prevent the bad thing from happening again, or ways to handle it differently in the future.

    9. Fill your home with plants

    Bring the outdoors in and enjoy the health benefits. Having plants in your indoor spaces can help relieve stress, improve mood, lower blood pressure and improve air quality. Just be sure to check that they’re not toxic for you, your family or your furry housemates. 🌼

    10. Have a regular date night

    Whether with your significant other or a bestie, having a regular date night scheduled gives you something to look forward to. It also means there’s less chance that other commitments get in the way of you spending dedicated time with that person, which is essential for nurturing your relationship. 🧡💚💛

    11. Say no

    We all want to please others, so saying no can be challenging. But you need to weigh up everything you have going on and decide whether you can take on something else. If you can’t, then say no. And don’t feel you have to apologise for doing so.

    12. Discover new places

    Embrace your inner adventurer and explore new places. Far or near – it doesn’t matter. The point is to get out in the world and experience new sights, sounds, smells and tastes. Immerse yourself in new experiences.

    13. Listen to music

    Music is a powerful force we often don’t think about – or at least not too deeply. It’s always there, often in the background. But music can improve your mood, help you focus, get motivated and even ease your pain. Find out more about the power of music.

    14. Pat your pets

    Spending time with your pets is a wonderful tonic. It can decrease blood pressure, reduce feelings of loneliness, reduce stress, improve your mood and increase opportunities for exercise and outdoor activities. And they’re so much fun! 🐶😺

    15. Get tidy and organised

    Nothing can make you frazzled faster than not being able to find that ‘thing’ you’re looking for. So taking time to put things away in their place after you’ve used them, or reorganising your cupboard/pantry/child’s room, so that things are orderly and easy to find can bring a lot of calm to your life. The level of order you want to achieve is up to you. Although there are MANY social posts about the perfectly organised home, don’t fall down that rabbit hole. All you need to achieve is a space that makes you feel good and suits your lifestyle.

    16. Eat mindfully

    How often have you eaten dinner but can’t remember what it tasted like because you were watching TV? Or wondered how on earth you ate a whole packet of potato chips while scrolling through Insta? If this sounds familiar, try some mindfulness. You may have tried mindfulness meditation, but you can also be mindful when you do other activities, like eating. It simply means that you focus on the moment and the activity without being distracted. So when you’re eating, really take time to focus on the textures, smells and flavours and how the food makes you feel.

    17. Get your meds sorted

    Medicines are an important part of our self-care, but it’s easy to miss doses, get them mixed up with others meds or take them at the wrong time. So have a chat with your pharmacist. Ask questions about your medicines and supplements, so you’re fully informed about each one.

    Many pharmacies have apps you can download that alert you when you need a new script, or you can download the MedicineWise app from NPS. If you take lots of medicines, or you find it hard to keep track of whether you’ve taken them or not, consider using a pill dispenser. You can buy one and fill it yourself, or your pharmacist can do this for you.

    18. Listen to your body

    Living with a chronic condition means that you need to be self-aware of how you’re feeling. If you’re exhausted, rest. If your back’s stiff, move. If you’re feeling sluggish, get some fresh air. If you’re feeling full, stop eating. Whatever your body is telling you, listen and take action.

    19. Treat yourself

    Many self-care posts we see on socials are very much of the ‘treat yo’ self’ variety. Going to a day spa, enjoying decadent foods, doing some online shopping, getting a pedicure, binging a favourite TV series, or travelling to exotic places. And why not? Why not indulge in pleasurable things that make you happy every now and again? As long as you’re not overindulging, overspending or overeating. Find the right balance and treat yourself. 😍

    20. Stand up

    We spend so much of our time sitting. In the car, on the couch, at the office, in waiting rooms. But we know that too much sitting can be bad for our health. It increases the risk of developing heart disease, type 2 diabetes and some forms of cancer. It also makes us feel tired, and our muscles and joints become stiff and sore from inactivity. So stand up and move regularly. Set alerts on your phone to remind you. Or download the Baker Heart and Diabetes Institute Rise & Recharge app, which helps reduce sitting time and encourages regular movement.

    21. Play

    We loved to play when we were kids. Chasing each other, making up games, not overthinking things and just having fun. But as adults, we become too busy for play. Or we feel silly or self-conscious about how we might appear when we play. But playing is fun! It helps us forget about our work and commitments. It lets us be in the moment and let our inhibitions go. Play relieves stress and allows us to be creative and imaginative. So rediscover playing – with your kids, pets, partner, and friends. Let your inner child loose, play and have fun! Rediscover chasey (the dogs love that one), play hide and seek, build a blanket fort in your lounge, throw a Frisbee, play charades, the floor is lava, or a video game tournament. There are no rules – just have fun!

    Contact our free national Help Line

    Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

    Reference

    (1) Drinking water and your health, Healthdirect

    CONTINUE READING
    Yoga.jpg
    Lisa Bywaters
    07/Jul/2022
    Health InformationMSK articles

    Low-impact cardio exercises to get you moving

    Pilates, yoga, and tai chi

    How’s your exercise routine going? Are you doing the amount of activity recommended in the Australian physical activity and exercise guidelines?

    As a reminder, the guidelines say that adults should be active most days, preferably every day.

    Each week, adults should do either:

    • 2.5 to 5 hours of moderate-intensity physical activity – e.g. a brisk walk, golf, mowing the lawn or swimming
    • 1.25 to 2.5 hours of vigorous-intensity physical activity – e.g. jogging, aerobics, fast cycling, soccer or netball
    • an equivalent combination of moderate and vigorous activities.(1)

    I know I’m meeting these recommendations, but like me, are you finding that exercise has become a little dull? Has your exercise routine been reduced (because of COVID fears and restrictions 😷) to simply walking? Lots and lots of walking 🚶 🚶 🚶?

    Although I love a good walk, it isn’t working my body as much as it needs to be worked for optimal health and wellbeing. So while I’ll continue doing it, it’s time to add something new … something that will also improve my fitness, stamina, balance and flexibility.

    And now’s the perfect time. Even though it’s cold and wintery, many of these exercises can be done indoors, where it’s cosy and warm.

    Before we go any further, what are low-impact cardio exercises?

    Simply put, low-impact exercises or activities are easy on your joints. They put little or no impact on them – hence ‘low-impact’. Examples include swimming, cycling, tai chi and yoga. While doing these exercises, you’re putting minimal stress, weight, or pressure on your joints.

    Compare these activities to more intense ones such as running, basketball or tennis. They aren’t low-impact because your joints are being jarred or impacted by the activity. For example, your hips, knees and feet feel the impact when you run, and your arm, shoulder and wrist feel the jarring as your return a tennis volley.

    The ‘cardio’ aspect means that while you’re being kind to your joints, you’re still getting a workout. Cardio exercises increase your heart rate and improve the health of your heart and lungs (or your cardiovascular system).

    What are the benefits of low-impact cardio exercises?

