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    gardening-web.jpg
    Lisa Bywaters
    08/Oct/2020
    Health InformationMSK articles

    Time to get down and dirty

    Gardening and musculoskeletal conditions

    “We may think we are nurturing our garden, but of course, it’s our garden that is really nurturing us.” Jenny Uglow

    With spring well and truly in the air, our gardens are coming alive. It’s the perfect time to get outside and dig in the dirt.

    Gardening’s a wonderful way to get some fresh air and vitamin D. It can also be extremely relaxing, and a good workout. What’s not to love?

    Sadly, for those of us who like to garden, there are times when our condition or our pain may affect our ability to garden as we’d like to. But there are many things you can do so that you can still get into your garden and enjoy yourself.

    • Pace yourself. I know, I know, we go on about pacing all the time. But it’s so easy when you’re feeling good and you’re having a great time to get carried away. And then you pay for it the next day (or three). So don’t try to do too much in one go and remember to take regular breaks. This’s a good opportunity to rest – but also to drink some water while you sit back and admire your work, contemplate what to do next, and imagine future gardening projects.
    • Warm up. Gardening is physical, so get your body ready for it, just as you would before doing any form of exercise. Do some stretches or go for a walk around your yard or the block so your muscles warm up and you feel looser. Then ease into the gardening.
    • Be aware of your posture and use good technique when lifting and carrying things. It’s easy – especially if you’ve been working all day and you’re a bit tired – for poor technique to slip in. Remember to carry things close to your body (or use a wheelbarrow or cart), be careful when kneeling or squatting that you don’t overbalance, and that you maintain the natural curve of your spine. Try not to stay in the same position or do lots of repetitive movements for long periods of time. Swap your activities so that you’re using a range of muscles and joints, rather than overworking one part of the body.
    • Contain it. Use pots and other containers for small, manageable gardens. This is perfect if you only have a small space, you live in a rental property or you want the flexibility to change plants and plant locations regularly. You can use regular garden pots or containers, or be creative and use other containers you have lying around – e.g. old wheelbarrows, teapots, colanders, tyres, boots. Check out Pinterest for some great ideas. Just make sure you have plenty of time – it’s a great place to lose track of time. You’ve been warned!
    • Create raised garden beds and vertical gardens. This will take a bit more planning and work, but they allow you to access your garden with a lot less bending or kneeling. Perfect if you have a sore back, hips or knees. You can build your own –there are lots of videos and guides online to show you how to do this – or you can buy them in various shapes and sizes from gardening and hardware stores.
    • Use the right tools. There’s a huge range of gardening tools and equipment to help you manage in the garden including:
      • gardening gloves – protect your hands and wear decent gloves. It’s worth paying a bit more and getting a good quality pair (or two) that provide good grip and protect your skin.
      • tools that work for you – including ratchet style secateurs that allow you to cut branches with much less effort (they do all the hard work), and long handled tools that save you from having to bend down to weed or from stretching overhead to reach branches.
      • thicker handled garden tools – perfect for anyone with sore hands or difficulty gripping. You can also buy thick rubber or foam tubing from the hardware store, cut it to length and fit it over the handles of your existing gardening tools.
      • wheelbarrows and garden carts – to help you carry heavier items from one place to another, or to carry several smaller things in one go. Just be careful not to overload it and try to move more than you know you should. Listen to your body.
      • cushioned knee supports – knees pads, kneeling mats, or even gardening stools can help cushion and protect your knees and help you get up and down off the ground.
    • Get some help. Whether it’s family, friends, or a local handyman or gardener, get some help if you have some big jobs that need doing – e.g. creating raised garden beds, pruning trees, mowing lawns. You don’t have to do everything yourself. Save the things you really enjoy and let someone else tackle the less enjoyable jobs.
    • Stay hydrated. Make sure you drink plenty of fluids. Gardening can be hot, strenuous work, so don’t let yourself become dehydrated. Keep a water bottle close by.
    • Have a warm shower after your exertions. It can help loosen up muscles that have become tight while gardening. After your shower, don’t immediately sit down if you can help it. If you’re feeling a bit stiff, go for a short walk. You’ll feel so much better for it in the long run.
    • Talk with an OT. An occupational therapist can help you find ways to modify your activities to reduce joint pain and fatigue and save energy. They can also give you tips and ideas about different aids and equipment available to make gardening easier and more enjoyable.

    With the weather warming up, getting outdoors and playing in the garden is a wonderful way to forget the worries of the world, for a while at least (COVID-who?). So plant some bright flowers in pots or garden beds around the entrance to your house. Prune trees and shrubs and remove any dead winter growth. Add some mulch to the gardens beds. Plant some vegies for summer salads. Then grab a cold drink, sit back and enjoy the fruits of your labours.

    “Flowers don’t worry about how they’re going to bloom. They just open up and turn toward the light and that makes them beautiful.” Jim Carrey

    Call our Help Line

    If you have questions about things like managing your pain, COVID-19, your musculoskeletal condition, treatment options, telehealth, or accessing services be sure to call our nurses. 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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    Lisa Bywaters
    10/Sep/2020
    Health InformationMSK articles

    Coping with flares

    If you live with a musculoskeletal condition, chances are you’ve had a flare at some stage. Your body turns up the dial on your pain-o-meter and wow…that hurts. As well as increased pain you may experience increased joint stiffness, inflammation and fatigue. As a result everyday activities – getting out of bed, showering, looking after the kids, working, cooking – become much more difficult.

    Flares are frustrating and painful. You don’t always know why they happen – and sometimes they seem to come out of the blue. How long they last is also uncertain and can in part depend on how you deal with them.

    What causes a flare?

    Flares can be caused or triggered by a number of things including:

    • stress
    • changes in medications
    • overdoing it physically
    • changes in weather
    • poor sleep
    • illness, infection or injury.

    Knowing the triggers that cause you to have a flare can help you be prepared and take control.

    Your flare plan

    Be prepared

    • Talk with your doctor about the things you can do to manage a flare when one occurs. This may include pain relieving medications to help you get through the worst of it, as well as self-management strategies, including rest, gentle exercise and the use of heat and cold. You may also need to adjust your medications, or alter the dosage during a flare.
    • Have a plan in place for how you’ll deal with your commitments when you’re in the middle of a flare – family, work, home life, social activities. Can you alter your work hours, work from home, get your family to help out with chores?
    • Manage your stress. Many people find they’re more prone to flares when they’re stressed. Unfortunately we’re living through a particularly stressful time at the moment. But there are things you can do to deal with stress. Try relaxation techniques such as meditation, breathing exercises and visualisation, avoid caffeine, alcohol and cigarettes. And talk to someone – whether it’s a family member, friend or a mental health professional. Talk through what’s stressing you out so you can deal with it, and hopefully avoid a flare.
    • Don’t overdo things. We’ve all done it. Countless times. We’re feeling great so we decide to go for the extra-long walk. Or clean the house from top to bottom. Or weed the entire garden. Afterwards we’re proud of our achievements…until we wake up and can’t move. And we tell ourselves never again. But we really need to follow through with the ‘never again’. So when you’re feeling great, pace yourself. Go for the walk – but don’t go too far, or stop for a coffee break and a rest. Do the cleaning or gardening – just don’t get carried away, and get help from others. By managing your activities, energy levels and pain, you can hopefully prevent a flare from occurring.