    These exercises allow you to stretch and strengthen your muscles without putting your joints through too much stress. They’re also a great place to start if you’re a beginner, haven’t exercised in a while, or you’re recovering from an injury.

    Low-impact exercises can also improve flexibility, mobility and help relieve joint pain and stiffness. Because you’re getting a solid workout, the exercise builds endurance and stamina, aids weight loss, helps reduce your risk of other health problems (e.g. diabetes) and can improve your sleep quality.

    Regular exercise improves your mood and mental health. It also improves your balance and can reduce your risk of falls, which is essential if you have osteoporosis or are at risk of poor bone health.

    Let’s look at a few low-impact exercises that will provide a good workout but, when performed correctly, won’t aggravate musculoskeletal conditions.

    Tai chi

    Tai chi is an ancient form of martial art originating in China. It’s evolved over centuries into what’s been called ‘moving meditation’ because it combines gentle, flowing movements with mindfulness and deep breathing.
    It’s a low-impact, slow-motion exercise with specific controlled movements. When doing tai chi, your muscles are relaxed rather than tensed, and your joints aren’t fully extended or bent.

    There are many forms of tai chi, and some have been modified to suit people with various health conditions, including arthritis and osteoporosis.

    Tai chi promotes correct body posture and balance, improves flexibility and integrates the body and mind. It’s practised by people of all ages and fitness levels.

    You can learn tai chi online or from books or DVDs, but most people find it easier to learn from a qualified instructor. They’ll ensure you’re performing the movements correctly and safely.

    The Tai Chi for Health website has a search function to help you find a qualified tai chi instructor in your area.

    Online recordings, books and DVDs are useful to help you practice between classes. Your instructor will be able to recommend some websites and titles.

    Yoga

    Like tai chi, yoga incorporates mind, body and breath. Yoga originated in India over 5,000 years ago. Since then, it’s become incredibly popular around the globe.

    It’s so popular that it’s all over Insta, TikTok, Facebook and YouTube. But take what you see on these platforms with a grain of salt. They often show us the extremes of yoga – fit and flexible people bent and twisted into challenging poses. This can be a little off-putting 😮!

    The good news is there are many different types of yoga to suit all needs and interests. There are even types of yoga that have been modified so that you can use a chair, a block or other aids to help you do the postures without straining your joints or aggravating your condition. So if you’re interested in trying yoga, you’re sure to find a type that suits you.

    Search the Yoga Australia website for a qualified yoga teacher. When making contact with them, ask about the type of yoga they teach, whether it’s suitable for people with your condition (and any other health conditions you have) and if they’ve successfully taught people with your condition before.

    Pilates

    Pilates was developed in the 1920s by German physical trainer Joseph Pilates. It focuses on postural alignment, strengthening the trunk (your abdominals, hips, inner and outer thighs, and back), body awareness and breath control. Initially, it was dancers, athletes and soldiers who used Pilates to strengthen their bodies and recover from injury.

    However, it didn’t take long for Pilates to become popular amongst the wider community. Pilates’ slow, controlled movements are suitable for people of all ages, fitness levels and abilities.

    Pilates can be performed on a mat or using special equipment (e.g. the Reformer) in a Pilates studio. The difference is that mat Pilates uses only your body weight and gravity as resistance, whereas the equipment involves springs, ropes, and straps for added resistance. Depending on your needs and preferences, you can choose to do Pilates on a mat at home or in a class environment, or in a studio using equipment. Or you can do both, as Joseph Pilates intended.

    Ensure you see a qualified instructor who can teach you how to perform each exercise correctly and safely.

    You can find a Pilates instructor via the Pilates Alliance Australasia or the Australian Pilates Method Association.

    Health insurance

    In 2019, the Australian Government made changes to private health insurance. Many natural therapies are no longer covered by your extras, including Pilates*, tai chi, and yoga.

    With no rebate available, this will affect your out-of-pocket costs, so when making inquiries about classes or sessions, ask for prices 💰.

    *Note: Clinical Pilates, delivered by a physiotherapist, is covered under physiotherapy care as part of your extras cover without any changes.

    Starting classes

    If you decide to try Pilates, yoga and/or tai chi, there are a few things you should do:

    • Talk with your doctor about whether these exercises are suitable for you. Discuss any potential benefits and risks.
    • When inquiring about classes, ask if your instructor is qualified and if they’ve worked with people with musculoskeletal conditions.
    • Ask how much the classes/sessions cost and how often you need to attend.
    • Don’t rush through the warm-up and cool-down – they’re important for preventing injury and pain.
    • Focus on your movements and technique to ensure you’re exercising correctly and safely.
    • Listen to your body. Some pain is expected when you begin exercising your body in a new way, but it shouldn’t be severe. Stop the exercise and discuss it with your instructor if you feel unusual pain. You may be performing the exercise incorrectly, or need to modify it to suit you.

    Contact our free national Help Line

    Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

    Reference

    (1) Physical activity and exercise guidelines for all Australians: For adults (18 to 64 years)
    Australian Government, Department of Health and Aged Care

    CONTINUE READING
    hands-on-bike.jpg
    Lisa Bywaters
    07/Jul/2022
    Health InformationMSK articles

    10 tips for protecting your hands and arms when cycling

    Guest blog by hand therapist Catherine Reid, B.App. Sci, (OT), M.Sci (H&UL rehab), MAHTA (As awarded by the AHTA), CHT

    The advent of COVID has seen many more people riding their bikes, either for exercise or for their daily commute. It’s a great exercise for the heart and lungs and a low-impact exercise for people with musculoskeletal conditions.

    In recognition of the health and environmental benefits of riding a bike, the United Nations declared June 3rd to be World Bicycle Day. Unfortunately, as a hand therapist, I frequently hear patients complain that hand and upper limb pain or weakness limits their ability to ride.

    Hand therapists are experts in rehabilitating the upper limb. We understand anatomy and how it relates to everyday activities. We can help determine what’s causing the problem, if it’s due to an injury, illness or activity, and provide appropriate treatment.

    Some pain experienced when riding a bike may be due to vibration transmitted up through the bike into the arms or due to the prolonged time or force with which the handlebars are gripped.

    If you love to ride but find it a bit painful, here are my top 10 tips for protecting your hands and upper limbs while riding. The best place to start is from the ground up.

    1. Tyres

    If you’ve ever ridden a bike or billy cart with solids tyres rather than rubber, air-filled, pneumatic tyres, you know what a difference a little air and rubber can make!

    Yet even with pneumatic tyres, vibrations or jolting through the handlebars can be painful for people with arthritis or joint injury. Ensuring the tyres on your bike are properly inflated can help reduce stress going up through the arms and into your body. The current thinking in the biking world is that wider tyres with less pressure offer better rolling resistance and comfort.

    Wheels for bikes can also vary in stiffness depending on the design and the material they’re made from, so some are better at absorbing shock than others.

    2. The frame

    If you plan to explore the world and take your bike with you, you need to consider the weight of your bike. Is the weight manageable for you?