    Take control

    Even when you do all you can to prevent a flare, you can still have one. Some flares we can predict, but sometimes they seem to happen for no reason at all. Or they may be triggered by things we can’t control – such as changes in weather or changes to meds. So you need a plan for dealing with them in the moment.

    • Over-the-counter and/or prescription medications may help you manage the pain and inflammation of a flare. As we mentioned earlier, discussing this with your doctor before you have a flare means that you can act quickly as soon as a flare strikes. You’ll have the medications you need, when you need them. But if you haven’t had the opportunity to have this discussion, now’s the time. Make an appointment as soon as possible. Don’t try to soldier on. This will only make life miserable, and can potentially make your flare last longer and cause more damage.
    • Write down what you were doing before the flare. It might seem like it came out of the blue, but there may be triggers you aren’t aware of. Tracking your activities, sleep patterns, stressors, diet and even the weather each time you have a flare may help you identify potential triggers. This will help you reduce your risk of future flares.
    • Prioritise your tasks and activities. You still need to be able to get through your day and commitments, so you need to prioritise what’s most important. You may not be able to do everything if you’re in a lot of pain or you simply can’t focus because you’re so tired. So be realistic – what really, seriously needs to be done? Only do those things. You can get to the other things when you’re feeling better.
    • Pull out all of your pain management strategies. Use heat or cold packs, get a massage, go for a walk, distract yourself…use all the things you know help you manage your pain.
    • Rest when your body needs it – but not for too long. Going to bed and being inactive during a flare can make your pain and fatigue worse. Continue to exercise, but at a lesser intensity than usual. It’s important you listen to your body.
    • Use aids and other gadgets when your joints are painful and swollen. Aids include splints, walking sticks, jar openers, tap turners and pick-up reachers. They’ll help protect your joints, and reduce some of the pain you feel when doing everyday tasks. Check out our online shop to view some of the items we have available to make life easier.
    • Get a good night’s sleep. Not enough sleep or poor quality sleep has a negative effect on our mood, our physical wellbeing, pain levels and our energy. It can also trigger a flare. Unfortunately it’s easy to say ‘get a good night’s sleep’ but it’s often hard to do when you’re in a lot of pain. The good news is there are lots of things you can do to improve your sleep. Find out more.
    • Track your flares. Keep an accurate record of when you had a flare (or flares). Also note down the symptoms you experienced and rate them. For example if you have increased fatigue, how would you rate it compared to the fatigue you feel when you’re not having a flare? Do this with all of the symptoms you experience. All of this information is valuable to help you and your doctor understand how your condition is progressing, if it’s being well managed or if your treatment plan is providing the best results.
    • See your doctor. If your flare is lasting longer than usual, your symptoms are much worse, you’re experiencing unusual symptoms or you’re having more frequent flares, go and see your doctor or specialist. You may need your medications to be adjusted. Or you may need an assessment of your current treatments to see if there’s an alternative that will help you gain control over your condition.

    Some of the suggestions listed here are easy, however others involve a bit of thought, as well as input from others. But taking the time to work out a plan that works for you will help you manage your flares better, and with less disruption to your life.

    Call our Help Line

    If you have questions about things like managing your pain, COVID-19, your musculoskeletal condition, treatment options, telehealth, or accessing services be sure to call our nurses. 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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    walking-dog-beagle.jpg
    Lisa Bywaters
    13/Aug/2020
    Health InformationMSK articles

    Exercise during the rona

    I know, I know. We talk about exercise a lot.

    But as anyone with a musculoskeletal condition knows, exercise is such an important tool for managing your condition. It keeps your joints moving, it’s vital for bone health, it helps you manage your pain, weight, mood, sleep. It’s practically magic!

    However during these weird times, many of us are probably not exercising enough. Our routines are all over the place, we’re working from home/not working/or working strange shifts. There are restrictions (depending on where you live) around going to the gym or the pool, team sports, catching up with friends for exercise or even leaving your home. And because we have to stay at home as much as possible, we’re not getting as much incidental exercise as we once did – such as walking around shopping centres, commuting to work, walking to a colleagues office. That means many of us are more sedentary and becoming unfit and deconditioned. This’s a big problem.

    So even though we’re six months into this pandemic in Australia, we need to take stock and be honest with ourselves. Ask yourself – “are you really doing as much exercise as you can?”

    Or have you gotten into a routine (I know I have) where it’s easier to stay cooped up indoors, working, watching TV and avoiding exercise outdoors in the cold, wet, COVID-winter? If you answered “no, I’m not doing as much exercise as I could” (like me), what can you do about it?

    Steps to becoming more active

    1. The first step was admitting it. Well done!
    2. Now, look at the barriers to exercise. What’s stopping you? This may include things like a lack of time, the weather, being worried about being in public with others, not having access to your usual exercise outlets such as the gym, not feeling motivated.
    3. Once you’ve identified the problem/s, it’s time to do some problem solving. Let’s say the issue you identified is a lack of time. That’s always a tough one. When we have so many things competing for our time and attention, exercise often gets pushed to the bottom of our list of priorities. But it’s important we make it a priority as it has so many benefits for our physical and mental wellbeing. So here are some simple steps to help you come up with some solutions:
      • Identify the problem – done. Don’t have time to exercise.
      • Brainstorm possible solutions and write them down, e.g. exercise in the morning, exercise after work/school, exercise for small periods of time several times a day (e.g. 3 exercise sessions that last 10 minutes each), set reminders on your watch/phone to remind you to get up and move.
      • Choose one and try it. Evaluate how well it works for you. Make sure you give it a solid attempt. Don’t stop after only one try.
      • If it didn’t work out so well, choose another solution and try it.
      • Keep going until you find the solution that works for you.
      • Make it a part of your daily routine.
      • And keep it at the forefront of your mind. Don’t let it slip off the radar again. It may help to write a note on your fridge, bathroom mirror, or the back of the toilet door. Visual clues help us stay motivated.

    Motivation

    Getting and staying motivated is often a big challenge when it comes to becoming more active. It’s cold, you’re in pain, you miss exercising with your friends, you can’t be bothered – there can be so many reasons why our motivation to exercise disappears. Especially if we haven’t been exercising regularly for a while. Here are some tips to help you if your motivation has gone south for the winter:

    • Remind yourself of the benefits of regular exercise – pain management, improved fitness, joint mobility, muscle strength, better balance, improved sleep and mood, weight management.
    • Add it to your routine. Just like you know you’ll always clean your teeth every morning, make exercise a regular part of your day. It should become that habitual. It may take some time, but if you do it regularly, it will become a habit.
    • Plan to do it when you know you feel the best. If you know you’re generally stiff and sore when you wake up, don’t schedule your exercise routine for the early morning. Schedule it for a time you know you’re feeling loose and limber.
    • Do something you enjoy. You’re more likely to continue to do it if you enjoy it and look forward to it.
    • Exercise with someone – if you have others in your household, include them. They need exercise too! If you live on your own, do some virtual exercise with friends or family. Connect with them over the phone or video and exercise together. Call someone while you both go for a walk – so you not only exercise together, but you get to catch up (just be sure you’re moving at a pace that makes you huff and puff a little – though not so much you can’t speak).
    • Exercise on your own – if you have others in your household, this can be a great way to get some alone time. We’re living in tight quarters at the moment and going a little stir crazy. Scheduling time every day (even if it’s only 10 minutes) will give you time to refresh, breathe and retain your sanity.
    • Make sure you do a variety of exercise – you don’t want to get stuck in a rut. That’s boring and you’re more likely to stop doing something that bores you. Look online at the different exercise videos offering everything from Bollywood dancing, yoga, tai chi, chair exercises and more (see the More to Explore section below for more info. And make sure you read our blog about evaluating online videos for safety and quality.
    • Track what you’re doing. Use a tracking app, a pedometer or a notebook – whatever works – but make sure you track how you’re going over time. Seeing how far you’ve come and how you’ve improved is an amazing feeling. And it motivates you to keep going and challenging yourself.
    • Continue to challenge yourself and increase the intensity of your exercise as your fitness improves. It’ll make your exercise more interesting, and also have greater health benefits.
    • Don’t set yourself up to fail. It’s easy when you’re gung ho and ready to make a change to set unrealistic goals, for example 10,000 steps every day or an hour of aerobic exercise 5 times a week. Or you may attempt to do something you used to be able to do pre-COVID. That may no longer be achievable at the moment, which can be a little disheartening. If you haven’t been exercising regularly, start slow and increase your steps/distance/time gradually.
    • Set goals. Having a clear goal can really motivate you to stay on track with your exercise program. Make sure your goal is SMART – Specific, Measurable, Achievable, Realistic and have a Timeframe. For example, your goal may be to walk a lap around your local park, a distance of 3.5kms. You want to be able to do this without stopping within a month. You plan to do this by walking short distances each day, and going slightly further every day. This goal is specific – it states exactly what the goal is; you can measure it – both time and distance; it’s achievable – as it lists the steps for how it’ll be done; it’s realistic – it gives you a realistic time frame to do it in so they can build up your fitness and endurance; and it has a timeframe. For more info about goal setting read our blog.
    • Make it enjoyable – listen to music, podcasts, audio books when you go for your walk.
    • Reward yourself. Especially if you’ve exercised even though you didn’t feel like it. That’s amazing! You should be proud of yourself. Have a bubble bath. Give yourself a foot massage (or better yet have some else do it). Call a friend just for a chat.

    Variety is the spice of life

    To get the most out of exercise, you should include a variety of different exercises that help with:

    • flexibility – stretching and range of movement exercises help maintain or improve the flexibility of your joints and nearby muscles. They’ll help keep your joints moving properly and ease joint stiffness.
    • strength – to build muscle strength, provide stability to your joints, improve your bone health and improve your ability to perform daily tasks.
    • overall fitness – exercise that gets you moving and increases your heart rate (e.g. walking, swimming, cycling) will help improve the health of your heart and lungs and can also help with endurance, weight loss, prevention of other health problems (e.g. diabetes). This type of exercise is also called aerobic exercise, cardiovascular exercise or ‘cardio’.

    Types of exercise

    There are so many ways you can exercise so that you enjoy the benefits listed above. It’s really a matter of finding the things you enjoy doing. So why not try:

    • online exercises – so many gyms and fitness instructors have moved their classes online due to COVID so you’re sure to find some that will appeal to you
    • tai chi, Pilates, yoga – again try online videos/classes, or go ‘old school’ and borrow DVDs from your local library
    • swimming, exercises in water – if you live near the beach, have your own pool or the public pools have reopened
    • ride a bike, scooter, skates, skateboard
    • tennis, cricket, basketball
    • croquet, lawn bowls – you can get all the equipment you need to play these in your own backyard or park
    • active video games – for example WII Fit, Nintendo Switch
    • walk the dog (or cat)
    • skipping rope – by yourself or get the family involved – double Dutch anyone?
    • strength training using free weights and resistance bands
    • dancing/playing air guitar…rock on!

    Note: not all of these options will be available for everyone at the moment. It’ll depend on where you live and the current COVID restrictions.

    Tips to stay safe

    Exercise is really important for good health, but we need to be careful we don’t get hurt or exacerbate an existing condition. Here are some tips to help keep you safe:

    • see your doctor before starting any new exercise program. If you’ve had a joint replaced, find out from your surgeon or health professional which movements you should limit or avoid.
    • talk to a physiotherapist or exercise physiologist – in person or via telehealth – if you need specific help, or want an exercise program tailored to your specific needs and health conditions.
    • don’t exercise a painful, inflamed or hot joint. Instead, gently move the joint through its range of movement to help reduce stiffness and improve circulation.
    • start gently and increase the intensity of your exercise program gradually over weeks or months.
    • always warm up and cool down.
    • pay attention to good technique and try to move smoothly. Don’t force a joint beyond a comfortable range of movement.
    • if you’re short of breath or in pain, ease back on the intensity of your exercise.
    • if your joint feels particularly painful afterwards (for longer than two hours after an exercise session), reduce the intensity of your next exercise session.
    • if an activity causes you pain or increases your pain beyond what’s normal for you, then stop this activity.
    • drink plenty of fluids during and after exercising.
    • wear appropriate clothing and footwear when exercising.
    • practise good COVID habits – wear your mask (if applicable), follow restrictions, maintain physical distancing (at least 1.5 metres), don’t exercise if you’re sick and don’t leave your home if you have tested positive to COVID.

    Contact our free national Help Line

    If you have questions about things like managing your pain, COVID-19, your musculoskeletal condition, treatment options, telehealth or accessing services be sure to call our nurses. 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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    dog.jpg
    Lisa Bywaters
    13/Aug/2020
    Health InformationMSK articles

    Pets

    The purr-fect treatment for COVID and MSK conditions!

    In the midst of all of the stress, unhappiness, boredom and frustration of this pandemic, something that always lightens my heart is the presence of my cats. Their antics while I work from home are so entertaining (and often distracting).

    And nothing lifts the spirits more than seeing ridiculously happy dogs in the park as they take their owners for a walk.

    There’s a reason we share so many animal memes and videos. Animals take us out of our own world for a moment, and make us smile and laugh out loud with their boundless joy and exuberance.

    In the absence of a specific treatment or vaccine for this pandemic I think our pets, and the animals around us, are the perfect therapy. They’re always ready for walks, pats, cuddles and conversation. They ease our loneliness, they listen to our rants, they don’t judge our moves as we dance around the house. They give us a reason to get out of bed, to be active and to just keep going when things seem bleak.

    Apart from helping us through these tough COVID-times, our pets are wonderful therapy for helping us manage our chronic conditions. They distract us from our pain and can help us manage our anxiety.

    Research has shown that owning a pet can:

    • decrease cholesterol levels and blood pressure
    • decrease feelings of loneliness
    • reduce your stress
    • improve your mood
    • increase opportunities for exercise and outdoor activities.

    With all of that good stuff, it’s no wonder almost two-thirds of Australian households have a pet, and 90% of us have had a pet at some time. (1)

    The time’s right – let’s get a pet!

    Hold your horses for a minute. If you’ve been thinking of getting a pet, and you think now’s the right time, it’s important that you do your research. It’s easy to get swept up in the excitement of adopting a pet. Especially now in the thick of a global pandemic and you’re feeling lonely or bored.

    But you need to make sure the fit is right for you and the animal. You need to be willing to take on the pet for the entirety of its life. That’s a big responsibility. You need to have space for them, be able to afford them (including food, bedding, vet bills, vaccinations, litter, boarding), have time to play with them and exercise them.

    The RSPCA has several resources to help you decide on the right pet for you. Check the More to Explore section below for links.

    I love animals, but I can’t have a pet.

    Sadly pet ownership isn’t an option for everyone. You may live somewhere that doesn’t allow pets, you don’t have space, you’re allergic or you live with someone who is, or you work long hours and aren’t home very much.

    If that’s the case, but you want to be around animals more, there are lots of other options:

    • offer to walk a family members/friends/neighbours pet. Just make sure you follow all the COVID requirements for your area, including washing your hands thoroughly before and afterwards.
    • volunteer your time at an animal shelter – there are lots of things you can do – playtime socialisation, patting cats, walking dogs.
    • look after a family member or friends pet when they go on holiday (remember those?).
    • think outside the litter box. There are others pets you can adopt that may be an option including fish, birds, spiders, mice, rabbits, ferrets and rats. They may provide a bit more flexibility than the traditional cat or dog ownership.
    • watch videos online. The internet is practically one big animal video…crazy cats, daggy dogs, goofy goats. It’s all there waiting for you to find. And even though you’re not in physical contact with an animal, this connection can boost your mood and relieve stress.

    What about COVID?

    According to the World Health Organization “several dogs and cats…in contact with infected humans have tested positive for COVID-19. In addition, ferrets appear to be susceptible to the infection…however, there is no evidence that these animals can transmit the disease to humans and spread COVID-19.”(2)

    Phew. But what if you get sick?

    First – the Australian Veterinary Association advises that if you get COVID-19, you should minimise close contact with your pet during this time, such as hugging, face to face contact or sleeping on your bed.(3)

    Second – you have to isolate until the Public Health Unit lets you know you can go back into the community.

    That means you can’t leave your house except in an emergency or to get essential medical care. But if you have a pet, you might need some help. You may not feel well enough to care for your pet/s, you may need more food and supplies for them or need someone to take your dog for a walk. Or your pet may need to see the vet.

    Some things you can do:

    • order food and other essentials online, via pet supply stores or your grocery store, and have them delivered to your door
    • ask a friend/family member/neighbour to pick up supplies for your pet, or take your dog for walks
    • if you’re too sick to look after your pet, ask a friend/family member/neighbour if they can take them in, or look after them
    • if your pet is unwell and needs to see the vet, don’t leave your home. Call your vet and ask for their advice. They’ll work with you to ensure your pet gets the treatment they need while keeping vet staff safe.

    It’s vital that you take all precautions to ensure that whoever helps you isn’t exposed to you and the virus. You’ll also need to be mindful of current restrictions. Check your local state/territory health website for info.

    Finally – the Battersea Dogs and Cats Home (UK) has some information on other things you can do to care for your pets if you’re ill or have to self-isolate due to coronavirus, including brain games to keep your dog occupied and happy. This is a general guide. Please be mindful that some of the restrictions in the UK are different to those in Australian states and territories.

    Coming out of COVID-cray-cray

    One day things will calm down and we’ll spend less time at home. We’ll be able to go to work, visit friends and stay away from our homes for longer periods of time. So we need to help our pets – those wonderful little creatures that have kept us sane during an insane time – get ready for this change. They’ve had us for AGES, and they’ll miss us being around all the time. This may cause them unnecessary stress and anxiety. The RSPCA has written a great article full of tips and advice on how you can make this transition less stressful for your pets: How can I prepare my pets for easing of COVID-19 restrictions? 

    Contact our free national Help Line

    If you have questions about things like managing your pain, COVID-19, your musculoskeletal condition, treatment options, telehealth or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

    References

    (1) Pets in Australia: A national survey of pets and people
    Animal Medicines Australia, 2019
    (2) Q&A on coronaviruses (COVID-19)
    World Health Organization, 17 April 2020
    (3) Advice from the Australian Veterinary Association to pet owners: COVID-19 and companion animals
    Australian Veterinary Association Ltd

    Photo by Danika Perkinson on Unsplash

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    cold-hands.jpg
    Lisa Bywaters
    30/Jul/2020
    Health InformationMSK articles

    Put your hands together and applaud

    ….your hands!

    Did you know that each of your hands has 27 bones, 27 joints, 34 muscles, and over 100 ligaments and tendons?

    They really are amazing, complex and delicate structures. And we often take them for granted – until something happens – we hit our thumb with a hammer, we slam a finger in a drawer or we develop a musculoskeletal condition.

    Many conditions such as osteoarthritis and rheumatoid arthritis cause pain, swelling and sometimes disfigurement in hands. Other conditions such as Raynaud’s phenomenon and carpal tunnel syndrome can make your hands painful, and can cause pins and needles, as well as numbness.

    For many people who have hand conditions, the colder months can make it worse. Your joints may ache more because of the cold, the constant hand washing can make your skin dry and the use of hand sanitiser (which often has a cooling effect) makes it feel like your fingers are about to drop off.

    But there are things you can do to decrease hand pain, deal with the cold and COVID, and make everyday activities easier.

    Look after your hands. Inspect them for things such as swelling, nail and skin changes and any changes to the joint shape or direction of fingers and/or thumbs. By being aware of our hands and any changes that occur, you can seek advice sooner and prevent things from getting worse..

    Wash and dry your hands regularly and thoroughly. Just as washing with soap and water for at least 20 seconds is necessary to help prevent the spread of germs (including SARS-CoV-2), drying your hands thoroughly is also important. Germs love moisture and thrive in moist places. Drying your hands reduces your chances of spreading or picking up germs when you touch things with damp or wet hands.

    Apply a moisturising hand cream regularly to keep your skin healthy and nourished. With our more frequent hand washing and use of hand sanitiser, it’s easy for our hands to become dry and cracked. Cracked skin is an opening for germs to get in and potentially cause an infection. And if you have a condition such as scleroderma or psoriatic arthritis, skin care is an important part of your overall management plan. You may need to use a medicated skin cream, rather than an over-the-counter product. Talk with your doctor or pharmacist for more info.

    Use assistive devices if your hands are painful and stiff. They can help if you have difficulty gripping or holding everyday items. Assistive devices such as jar openers, book holders, tap turners, button hook and zipper aids and easy grip utensils can make tasks easier by reducing joint stress and eliminating tight grasps. You may need to speak with an occupational therapist about what equipment is best suited to you. Also check out our online shop. We have some products available to help you with your everyday activities.

    See a hand therapist if you have hand/wrist pain or a condition that affects your hands, especially if it’s causing you issues with your day to day activities. Hand therapists are occupational therapists or physiotherapists that have undergone advanced training to become experts in the assessment, diagnosis and treatment of upper limb problems (shoulder to hand). They can provide advice on joint protection and energy conservation (e.g. splints) as well as recommendations for adaptive devices/equipment to improve hand function.