    And when choosing a bike rack, one mounted on the back of the car might be an easier option than lifting your bike over your head onto the roof of a car. Lower lifts reduce the strain on sore or stiff shoulders.

    Carbon fibre and titanium bikes are much lighter than traditional steel-framed bikes but come at a cost.

    Another consideration is that the further away your seat is from the handlebars, the more of your weight your arms will be supporting.

    3. Shock absorbers

    The front fork of a bike can have shock absorbers that reduce the force going up into your arms from uneven terrain while keeping the tyres in contact with the ground for better control. They can be easily adjusted to provide more or less bounce.

    4. Stem flexibility

    The stem attaches the handlebars to the bike, and the modern stems have pivots, elastomers and moving parts to provide suspension. They may be as effective at smoothing the force from rough terrain as the fork suspension but may be a cheaper option to retrofit to a bike.

    5. Handlebar shape

    There’s a huge variety of handlebar shapes, which roughly fall into three categories: swept back, drop or flat handlebars. Some of the handlebars offer several different grip positions enabling the rider to vary their grip.

    For example, the drop bars enable the rider to use three different positions

    • the hooks, the part that curves or drops down, taking most of the weight through the hand;
    • the hoods are the rubber covers around the hinges of the levers. For smaller hands, it might be more comfortable holding the levers here, but there’s some loss of strength as the grip is near the hinge and not the end of the lever;
    • the third place you can hold a drop bar is on the top of the bar. This gives the rider a more upright position and places the hands in a palm down position, but this is a less anatomically friendly position for the wrist. Placing hands in a palm down position also puts pressure on the nerves in the palm of the hand, which can cause compression neuropathies such as carpal tunnel syndrome or cyclist’s palsy. Carpal tunnel syndrome affects the thumb side of the hand, while Bicycler’s neuropathy affects the little finger side; both conditions cause numbness and tingling in the hand.

    6. Handlebar rise and sweep

    Handlebar rise is the vertical rise measured from the centre of the bar to the bar end. The handlebar height can be adjusted by raising the stem or by increasing the rise of the handlebars. Increasing the rise changes the body position of the rider to a more upright position, meaning more weight is placed through the saddle, and less weight is placed through the shoulders, wrists and hands. Handlebars can have an upsweep and a backsweep. Sweep is the angle from the stem to the end of the bar either in an upward angle (upsweep) or in a backward angle (backsweep). More upsweep generally places more pressure on the hands, wrist and shoulders, whereas more backsweep places the wrists in a more natural (palms facing) position.

    7. Handlebar material

    The material the handlebars are made of can affect their ability to reduce or dampen the forces going through them. Carbon fibre and aluminium dampen vibrations better; however, steel and titanium flex. A little bit of flex in a handlebar is a good thing as it absorbs some of the force from bumps in the road.

    There’s also a line of handlebars that have a foam-filled core to deaden the vibration through the core.

    8. Grips and tapes

    Larger grips generally distribute the weight more evenly through the hand. There are lots of commercially available grips, and many can be retrofitted to your bike.

    Some change a flat handlebar to provide a vertical grip as well, allowing for a change of hand, wrist and elbow position. This can help reduce hand stiffness and provide rest from pressure on a particular joint or nerve. Tapes can either be gel or cork. The advantage of cork tapes over gel is that they don’t compress over high-pressure areas and are generally more durable.

    9. Gloves

    Gloves offer added protection from blisters and falls and improve grip. Glove fit should be firm so they don’t bunch up and cause pressure areas. They should also fit firmly around the cuff so water can’t leak in when it’s raining.

    Keeping hands warm with waterproof or thermal gloves helps maintain hand dexterity, especially for arthritic hands. Lightweight, breathable summer gloves with wicking ability may be helpful to reduce sweaty palms, which reduce grip.

    Some gloves have padding to reduce vibration, which irritates the nerves of the hand, or silicon tips or open tips to improve touch.

    Gloves can provide skin protection in the case of a fall or protection for mountain bikers with inbuilt carbon fibre inserts to protect the backs of the hands from trees.

    10. Gears and brakes

    Traditionally gears fall into 3 categories:

    • Twist or grip shifters,
    • Trigger shifters, or
    • Shimano Total Integration (STI) brake lever shifters.

    More recently, digital computerised gear mechanisms have been introduced. They require very little resistance to use, but unfortunately, they’re expensive to retrofit to your bike.

    Twist shifters can only be fitted onto straight handlebars and are controlled by rotating the wrist. They’re easier on the fingers and the thumb as wrist motion is used to control the gears. So if you have painful fingers or reduced dexterity, twist gears might be advisable. Twist shifters are known to become stiffer over time, which might put undue strain on the wrist. They also require frequent repositioning of the wrist.

    Trigger shifters generally require little force and can be activated with different fingers. To shift gears, the top lever is moved with the fingers, and the bottom lever is moved with the thumb. The benefit of trigger shifters is that the wrist stays in a neutral position. This is helpful if you have tennis elbow as it reduces strain in the muscles at the elbow joint.

    STI Brake lever shifters are a combination of the gear shifter and the brake lever on the one fitting. This allows the rider to shift gears without moving their hand from the bars. They’re generally found on touring or racing bikes and can be activated while holding the hoods. They require minimal force to use.

    Brakes can either be hydraulic or cable brakes.

    Hydraulic brakes are preferable if you have upper limb problems as they take far less force to use. The back pedal (coaster) brakes are less common these days and are generally found on cruiser bikes or kids bikes. They’re worth considering if you have poor eye-hand coordination or poor hand strength. If the levers are too far out from the bars, people with smaller hands have difficulty reaching their fingers around the brake levers, making it difficult to grip forcefully. This can be adjusted with small rubber inserts placed at the hinge end of the brake lever.

    Getting your bike tailored to meet your specific needs may just require some minor changes to your existing bike. But sometimes, purchasing a new bike can be more cost-effective. Remember, changing any part of your bike will affect your bike’s fit and may affect your bike’s handling. It’s worth getting your existing bike correctly fitted to you before making too many expensive changes.

    If changing your bike isn’t helping, then you need to see a hand therapist to evaluate the cause of the pain and, if needed, provide upper limb exercises, treatments or supportive splints to enable you to keep riding. A hand therapist in your local area can be found on the Australian Hand Therapy website.

    Our guest blogger Catherine Reid is an occupational therapist with a Master of Science in Hand and Upper Limb Rehabilitation. She’s a full member of the Australian Hand Therapy Association and works in her private practice Western District Hand Therapy, in Warrnambool, Victoria.

    Contact our free national Help Line

    Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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    axSpA.jpg
    Lisa Bywaters
    07/Jul/2022
    Health InformationMSK articles

    What is axial spondyloarthritis?

    It’s definitely a mouthful, but what is axial spondyloarthritis?

    Axial spondyloarthritis (axSpA) is the umbrella term for two different types of inflammatory arthritis that affect the spine: ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA)

    Ankylosing spondylitis (AS) affects the spine and the joints that connect the lower spine to the pelvis (sacroiliac joints). These changes are visible on x-ray.

    In non-radiographic axial spondyloarthritis (nr-axSpA), these changes aren’t yet visible on an x-ray but may be seen on an MRI. For some people, nr-axSpA will never progress to the stage where joint changes are seen on x-ray. For others, these changes will eventually be seen on an x-ray, and their diagnosis will be changed to AS.

    These conditions cause pain, stiffness and reduced mobility in your spine. They can also cause symptoms including inflammation of tendons and ligaments, inflammatory bowel disease, psoriasis and inflammation of the eye.

    The good news is that axSpA can be treated effectively with medicine and self-care.

    Q. What are the signs that I may have axial spondyloarthritis?
    A. The signs or symptoms of axial spondyloarthritis vary from person to person. The most common symptoms are pain and stiffness in the back, often the lower back and into the buttocks that:

    • comes on gradually over weeks or months
    • is worse in the second half of the night and wakes you up
    • is worse first thing in the morning, with early morning stiffness that lasts 30 minutes or more
    • is worse after rest and feels better after activity and exercise
    • has been present for 3 months or more
    • may involve pain deep in the buttock that can swap from one side to the other over time, especially in the early stages (doctors call this ‘alternating buttock pain’).

    Other symptoms can include:

    • fatigue (extreme tiredness)
    • inflammation and pain in tendons (which connect muscles to bones) and ligaments (which connect bones to each other), which you may feel as pain in the front of your chest, back of your heel or underneath your foot
    • arthritis in one or more of your peripheral joints – such as the joints in your hands, feet, arms or legs
    • inflammation in your eye (uveitis)
    • inflammatory bowel disease
    • psoriasis
    • feeling feverish and having night sweats
    • losing your appetite and losing weight.

    Symptoms may change from day to day. At times your symptoms (e.g. pain, fatigue, inflammation) can become more intense. This is a flare. Flares are unpredictable and can seem to come out of nowhere.

    Q. What causes axial spondyloarthritis?
    A. Axial spondyloarthritis is an autoimmune disease. That means it occurs as a result of a faulty immune system.

    Instead of identifying foreign bodies (e.g. bacteria, viruses) and attacking them to keep you healthy, your immune system mistakenly targets healthy tissue in and around your joints, causing inflammation and pain.

    We don’t know why this happens. Genes are thought to play a role. You’re more likely to get axSpA if you have a history of it in your family. Most people with axSpA have the gene called HLA-B27; however, this gene can also be found in people who don’t have axSpA.

    Since this gene doesn’t automatically lead to the development of axSpA, other factors are thought to be involved.

    We used to think axSpA affected more men than women, but recent research suggests men and women are affected relatively equally.

    Q. How do I know if I have axial spondyloarthritis?
    A. If you have ongoing back pain and stiffness or other symptoms of axSpA, it’s essential that you see your GP. Getting a diagnosis as soon as possible means that treatment can start quickly. This will give you the best possible outcomes.

    No one test can diagnose axSpA, so your doctor will use a combination of tests to confirm your diagnosis. They may include:

    • Your medical history. Your doctor will ask about your symptoms, family history and other health issues.
    • A physical examination to assess joint tenderness, flexibility, and stiffness.
    • Blood tests to check for inflammation associated with axSpA.
    • Genetic testing to look for the HLA-B27 gene, which is present in most people with axSpA.
    • Scans such as an x-ray and MRI (magnetic resonance imaging) to look for joint inflammation and damage.

    Your GP will refer you to a rheumatologist if they think you have, or have diagnosed you with axSpA. Rheumatologists are doctors who specialise in diagnosing and treating problems with joints, muscles, bones and the immune system.

    Q. How is axial spondyloarthritis treated?
    A. Your rheumatologist will recommend and prescribe medicines for your axSpA.

    The two main types of medicines used to treat axSpA and help manage its symptoms are NSAIDs and targeted therapies:

    • Non-steroidal anti-inflammatory drugs (NSAIDs) are nearly always used as the first medicine to treat the pain, inflammation and stiffness of axSpA unless there’s a reason that you can’t take them. Research shows that NSAIDs are very effective in managing symptoms of axSpA. Some people may need to take them regularly, while others will only take them as needed. This will depend on your symptoms and how you respond to the NSAID. Your rheumatologist will talk with you about how often you should take NSAIDs and the long-term benefits and risks of using them. There are many different types and brands; some are available over-the-counter, while others are only available on prescription.
    • Targeted therapies are medicines that ‘target’ specific proteins in the immune system that produce inflammation. They include biological disease-modifying anti-rheumatic drugs (biologics), biosimilars and targeted synthetic disease-modifying anti-rheumatic drugs. These targeted treatments have dramatically improved the quality of life for people with axSpA who need more than NSAIDs to manage their condition. They work to control your immune system in a targeted way, slowing down the attack on your spine and joints. Your rheumatologist will talk to you about using these medicines if you need more than NSAIDs to manage your axSpA or you’re unable to take NSAIDs.

    Q. What can I do to control my symptoms?
    A. As well as taking your medicines as prescribed, there are things you can do.

    • Learn about your condition. Understanding axSpA allows you to make informed decisions about your healthcare and actively manage it.
    • Exercise regularly. This is the most important thing you can do to help manage your axSpA. Exercise can improve symptoms including stiffness, pain, fatigue, breathing capacity and posture. It helps increase your flexibility and range of movement, so it’s easier to do many everyday tasks. As soon as possible after receiving your diagnosis, you should ideally begin a personalised exercise program developed by a physio or exercise physiologist (EP) and aim to do some exercise every day. Being active is also essential for your overall health and wellbeing. It helps keep your muscles, bones and joints strong so that you can keep moving. It reduces your risk of developing other conditions such as heart disease, osteoporosis, diabetes and some forms of cancer. It boosts your mood, benefits your mental health, helps with weight control and improves sleep.
    • Manage your weight. Being overweight or obese increases inflammation throughout your body. This inflammation affects not only your joints but also blood vessels and insulin levels. This can increase your risk of chronic health conditions such as heart disease and diabetes. Losing weight is an important thing you can do to reduce your risk of these conditions and to reduce your axSpA symptoms. Being overweight or obese also limits the effectiveness of some medicines used to treat axSpA. Losing weight can be challenging, so if you need to lose weight or advice on healthy eating, talk with your doctor or dietitian.
    • Learn ways to manage your pain. Pain is the most common symptom of axSpA, so learning to manage it effectively is crucial. Read our A-Z guide for managing pain for more information.
    • Work closely with your healthcare team. The best way to live well with axSpA is by working closely with the people in your healthcare team (e.g. GP, rheumatologist, physio). Keep them informed about how you’re doing and if you’ve experienced any changes in your symptoms or tried new medicines, complementary therapies, supplements or other treatments.
    • Use aids and equipment. Supports such as long-handled shoehorns, reachers and canes can reduce joint strain and make life easier, especially if your condition has reduced your flexibility and mobility. An occupational therapist can advise you on aids, equipment and home modifications. You can also check out our range of aids in our online shop.
    • Sleep well. Not getting enough quality sleep can worsen your symptoms; however, getting a good night’s sleep when you have axSpA and chronic pain can be difficult. If you’re having problems sleeping, talk with your doctor about ways you can address this.
    • Manage stress. Stress can also aggravate your symptoms, so learning to deal with stress is extremely helpful. Things you can do to manage stress include planning your day and setting priorities, using relaxation techniques such as going for a walk, getting a massage or listening to music, and, where possible, avoiding people and situations that cause you stress.
    • Practise mindfulness. Regularly practising mindfulness meditation can improve your mood, relieve stress, improve sleep, improve mental health and reduce pain.
    • Eat a healthy, balanced diet. While there’s no specific diet for axSpA, it’s important to have a healthy, balanced diet to maintain general health and prevent weight gain and other health problems, such as diabetes and heart disease.
    • Quit smoking. Smoking cigarettes is not only bad for your general health but also negatively affects your bone health and increases inflammation.
    • Seek support from others. You might find it helpful to contact Ankylosing Spondylitis Australia or the Ankylosing Spondylitis Group of Victoria and speak to others who have axSpA and know what you’re going through.