    Splints and other supports may be an option. They can give support to a painful joint by providing mild compression, warmth and/or joint protection. There are two main types of hand or wrist splints – resting splints and working splints. The choice of splint will depend on your condition and your current needs. Splints need to fit your hand comfortably and correctly, so speak with a hand therapist about what’s best for you and how often you should wear them.

    Exercise your hands, as well as the rest of your body. Regular hand exercises can reduce stiffness and support your joints by keeping your muscles strong. If you’re considering hand exercises, it’s best to get advice from a hand therapist or other specialist as to which exercises are most suitable for you. Exercises should be mild and should not cause you additional pain when you’re doing them. See our Hand information sheet for some basic range of motion exercises.

    Wear gloves in the cold weather, especially if you have Raynaud’s phenomenon. Hand warmers are also helpful. If you’re going to the shops for supplies and you have to use hand sanitiser before you enter, be aware that many of them have a cooling effect. This can really aggravate your condition. Having a couple of hand warmers in your pockets can help. You can get disposable hand warmers, or reusable ones. Just remember if you use the reusable ones to thoroughly wash the fabric pouch it’s contained in between uses. They can easily become contaminated, and hygiene is everything during this pandemic.

    Also wear gloves when you’re gardening, washing dishes or doing any tasks that have the potential for your hands to get dirty or damaged.

    Medications may provide some temporary pain relief, depending on the underlying condition causing the problem in your hand/s. Your doctor may suggest analgesics (pain relievers like paracetamol) as well as nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen. A cortisone injection is generally not recommended for osteoarthritis of the hand, but may be used for rheumatoid arthritis or acute attacks of gout. In conditions such as rheumatoid arthritis you may also be taking disease modifying anti-rheumatic drugs (DMARDs). It’s important to take these medications as prescribed by your doctor.

    With conditions such as Raynaud’s, if simple measures like keeping your hands warm hasn’t helped, you may need to be prescribed medications that widen your blood vessels and improve circulation. Talk with your doctor for more info.

    Making life easier on your hands

    Sometimes simply changing the way you do everyday tasks can reduce pain and protect your joints. You can make life easier on your hands by considering the following:

    Listen to your body – pain can serve as a warning sign that your joints are being overworked. Try to find a balance between activity and rest by pacing yourself. Take regular breaks when completing tasks and try not to overdo it on a good day. You might like to try heat or cold packs to help relieve pain. Some people also like to soak their hands in warm water or wrap their hands around a warm mug of tea.

    Try to avoid using a tight grip for long periods. For example:

    • use foam or sponge to increase the grip size of handles on cutlery, pens and other hand held devices
    • use assistive devices with thick rubber grip handles (e.g. key turners, jar openers)
    • use rubber squares and gloves to help improve grip
    • consider lever handles around your home to minimise any twisting forces (e.g. mixer taps in bathrooms/kitchens).

    Avoid repetitive movements. For example:

    • prolonged typing, pruning and power tool usage particularly those that vibrate
    • when gardening ensure your tools are sharpened and well maintained for ease of use
    • if you can’t avoid these repetitive movements, make sure you take regular breaks.

    Try to use your body’s larger joints and muscles when you can. For example:

    • use your forearms to carry bags instead of your hands
    • when carrying items hold them closer to your body
    • when lifting heavier items squat and use your thigh muscles.

    Spread the load – try to spread the load of an object over more than one joint. For example:

    • when picking up objects use two hands
    • slide sheets and swivel pads can help move items with less strain
    • divide shopping into smaller bags and try using a backpack and/or trolley.

    Find an alternative. For example:

    • buy pre-cut meat and vegetables instead of trying to cut them up yourself
    • use electrical items instead of manual (e.g. can openers and graters)
    • look for items that are easier to use (e.g. push on pegs)
    • keep a pair of scissors handy to open packaging.

    Rethink personal care/hygiene – for people with decreased hand function or fine motor skills, everyday tasks such as showering and toileting can be quite challenging. To make things easier you could use:

    • a bidet to help with cleaning difficult to reach areas
    • baby wipes/moist towelettes instead of toilet paper (but remember that they’re not flushable)
    • toilet paper tongs/aids to help with grip
    • soap dispensers instead of a bar of soap
    • items to make dressing easier e.g. sock sliders, elastic shoe laces, button hole hooks/zip pullers, front fastening bras as well as dressing aids for coats and cardigans o shoes with velcro fasteners instead of laces.

    Our hands are complicated and important and we depend on them more than we realise. Painful hands can often be managed with simple self-care strategies, however if your hands are causing you a lot of grief, and affecting your day to day functioning, talk with your doctor for information and support.

    Contact our free national Help Line

    If you have questions about things like managing your pain, COVID-19, your musculoskeletal condition, treatment options, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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    Lisa Bywaters
    30/Jul/2020
    Health InformationMSK articles

    Put your best foot forward

    Looking after your feet

    Our feet are amazing ‘feats’ of engineering (sorry, I just couldn’t resist that one).

    Each foot has 26 bones, 33 joints, and more than 100 tendons, muscles, and ligaments. They support us through thick and thin – whether we’re walking, running, jumping, dancing, skipping or hopping. We cram them into ill-fitting shoes, torture them in high heels and stub them against the bedside table in the middle of the night (or is that just me?).

    As well as the many injuries and calamities that befall our feet, many musculoskeletal conditions, such as osteoarthritis, rheumatoid arthritis and gout can affect the feet.

    They’re the unsung heroes of this pandemic as we hit the streets, parks and trails for exercise. Walking has become the exercise of choice for people at the moment. Many of us can’t – or don’t feel safe to – return to gyms or exercises classes. And lots of people are walking instead of catching public transport to avoid being in close contact with others. As a result we’re all walking many more steps than we did pre-COVID.

    So we need to stop taking our feet for granted. We need to look after them so we can continue to do the things we want and need to do as pain-free as possible.

    So what can we do?

    Give your feet the TLC they deserve. It’s really important to look after your feet. Wash and dry them regularly. Inspect them for anything unusual such as cuts, blisters, changes to the nails and skin. By being aware of your feet and any changes that occur, you can seek advice sooner. And if they’re sore after a day of walking, maybe give them a warm soak in the bath, or in a bucket or a foot spa (if you have one) while you watch TV. Then dry them thoroughly and rub a moisturising foot cream into your skin. Take your time and give your feet a nice massage. Better yet, see if you can talk someone else into giving them a massage while you relax on the couch.

    Manage your condition. If you have a musculoskeletal condition that affects your feet, it’s important that you work with your doctor and healthcare team to look after your feet and manage your condition effectively. The treatments used for foot conditions will vary from person to person, depending on your condition and how it’s affecting you. And this may change over time as your condition and your feet change.

    See a podiatrist. If you have foot pain, or a condition that affects your feet, visit a podiatrist. They’re feet experts and can assess, diagnose and treat foot and lower limb problem, including skin and nail problems, foot and ankle injuries, foot complications related to medical conditions and problems with your gait or walking. Podiatrists can also give you advice on appropriate footwear, and can prescribe custom foot orthotics.

    Consider orthotics. Orthotics are corrective insoles that can help alleviate pain by redistributing pressure away from the painful area and support your arches. You can buy off-the-shelf orthotics or you can have orthotics made that are specifically fitted to your feet by a podiatrist.

    Fit your feet with appropriate footwear. With our worlds turned upside down due to COVID, and many of us having to stay home, it’s tempting to stay in our slippers all day. There’s something so comforting about warm, fluffy slippers. However our feet and ankles need proper support. Wear the right footwear for whatever you’re doing. Going for a walk? Put on your sneakers. Working at home? Wear your casual shoes/boots that support your feet and keep you warm. And lounging around in the evening? Get those slippers on.

    If you’re buying new shoes, make sure they fit properly, support your feet and are comfortable. Look for shoes that are light, flexible at the toe joints and are hard wearing. Shoes made of leather are preferable over synthetic materials as they breathe better. Avoid slip-on shoes and if laces are difficult to fasten due to arthritis in your hands, Velcro or elastic laces may be an option.

    Let them breathe. Did you know you have about 250,000 sweat glands in each foot? That’s a lot of sweat! So let your feet breathe to avoid smelly feet and fungal infections. Change your socks and shoes at least once a day. Wear shoes that allow air flow around your feet: leather, canvas, and mesh are good options, avoid nylon and plastic. And avoid wearing the same shoes two days in a row. Give your shoes time (at least a day) to dry and air out. And if the weather’s warm, set your feet free and let them go au naturale. There’s nothing better than walking barefoot on warm grass on a sunny day.

    Exercise your feet. I’m not talking about walking here…but other exercises that keep your joints moving. Try non-weight-bearing exercises such as swimming, especially if you have foot pain, as they take the pressure away from the painful areas. You can also do exercises while sitting in a chair. NHS Inform (Scotland) has some foot exercise videos you can try. If you want exercises tailored specifically for you, visit a podiatrist or physiotherapist.

    Medications might help. If you’re having a lot of foot pain, speak with your doctor about whether medications may be an option. Depending on the underlying condition causing the problem, your doctor may prescribe a short-term course of pain relievers or anti-inflammatory medications, or they may prescribe other medications, such as a cortisone injection into a joint for rheumatoid arthritis or medication for acute attacks of gout.

    Diabetes and feet. Many people with musculoskeletal conditions also have diabetes. So it’s really important if you have diabetes that you take care of your feet every day because of the increased risk of developing nerve damage, ulcers and infections. Talk with doctor about how to look after your feet properly if you have diabetes.

    Surgery may be required. For some people, surgery may be needed if other conservative treatments haven’t helped. A referral to an orthopaedic surgeon who specialises in feet is usually required.

    Contact our free national Help Line

    If you have questions about things like managing your pain, COVID-19, your musculoskeletal condition, treatment options, telehealth or accessing services be sure to call our nurses. 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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    Lisa Bywaters
    16/Jul/2020
    Health InformationMSK articles

    Massage your pain and tension away

    For many of us, massage is an important tool for managing the aches, pains and muscular tension associated with having a musculoskeletal condition. It complements the other things we do to manage our condition such as exercise, medication and mindfulness.

    What is massage?

    Massage is a hands-on therapy that involves rubbing and manipulating the soft tissues of your body, especially your muscles. There are many different types of massage including relaxation, shiatsu, sports, deep tissue, hot rock and remedial.

    Massage can improve circulation, ease muscle tension and help you feel more relaxed. A massage can also help relieve stress and help you sleep.

    In this blog our focus is remedial massage and self-massage.

    What’s a remedial massage?

    Remedial massage treats muscles that are knotted, tense, stiff or damaged. (1)  In consultation with the client, a remedial therapist will assess and identify which areas of the body require treatment, and use a range of massage-based techniques to optimise muscle function.

    Remedial massage helps loosen tight muscles and ease your pain and stiffness. And for many people with musculoskeletal conditions such as arthritis or back pain, this type of massage is essential to keep you moving.

    Seeing a remedial massage therapist

    A qualified remedial massage therapist is trained to “assess and treat muscles, tendons, ligaments and connective tissue and treat injuries and soreness”.(2) 

    Seeing a massage therapist regularly can help prevent a build-up of muscle tension caused by chronic pain, inactivity and injury. They can also help you manage your pain, maintain joint flexibility and function, and provide you with exercises and stretches to do between visits.

    Questions to ask a massage therapist

    Before seeing a therapist, you should do your homework and find out as much as possible. Ask questions such as:

    • What type of massage do you provide?
    • What are your qualifications?
    • Are you accredited with the peak massage body in Australia?
    • Have you successfully treated people with my condition?
    • Do I need to take all my clothes off?
    • How long are the massage sessions?
    • What is the cost?
    • Can I claim this on my health insurance?

    When you see the therapist you should:

    • Be open with them and communicate your needs and any health issues – whether they’re ongoing or new.
    • Make sure you’re comfortable before they start massaging. They may have placed your arms in a position that aggravates a neck or back condition, or have you lie in a way that causes pain or discomfort. If this occurs, explain to the therapist that the position doesn’t work for you. They can then make changes to ensure you’re comfortable and that you get the most benefit from the massage.
    • Ask for extra support if you need it. If you need a pillow or cushion to support your neck, knees or back, let them know so they can accommodate you.
    • Let your massage therapist know if the pressure is too hard, too soft or if anything hurts. Don’t suffer in silence.
    • Ask yourself whether it matters if you see a male or female therapist. Massage therapists are professionals who want to help you. They’ve seen people of all shapes and sizes and will use towels and sheets to cover you. However you do need to be relaxed during a massage, and if you feel uncomfortable or self-conscious you won’t fully relax. So if you think this will be an issue for you, ask for a massage therapist that suits your needs.
    • Try not to feel embarrassed if you fall asleep or pass wind during your massage. It happens – especially when your body relaxes.

    After your massage

    • You may feel a little sore or tender after your remedial massage. This may last up to a day. The massage has worked and stretched your muscles, much like exercise does. If you’re not used to this or it’s been a while since your last massage, you may feel some pain. A warm shower or heat pack can help alleviate this.
    • Do some gentle stretches, as you would after exercising. This helps you maintain some of the benefits of your massage – such as increased flexibility and reduced muscle tension.

    Giving yourself a massage

    You can relieve many of your own aches and pains by giving yourself a massage. You may even find that you do this unconsciously – when you’re sitting at the computer and you rub your neck, when you have a headache and you gently rub your temples, or when you’re applying a heat rub to your sore knee.

    It’s a simple easy way to relieve pain and tension. The good thing about self-massage is you can do it almost anywhere and it’s free! Try it next time you feel tense and sore.

    Self-massage tips

    • Warm up first – ease some of your muscle tension with a warm shower or by applying a heat pack (warm not hot) to the painful area.
    • Use smooth, firm strokes. You’ll feel the difference between strokes that are relieving muscle tension, and those that are adding to it. Adjust the pressure, from hard to gentle, based on your pain.
    • Add some massage oil (or lotion) – it can help your hands move smoothly over the skin. This isn’t essential, but can add to the soothing feeling of the massage.
    • Don’t massage over bony areas. This can be painful and may cause an injury.
    • Try using massage aids – such as a foam roller, massage balls or other massage aids; e.g. use a tennis ball or a golf ball to massage the soles of the feet. Simply place the ball on the floor, place your bare foot on top of it and gently roll the ball along the length of your foot. If you’re unsteady on your feet, sit down while you do this. You can also use the shower to provide a massage, especially on your neck, shoulders and back.
    • Massage regularly – this’ll help prevent muscle pain and tension building up.