    Q. Are there any complications I should be aware of?
    A. Some people living with axSpA develop an eye problem called uveitis, which causes a painful red eye with blurred vision and sensitivity to light.

    If you develop eye symptoms, you’ll need to quickly get your eye checked and treated by an ophthalmologist. Treatment is usually with prescription eye drops, which reduce the chance of permanent eye damage.

    By understanding this risk and knowing what signs to be alert for, you can reduce the risk of damage to your eyes.
    Ask your GP or rheumatologist what you should do if you develop any eye symptoms.

    Q. What about surgery?
    A. Most people with axSpA can manage their condition using a combination of exercise, medicines and self-care.

    However, surgery may be considered in some cases if treatments haven’t provided relief from symptoms or if you have a spinal fracture or dislocation. Surgery that may be considered includes:

    • hip arthroplasty (replacement) surgery if you have severe and persistent hip pain
    • cervical fusion, where bones in the cervical (upper) spine are fused together to treat a fracture or dislocation
    • wedge osteotomy removes a wedge-shaped piece of bone from a vertebra to allow the spine to be realigned.

    If your doctor thinks surgery might be an option, they’ll refer you to an orthopaedic surgeon. Together, you can discuss the benefits and risks of surgery and decide if it’s right for you. If you’re unsure about surgery or don’t feel comfortable with the information from the surgeon, ask your doctor to refer you to another surgeon for a second opinion.

    Contact our free national Help Line

    Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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    food-prices.jpg
    Lisa Bywaters
    16/Jun/2022
    Health InformationMSK articles

    Healthy meals on a budget

    Times are tough; there’s no denying that. The rising costs of everything (hello, $10 iceberg lettuce 😭) are putting the household budget under significant pressure. And this is causing many of us to feel anxious.

    But we can do many practical things to relieve some of this stress. Let’s start in the kitchen with our tips for enjoying tasty, healthy meals and snacks that won’t cost an arm and a leg.

    Make a meal plan – and stick to it

    Before hitting the shops, plan your meals and snacks for the week. Check the fridge and pantry to see what ingredients you already have, and write a list of those you need. Writing a list is essential because, even if you’re not in pain or dealing with brain fog, it’s easy to forget things, buy the wrong quantities or items you don’t need in the heat of the moment. (Step away from the chips Lisa 😁). And if, like me, you hate shopping and really want to avoid crowds and germs, getting the shopping done quickly and efficiently is a must. With the steep price of petrol, it also makes sense to keep the trips to the shops to a minimum. So plan, plan, plan! Eatforhealth.gov.au has some helpful information on meal planning, including sample mean plans. There are also lots of meal planning apps you can download from Google Play or the App Store. They conveniently place your meal plan and shopping list on your phone, so no more forgotten shopping lists!

    Read the nutrition panel

    It’s a good habit to get into so you can track the amount of energy (kilojoules), fat, salt, sugar etc., in your foods. It’s also helpful when comparing different brands of the same product.

    Swap some meat dishes for vegetarian or vegan meals

    Research has found that vegan and vegetarian diets cost less than a diet that includes meat. You don’t have to go all-out vego; simply swap some of your meat dishes for plant-based meals. They’re tasty, healthy and cheap. Healthy vegetarian protein sources include tofu, chickpeas, beans, quinoa, lentils, eggs and nuts. If you need help, there are many websites with interesting and tasty vegetarian and vegan recipes.

    Note: You’ve probably noticed the multitude of plant-based ‘meats’ crowding the shelves in your supermarket, often alongside actual meat products. They’ve been developed to look and taste like meat and can be a good alternative to meat, especially if your family aren’t keen on giving tofu a go 😉! Just make sure you read the nutritional panel carefully before buying these products, as some have high levels of salt, saturated fat and other additives. The Cleveland Clinic has an interesting article to help you know what to look for when buying faux meats.

    Choose generic, home brand and no-name products

    They’re generally cheaper and are often exactly the same as the name brand, just without the fancy packaging.

    Prepare some meals in advance

    When you’ve got some free time, make extra meals that you can freeze and use when necessary. That way, when you’re exhausted, having a flare, or just can’t be bothered cooking, you’ll have some meals you know are healthy. And you won’t have to resort to takeaway foods or store-bought frozen meals, which can be costly and are often high in fat, salt and/or sugar.

    Buy local and in-season fruit and veg

    They’re generally more nutritious, fresher and more cost-effective. The Australian Farmers’ Markets Association has a tool to help you find your local farmers’ market, and Sustainable Table has a handy seasonal produce guide.

    Buy so-called ‘ugly’ produce

    These fruits and vegetables are cheaper and taste fine. Who cares if your carrot has two ‘legs’ or your apple has a spot? At the end of the day, they’re perfectly healthy and packed with all the usual nutrients. They just don’t look shiny and new, but who does these days 😉? You can get imperfect produce at many supermarkets and food subscription services.

    Read the unit price when comparing products

    This will enable you to see the price difference regardless of brand or quantity, and you can work out which provides the best value for money. Unit pricing works by using a standard measurement across all products of the same type.

    So, for example, if you compared yoghurt A with yoghurt B:

    • yoghurt A costs $6.40 for 1kg, so its unit price is $0.64 per 100g
    • yoghurt B costs $2.30 for 200g, so its unit price is $1.15 per 100g.

    That makes yoghurt A cheaper per 100g.

    Fortunately, you don’t have to do the mental gymnastics to work this out for yourself. The unit price is generally provided on the shelf label and online. Phew! Shopping is hard enough!

    Grow your own

    Over the past few years, many of us have discovered the joy of gardening. So why not grow some of your own produce? Whether on a small scale with a few pots of herbs on your balcony or larger scale vegie patch and fruit trees in your backyard, you can experience the pleasure and reap the rewards of growing some of your own foods. Nothing tastes sweeter than the food you’ve nurtured, grown and picked yourself 💚.

    Use frozen and canned fruit and vegetables

    They’re still healthy and usually cheaper than produce that’s not in season. They’ll also keep longer. Just make sure you read the ingredients list and nutrition panel. Canned foods may have added salt or sugar. So for vegies, look for ‘no added salt’ on the label, and choose fruits in natural juice with no added sugar rather than canned in syrup.

    Shop around and do your research

    Just because you’ve always shopped at a particular place doesn’t mean you always have to shop there. Visit the local farmer’s markets, keep an eye on catalogues and join online groups with other savvy shoppers. That way, you’ll always know who’s providing the best value for money for your groceries.

    Buy in bulk items you use regularly and have a long shelf life

    This includes things like rice, dried/canned legumes and pasta. And the best time to buy them is when they’re on sale. But please don’t go crazy and start hoarding or buying too much 😐. Bulk buying to save money is different to the panic buying we’ve seen during the pandemic. If we all shop for only the things we need, there’ll be plenty for everyone.

    Reduce your kitchen waste

    Shopping with a list will help, and only buy what you need. Take note of the foods you often throw out because they’ve become a mysterious, furry blob in your fridge. Avoid buying that item, or buy less of it when you shop. Look for ways to use food that’s becoming slightly less than fresh but is still good. Soups are a great way to use the last of the vegies in your fridge crisper. Visit the Foodwise website for tips to help you reduce waste.

    Getting takeaway

    Let’s face it, there’ll be times when you really, really want takeaway food. It’s quick, easy and delicious 😋. As long as it’s an occasional thing and you eat it in moderation, it shouldn’t have too great an impact on your health or wallet. Here are some tips from Health and Wellbeing Queensland to help you make the healthiest choices when it comes to takeaway food.

    Finally, don’t shop when you’re hungry

    It’s an easy way to end up with lots of things in your trolley that weren’t on your shopping list. This can blow your budget and plans for healthy eating right out of the water. So shop after you’ve eaten or munch on some fruit or handful of nuts before you even consider walking into the bright lights and air-conditioned aisles of your local shopping centre. Your budget will thank you for it.

    Contact our free national Help Line

    Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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    small-changes.jpg
    Lisa Bywaters
    16/Jun/2022
    Health InformationMSK articles

    Want to make healthy changes in your life? Start small.

    January 1, the traditional date many of us resolve to make healthy changes in our lives, has come and gone. Exercise more regularly, add new recipes to the repertoire, meditate in the evenings … sound familiar? And many of us gave it a red hot go.

    But as often happens when life gets in the way (or the continuing saga of the pandemic keeps on rolling 🤦), our goals can take a hit.

    If you still want to make these changes but haven’t had much success so far, you may want to rethink your approach.

    ‘Start small’; ‘slow and steady wins the race’; ‘small changes eventually add up to huge results’. These clichés are plastered over Pinterest and motivational boards for a reason. When we start small or break our goals into smaller tasks or actions, they’re less overwhelming and more achievable.

    Here are some tips to help you make small but deliberate changes that can have a big impact on your physical and mental health and wellbeing 😊.

    First – take the time to reflect on what YOU want to achieve.

    Now write it down. Try to be as clear as possible.

    Next, consider using the SMART framework. It can help you achieve your goals by helping you clarify your ideas and focus your efforts. SMART stands for:

    Specific. What are you trying to do? Losing weight isn’t a specific goal. But committing to a healthy eating plan and regular exercise with the aim to lose 10kg in 8 weeks is.

    Measurable. You need to be able to measure your progress so that you know when/if you’ve achieved your goal. With the weight loss example, we’ve specified how we’ll go about losing weight and included a measurable target, i.e. 10kg in 8 weeks.

    Achievable. The goal needs to be achievable for you. It should challenge you but still be attainable.

    Realistic. You need to be realistic, and your goal needs to be doable – for you and your circumstances. For example, if you’re currently under a lot of stress and not sleeping well, it can be more challenging to lose weight. Aiming to lose weight over a longer period might be a better option. Take the time to think about what’s realistic for you now. By doing this, you’re not setting yourself up to fail.

    Timeframe. The goal needs to have an end date that you’re working towards. This gives you the motivation to push yourself further.

    Don’t feel that you have to change everything at once. Say you’ve decided you want to improve your health and fitness. You’ve identified that you need to lose weight, exercise more regularly, quit smoking, start meditating, get more sleep, reduce your alcohol intake and drink more water. That’s a lot!

    And it’s not like you’re trying to do these things in a vacuum – you also have work/study, family life, social life and – oh yeah – managing a chronic condition or two.

    So instead, start with what you’d like to achieve most – e.g. exercising more – and work on that for a week or two. Then include other elements, e.g. talking with your doctor about safe weight loss options. When you feel like you’re making progress there, move on to other things, such as quitting smoking or reducing alcohol.

    You’ll still be making a change but in a more achievable, less overwhelming way. And remember that any healthy changes you make will impact other areas you want to improve; e.g. reducing alcohol will aid weight loss and help you sleep better, as will exercising regularly.

    Be mindful and focus…on your eating, exercise, time with family, hobbies, etc. We often move through life at breakneck speed and rarely pay attention to the small details. But these things and moments in time add meaning and colour to our lives. So take the time to savour your meals, notice how your body moves and supports you when you exercise, what it feels like to be with your family, or the enjoyment you get from your hobbies. These are small but important things you can practice every day.

    Eat when you’re hungry, not when you’re tired, emotional or bored. Working from home and pandemic stress has led many of us to eat things, or at times, we usually wouldn’t. Before you eat something, take time to reflect on whether you’re hungry or not. And if you’re not hungry, what’s making you reach for that food? If you’re hungry, and it’s between meals, do you have healthy snacks close at hand? Will a glass of water help fill you up? Or do you need to look at your meals and whether they provide the nutrients you need to get you through to your next meal without hunger setting in? If you’re not sure how to make healthy changes to your diet, talk with your doctor and/or a dietitian.

    Put the devices away for a while and detox from digital. Our preoccupation with our phones, TVs, computers, gaming consoles etc., can get in the way of being present in the moment. And when it comes down to it, how many cat videos, memes, or news stories do we really need to see 😹? Our devices can be a trap, and it’s easy to lose an hour or two before you know it. This could be time spent reading with your kids, cooking a delicious meal or relaxing so you can sleep well. So put them away for a bit and enjoy life offline.

    Incorporate the outdoors. Go for a walk in the park or another green space, take deep breaths and inhale the cool, crisp air. Not only will this get you moving, but there are many other health benefits associated with getting outdoors. They include reducing stress, lowering blood pressure, improving your mood and clearing your mind. However, be careful in these wet, wintery months of potentially slippery paths, rug up against the cold and wear appropriate shoes.

    You can also use pot plants to bring the outdoors in and enjoy the health benefits. Just be sure to check that they’re not toxic for you, your family or your furry housemates.