    Get help with self-massage

    Sometimes you need help when you’re giving yourself a massage. Reaching a sore spot in the middle of your back is tough. Or being able to apply firm, consistent strokes to your neck and shoulders may be impossible if you have a musculoskeletal condition that affects those areas. So ask for help. From your partner, a close friend or even the kids. Just be sure to clearly explain what you need.

    You can remain fully clothed and have them massage those areas over your clothes. Combined with using a heat pack, a home massage can provide some relief from your pain.

    Massage during COVID

    Many of us are finding our muscular aches and pains are worse at the moment and the need for a massage is even greater. Working from home and not having access to a proper desk or chair, trying to home school kids, not being as physically active as we’d like, and general stress about what’s happening in the world can all add to our pain levels and muscle tension. A massage – whether by a qualified therapist or a self-massage can help.

    The good news for people locked down due to stage 3 restrictions, is you can still access remedial massage therapists. Yay!

    Remedial massage and other allied health services like podiatry, mental health counselling and physiotherapy are essential to support health and wellbeing. So they’re not a restricted at this time. So wherever you are in Australia, you can get a remedial massage if you choose to.

    Just make sure you don’t see a massage therapist if you’re feeling unwell. If you feel at all sick, get tested for COVID-19 and stay home. Find out more about COVID symptoms on the Australian Government website or call the National Coronavirus Helpline on 1800 020 080.

    Take care, stay safe and give massage a go.

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. 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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    working-from-home-chaos.jpg
    Lisa Bywaters
    16/Jul/2020
    Health InformationMSK articles

    Taking control in these uncertain times

    We’re used to having a certain amount of control and consistency in our lives. Before COVID our lives were fairly predictable and we generally knew what was coming. It made us feel secure and settled.

    But at the moment it’s almost impossible to know what’s coming. Things are constantly changing and there’s so much we can’t control because of this new world we find ourselves in.

    The problem is that when we feel like we have little or no control, we can start to feel more anxious and stressed. Apart from the significant impact this can have on our mental health, we know our physical health is negatively affected by periods of increased stress and anxiety. Our pain and fatigue becomes more intense, our sleep is affected, as is our concentration and blood pressure. We may also get more frequent headaches and stomach upsets.

    So if we can take back some control, we won’t feel so powerless. This can help reduce the impact of stress and anxiety on our health.

    But we’re in a pandemic – what can I control?

    I’m glad you asked. While there are lots of big picture problems we can’t change, we can focus on the small, personal things that affect ourselves, our family and friends and our community.

    Start with rituals and routines

    Work – Hands up if your working from home attire is something you couldn’t wear to work even on a casual Friday? Many of us have relaxed into trackies, slippers and other comfy clothes. Unless we’re on a video chat, in which case our top half is more presentable.

    But this has the effect of blurring the lines between work and home life; just when we really need that distinction to give us work/life balance. And while I won’t go so far as to suggest we all get dressed in our pre-COVID work clothes (though some of you may do that) making a few simple changes may help solidify the lines between work and leisure.

    In a recent article in The Age, Melissa Singer wrote that when she’s working she puts on her work shoes, even if she’s wearing comfortable, loungy clothes. At the end of the day she can kick them off. This is her signal that work is done for the day.

    You can do similar things like putting on some perfume/aftershave, lipstick, a favourite work shirt, or putting your work away in a briefcase or work bag at the end of the day. They’re things we associate with work, and when we’ve finished work, we should go through our end of work day routine.

    And if you can, put your work out of sight so it’s not in view. Even if that means putting a sheet over it. Create a new work routine that helps you put work aside so you can relax and enjoy your leisure and home time.

    Daily routines – It’s important during times of change and uncertainty to have a daily routine that you stick to. It will help you feel more in control of your life and what’s happening at the moment.

    Your routine is very specific to you and your life, and will be affected by what you need to do in your day, if you have people depending on you, if you’re working from home, have school work (or need to help others with school work) etc.

    It might help to sit down with the members of your household and create a calendar that includes everyone’s commitments and needs. Things to think about when creating your calendar:

    • Get everyone involved. It’s vital that everyone feels that their needs matter and they’re being heard.
    • Include specific time for fun stuff, exercise and connecting with family and friends.
    • Keep your weekends separate – this is really important so that you can get your chores done (sadly the laundry doesn’t stop because of a pandemic) and you have time to do creative stuff, exercise, and get a break from the workday routine.
    • Be very clear on your hours. It’s really easy to lose track of time. If you find this happening, set reminders on your phone to alert you.

    Birthdays, weddings, graduations, funerals – These are big events for us all. They make us feel connected with our people. And while there may be some restrictions depending on where you live, it’s important we continue to mark these occasions in whatever way we can. In person, via video or phone. We can send celebratory or condolence cards; we can even go the extra mile and make our own. We can write letters and actually put down on paper how much people mean to us. I can guarantee that this will mean so much to the recipient.

    Things are different, but there’s no reason we can’t still connect when it comes to the important occasions in our life. Or just on a random Tuesday.

    Our health

    We need to continue to look after ourselves. We have musculoskeletal conditions, so we need to continue to manage them as best we can. That means staying in touch with your healthcare team, alerting them to any changes or concerns, exercising, getting your regular tests done when they’re due, managing your weight and looking after your mental health.

    Many of us have other health conditions as well. So we need to manage those too. Looking after your health is a really tangible thing you can do to feel in control in an upside down world.

    The COVID three

    This would be the worst band name ever, but it’s stuck in my head from all the ads in the media. Which I guess is the point.

    We can control how we react to the pandemic and reduce our risk of becoming infected, or spreading the virus, by following what Deputy Chief Medical Officer Dr Nick Coatsworth calls the COVID 3.

    Wash your hands, physically distance yourself from others and consider downloading the COVIDsafe app. Stay home if you’re unwell and get tested. Cough and/or sneeze into your elbow. Consider wearing a mask. Use hand sanitiser when you don’t have access to soap and water. And follow the advice of the chief health officer in your state or territory. Wait, hang on, that’s 10 things.

    Oh well, just stay safe people. Stay kind. And look after yourself and others.

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

    Reference

    • Even behind the curtain of Zoom, the show must go on
      The Age, 9 July 2020
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    vulnerable_image.jpg
    Lisa Bywaters
    02/Jul/2020
    Health InformationMSK articles

    Feeling vulnerable? You’re not alone

    We’ve been noticing an increasing number of posts on social media and calls to our Help Line from people with musculoskeletal conditions, autoimmune conditions or with weakened immune systems who are feeling really anxious and vulnerable at the moment.

    In the general population there’s a giddy exhilaration about restrictions easing. Unfortunately this seems to have led many people to forget all of the good things they’ve been doing over the past few months to flatten the curve. People are gathering in large numbers and forgetting all about physical distancing and giving others plenty of space.