    Put some physical distance between yourself and your phone. Many of us constantly check our phones to see what the latest beep, blip or alert was for. And most of the time, it wasn’t for anything important. It takes you out of the moment and shifts your focus and concentration. The next thing you know, you’ve zoned out on conversations or started doom-scrolling. So give yourself some space.

    Another benefit is that having your phone in a place you need to get up to access it can add quite a bit of incidental exercise to your day. For example, if you use your phone as your morning alarm, moving it away from your immediate bedside area means you’ll have to get up to turn it off. This also means you’ll be less likely to hit snooze countless times 😉.

    Make it achievable. Whether you’ve decided to use the SMART framework or not, always make sure the goals you’re setting are achievable; otherwise, it can be disheartening if you don’t reach your target. For example, say you want to drink more water but only manage a glass of water a day at the moment. Trying to immediately go from a glass to the ‘magic’ 2 litres a day will be challenging. So don’t go straight for the big guns; ease your way in and increase your quantity over time.

    Take time to make decisions. We’re often quick to say yes when family and friends invite us to dinner or a party, or a colleague asks to collaborate on a project. But try to slow your reaction. A night out or working together on a project might sound great at the time, but take a moment to consider it properly. What’s your schedule like? How are you feeling? Are you able to add another thing to your calendar? Instead of an immediate yes, try saying, “That sounds great; I’ll let you know once I check my schedule”, or “I’ve got a big week ahead, so I’ll have to get back to you”.

    Taking control of your time at the outset is better than falling in a heap after over-committing. And those who know you will understand that this is essential to self-care and managing a chronic condition.

    Slow and steady wins the race. Do you get to the end of the week and find that you have piles of laundry, too many unread emails and a garden full of weeds? It’s exhausting to even think about! A good practice is to break these jobs into smaller tasks and deal with them methodically during your week. Set aside some time to do these mundane chores each day. It’s up to you how long you spend on this – but having some dedicated time to deal with it means it’s less likely to overwhelm you by the end of the week. Leaving you with more time for the fun stuff! 🕺

    Enlist help. There’s lots of help available if you need it. Family, housemates and friends can help you get things done around the home – on a regular or occasional basis. Then there are the professional cleaning/gardening/meal services you can have on standby if you need some backup. You can also talk with your doctor about accessing healthcare services if you need help developing things like a safe exercise program or a healthy eating plan. All you need to do is reach out.

    Write it down. How often do you think, “I’ll remember that”, and completely forget it moments later 😣? The name of a TV series someone recommended, a new recipe, the date of your healthcare appointments 😑. It’s so frustrating! But having a foggy brain, persistent pain, sleeplessness, busy lives, and pandemic-brain can make us lose track or forget things. So write it down. On your phone, notepad, fridge … whatever works for you.

    Focus on your breathing. Most of us take breathing for granted. It’s just an unconscious thing we do. But your breathing can become shallow if you’re in pain or anxious. However, you can reduce your pain and anxiety by focusing on breathing more deeply. Deep breathing increases feelings of calmness and relaxation and improves your focus and concentration.

    Making changes to improve your health and wellbeing is admirable, but it can be challenging. That’s why starting small, building on your progress and asking for help are important. Talk with your family, doctor or the nurses on our Help Line for information and support. Because you can do this … one step at a time.

    Contact our free national Help Line

    Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

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    jaw-pain.jpg
    Lisa Bywaters
    25/May/2022
    Health InformationMSK articles

    What causes jaw pain?

    Did you know the joints in your jaw are the most frequently used joints in your body? They’re constantly on the move as you talk, chew, cry, swallow, sing, smile and yawn.

    Unfortunately, these joints can also be the source of pain and discomfort.

    Let’s explore the anatomy of your jaw to better understand what can cause pain in these joints.

    Lightly place your fingers on your face, between your nose and mouth, and spread them across your cheeks. This is the upper part of your jaw, called the maxilla. It holds your top row of teeth.

    Now place your fingers on your cheeks in front of and just below your ears. This is the lower part of your jaw or the mandible. It holds your bottom row of teeth.

    Open your mouth. You’ll feel the temporomandibular joints (TMJ) working. The rounded ends of your lower jaw (condyles) glide along the joint socket of the temporal bone. Close your mouth, and you’ll feel the condyles slide back to their original position.

    The temporomandibular joints connect your lower jaw to your skull. Inside the joint, between the two bone surfaces of your skull and jaw, is a disc of cartilage. It provides a slippery cushion that helps the joints move smoothly, absorbs shocks and prevents the bones from rubbing against each other. Muscles attached to and surrounding the joints control their position and movement, and enable your jaw to move up and down, side to side, and forward and back.

    Temporomandibular joint disorders (TMD) are conditions that affect the bones, joints, and muscles responsible for jaw movement. They’re the most common causes of jaw pain.

    What causes temporomandibular joint disorders?

    A number of different things can cause temporomandibular joint disorders, including:

    • teeth grinding or clenching (known as bruxism)
    • musculoskeletal conditions (e.g. fibromyalgia, rheumatoid arthritis and osteoarthritis)
    • movement or dislocation of the disc
    • stress, tension, anxiety, depression
    • jaw injury
    • dental problems (e.g. uneven bite, ill-fitting dentures).

    Who gets temporomandibular joint disorders?

    TMDs are common, affecting up to 60–70% of the population, especially adults aged 20–40 years. Women are at least four times as likely to have a TMD.(1)

    Many TMDs last only a short time and go away on their own. However, in some cases, they can become chronic or long-lasting.

    What are the symptoms?

    The most common symptom of TMDs is pain in and around the jaw, ear and temple, especially when eating. Other symptoms may include:

    • clicking, popping or grinding (crepitus) when you move your jaw
    • headache
    • earache
    • difficulty opening and closing your mouth or a ‘locking’ jaw.

    How are they diagnosed?

    If you’re experiencing pain in the jaw or other symptoms that are causing you problems, you should see your doctor or dentist. They’re usually able to diagnose a TMD by:

    • taking your medical history – where the pain is, when it started, what makes it worse, and any other symptoms you have, and
    • doing a physical examination – observing as you open and close your mouth, feeling your jaw, listening for clicking and other noises.

    Sometimes they may need scans (e.g. x-rays, or CT (computed tomography scans) if the history and exam weren’t conclusive or there’s uncertainty around your diagnosis.

    Treatment

    Many people with a TMD find that their symptoms go away without treatment.

    However, others require a treatment approach that involves a combination of self-care and medical care.

    Self-care

    There are simple and effective things you can do to ease the pain and other symptoms of TMDs.

    • Use heat or cold packs. Cold helps reduce swelling and pain, while heat can relax your jaw muscles. Always wrap the pack in a cloth so it doesn’t touch your skin directly.
    • Try some gentle stretches, exercises and massage. They help relieve muscle tension and pain in your face, jaw and neck.
    • Eat soft foods, cut your food into smaller pieces and take your time eating. This will rest your temporomandibular joints and reduce the amount of work they need to do.
    • Avoid eating gum, or foods that are tough or chewy, as they require lots of repetitive chewing.
    • Avoid extreme jaw movements (e.g. wide yawning, yelling).
    • Relax your jaw. This is something you’ll need to make a conscious effort to do because most of the time, we’re not aware that we’re clenching our jaw. It can be helpful while you’re getting in the habit of doing this to set an alarm or alert to remind you to do it.
    • Do some relaxation techniques for the whole body. If you’re feeling stressed or anxious, this can aggravate your TMD. You can do many things to relax your body and mind, including going for a walk, getting a massage, listening to music, and practising mindfulness.
    Medical care

    Not everyone will need medical treatment to ease their symptoms. But some of the treatments used are:

    • Medicines to relieve pain and inflammation and to relax muscles.
    • Wearing a mouth guard while sleeping to prevent tooth grinding. Your dentist can fit you for one.
    • Treating underlying conditions, such as dental problems, musculoskeletal conditions or mental health issues.

    Surgery is rarely needed to treat TMDs.

    Contact our free national Help Line

    Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

    Reference

    (1) Lomas, J. et al, 2018. Temporomandibular dysfunction. Australian Journal of General Practice, 47(4), pp.212-215.

    CONTINUE READING
    telehealth-consultation.jpg
    Lisa Bywaters
    25/May/2022
    Health InformationMSK articles

    Telehealth 2022

    In March 2020, at the beginning of the pandemic, the Federal Government made telehealth available for all Australians. This enabled us to access our general practitioner (GP) and other healthcare providers from the comfort – and safety – of our homes.

    As of 1 January 2022, many telehealth services became a permanent and ongoing part of Medicare.

    Eligible patients will continue to have access to GP, specialist, nursing, mental health care, midwifery and allied health services via telehealth where the healthcare provider believes it’s appropriate.

    It’s important to note that telehealth consultations will not take the place of face-to-face consultations. They’re just another option that may be convenient, and yet another example of the hybrid world we now live in 😉.

    What is telehealth?

    Simply put, telehealth enables you to consult with your healthcare provider over the phone or through a video platform (e.g. Zoom, Skype, FaceTime). Your healthcare provider may specify which platform you need to use.

    Depending on your available technology and how comfortable you are using it, you might have a conversation over your phone with your doctor (like any other phone call), or interact face-to-face via the video platform.

    If you’re only comfortable talking on your phone, that’s ok. You don’t have to download apps and learn how to use them, especially if this makes you anxious. You can choose to see your healthcare provider in person or consult over the phone if appropriate.

    But if you’re interested, video platforms are easy to use. And they allow your healthcare provider to see you and assess you visually. This obviously gives them a lot more information about you and your health. The platforms and technology just take a little practice 😊.

    However, a change that did come into place in January 2022 means that for initial and complex specialist consultations, face-to-face and video services are required. Telephone consultations are only available for subsequent and minor consultations. This is because you and your specialist will have a better quality consultation face-to-face or via video than you could over the phone. This is essential for your first consultation or if your situation is complex and can’t be managed effectively and safely over the phone.

    Why would I choose telehealth over face-to-face consultations?

    You may choose telehealth over face-to-face consultations if you’re feeling unwell or fatigued, and going in person would make you feel worse. Or, you may not be able to take time off work to go to an appointment, but you do have a quiet space at work where you can have a private telehealth consultation during a break. Or, you may live in regional or remote parts of the country and accessing a healthcare provider via telehealth is more convenient and timely.

    It’s also your only option if you have COVID and you’re self-isolating. We still need to restrict the spread of the virus.

    And remember, it’s not an either/or situation. Face-to-face and telehealth consultations will continue alongside each other – with both having their merits.

    What are the costs?

    During the initial phase of the COVID telehealth rollout, all telehealth consultations were bulk-billed. This was to keep us at home and reduce the spread of the virus.

    However, with most of the population now vaccinated and living in ‘COVID-normal’ times, you can’t assume that telehealth consultations will be bulk-billed. So when you’re making your appointment, ask if it will be bulk-billed or if you have to pay a consultation fee.

    The video platforms are free to download and use.

    Eligibility

    As with the rules when telehealth was first introduced in 2020, you still need to have an existing relationship with your GP to meet eligibility requirements. That means you must have had a face-to-face consultation with the same GP or another practitioner at the same practice in the 12-months before a telehealth consultation.

    It’s not always easy

    As many of us have discovered over the last couple of years, as we’ve been working, schooling and just trying to entertain ourselves at home, there are always teething issues. The two biggest issues are technology and time.

    Technology – it can make our lives easier and more entertaining, but sometimes it seems like it just makes things more complicated. Like when you’re tired, anxious, frustrated, unwell or in pain, everything, including technology, seems against you, and nothing seems to work 😑. Often this is because we find it difficult to focus or concentrate; after all, we’re tired, anxious, frustrated, unwell or in pain. Other times it may be because there’s a big demand on the system. Everyone is trying to get online for one reason or another, which may cause slower internet speeds.

    Time – as with any appointment, there can be issues with time. Your healthcare provider may be running late because of tech issues, other patients have needed more time, there’s been a medical emergency, or because they’re human and have lives and families too, and things can get in the way. Or you may be running late for similar reasons. We all need to be patient and give people a little leeway as we navigate this new ‘normal’ we find ourselves in.

    But we can make it easier

    We’ve identified these potential issues not to freak you out but to prepare you. Honestly, they may not happen at all. But there are things you can do to prepare for your telehealth consultation that will make things easier for everyone.

    Be patient – if your doctor is running late, if your internet is slow, if your appointment is rescheduled due to an emergency, be patient. This can be hard to do when you’re unwell or in pain. But becoming impatient won’t change the situation and will only make you feel worse – physically and emotionally. Make a cuppa, read a book, do a crossword puzzle, talk with your partner/cat/dog/kids – distract yourself while you wait.

    However, if you have chest pain, difficulty breathing, or a medical emergency, call 000 immediately. Don’t wait for your telehealth appointment.

    Be prepared – before your appointment, make a list of the things you want to discuss with your doctor. Put them in order from the most important to the least. That way, you won’t finish your consultation and then kick yourself for not asking X. Also – be aware that your appointment may end earlier than you anticipate if there’s a tech issue or an emergency. So lead with your most pressing questions or concerns, and if you have time, follow with the less important ones.

    Be kind – Our healthcare providers are doing the best they can, often under stressful, trying circumstances. During this crisis, they’re our frontline, so please be kind to them. And be kind to yourself. You’re learning new technology or new ways to do things and just trying to stay sane during an insane time – recognise that you’re also doing the best you can. So hang in there.

    Talk with someone who cares

    Call the National MSK Help Line – our nurses are available weekdays from 9am to 5pm on 1800 263 265, or you can email helpline@msk.org.au. They can help you with info and support about musculoskeletal conditions, managing pain, treatments, accessing services, and much more.

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