    That’s scary because most of us are still susceptible to the virus. And if you’re more at risk than others, it can make you feel really helpless and exposed.

    So what can you do to look after yourself?

    Acknowledge your feelings

    It’s a crappy, crazy time, so recognise that and allow yourself to feel frightened or anxious, cry, have a freak out, and then move on. Don’t bottle these feelings up or pretend everything’s fine. All of our feelings are valid and important – you don’t have to put on a happy face or turn that frown upside down. You need to acknowledge how you really feel.

    However if it feels like these feelings are taking over and they’re all you can focus on, talk to someone – your partner, a trusted family member or friend, your doctor or a mental health specialist.

    Talk to your doctor

    Make sure you keep your healthcare team up-to-date with how you’re doing – both physically and mentally. Continue to follow your treatment plan as prescribed, and if you have any issues contact your team immediately. If attending health appointments in person feels unsafe, use telehealth if you can. Obviously there are some appointments that will require you to attend in person – for example blood tests and scans – however there are many appointments you can attend from the comfort and security of your own home.

    It’s also important that you don’t change or stop your medications without talking to your doctor, regardless of what you may see online or in the news. A recent survey of more than 500 patients attending Monash Health’s Rheumatology Department found that over half were concerned that their medications would increase their risk of getting COVID-19, and more than 75% were concerned that their medications would increase the severity of the disease if they did get it. There’s a lot of misinformation floating around about medications and COVID, so if you’re worried, contact your doctor and get their expert advice.

    Stay home

    If you’re able to stay home, do it. The best way to avoid contact with someone who may have the virus is to stay at home. This is the advice of our health officers, especially if you’re in an area that has outbreaks. And quite frankly it’s so cold in parts of the country at the moment, it feels much better inside than out!

    So stay home when you can. Use telehealth to access your health professionals, go online to order your shopping and have it delivered (or have a family member/friend pick it up for you and leave it at your door), stay in touch with your people using video chat and phone calls, use exercise apps or online videos to keep active. Technology allows us to stay connected while staying home.

    Work from home if you can

    This will help reduce your risk of coming into contact with someone with COVID and other contagious illnesses like the flu. However if you can’t work from home, your workplace is required to have in place safeguards to protect you including physical distancing measures, access to soap and water and/or hand sanitisier, and clean and disinfected work spaces. For more information visit the Safe Work Australia website.

    Keep practising good hygiene

    This is just something we need to live with from now on. Wash your hands regularly and thoroughly (for at least 20 seconds), use hand sanitiser when you don’t have access to soap and water, cough or sneeze into your elbow, throw tissues into the bin after use and wash your hands immediately, clean and disinfect your surfaces with soap and water and a disinfectant. It’s important to clean before disinfecting because organic matter and dirt can reduce the ability of disinfectants to kill germs.

    Wear a mask

    When you do have to venture out, consider wearing a mask, especially if you have to catch public transport or you need to go to a location where physical distancing may be difficult. Read our updated blog about face masks for more info.

    Get vaccinated

    We’re all being urged to get the flu vaccination this year. This pandemic is overlapping with our flu season and while flu numbers in Australia are low due to our physical distancing measures, this may change. So see your doctor (if you haven’t already) and get your flu vax.

    Ask for help

    People living with health conditions are tough and resilient. We want to be able to do everything ourselves. However sometimes that’s not an option and we need to ask for help. This can be really hard and can feel like we’re giving away our independence. However this is a global pandemic – so asking for help when you need it is the smart thing to do – especially if it helps you look after your physical and mental health.

    Get support from others who understand

    There are some great peer support groups who meet online. You can chat with them, share your worries and concerns, get useful info and gain support from people who understand exactly what you’re going through. Being a part of these groups also give you the opportunity to give back and provide support to others.

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. 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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    mask_web.jpg
    Lisa Bywaters
    02/Jul/2020
    Health InformationMSK articles

    Masks – revisited

    This article was written a week before Melbourne and Mitchell Shire in Victoria resumed Stage 3 restrictions from 11.59pm 8 July 2020.

    We’ve updated it as information has changed for different parts of Australia. Latest update 30 July 2020

    Another week, another edit.

    “The advice from the Victorian Department of Health and Human Services has been updated. People living in metropolitan Melbourne and Mitchell Shire and will now be required to wear a face covering when leaving home for one of the four reasons, following a concerning increase in coronavirus cases in recent days. To give people time to purchase or make a face covering, this new rule won’t be enforced until after 11.59pm on Wednesday 22 July – but for those who can, please start wearing yours immediately. The fine for not wearing a face covering will be $200.”(1) 

    • All people in regional Victoria will be required to wear a face covering from 11.59 Sunday 2 August 2020.
    • NSW now recommends people wear a mask when physical distancing can’t be guaranteed.(8)

     

    Just as restrictions began easing across Australia, Victoria started recording outbreaks of COVID cases. For more than two weeks the number of Victorians infected has been in the double-digits. And on Wednesday many suburbs in Victoria were locked down to stop the spread of the virus.

    So if you’re immunosuppressed and feeling really vulnerable no one can blame you. This is a scary time, and having a condition or taking medication that makes you more at risk of getting ill from any contagion or infection, adds another level to this.

    Although, we’re being advised to stay at home as much as possible, sometimes we just have to go outside the house. Some of us can’t work from home, or we have an appointment that can’t be done online or via video chat, or we have to use public transport.

    So how do we protect ourselves when we have to go out?

    Three months ago we wrote a blog about face masks. We thought it was timely to revisit this blog in light of the latest evidence, and advice from the Federal and Victorian Governments.

    The advice from the Federal Government

    This information is general advice about the use of face masks in Australia. It’s important to note that the advice from your local state or territory health department supersedes any general advice about face masks and coverings.

    “In Australia the routine use of face masks in the community is currently not recommended, while the rate of community transmission of COVID-19 is low.” (2)

    “However, some members of the public may choose to wear a mask in situations where it is not feasible to maintain physical distancing e.g. on public transport and/or if they are at increased risk of severe illness if infected (e.g. because of their age or a chronic medical condition). This may provide some additional protection in these circumstances.” (3)

    This advice takes into account the fact that restrictions are easing, and people are going out more. And with the opening up of our communities, the risk of coming into contact with people who have the virus, whether they appear to have it or not, is increased.

    The advice also reinforces the message that masks aren’t a substitute for all the other things we’ve been doing: staying at home as much as possible, physical distancing, washing/disinfecting our hands regularly, not touching our face, coughing/sneezing into our elbow and staying home when we’re sick.

    The advice from the Victorian Government

    Parts of Victoria are currently experiencing significant outbreaks of COVID-19. For that reason the recommendations about face masks have changed.

    The Victorian Premier Daniel Andrews and Chief Health Officer Brett Sutton have advised that it will be mandatory from 11.59pm on Wednesday 22 July 2020 that people living in metropolitan Melbourne and Mitchell Shire must wear a face covering when leaving home for one of the four reasons, following a concerning increase in coronavirus cases in recent days.

    People in regional Victoria will be required to wear a face covering from 11.59 Sunday 2 August 2020. That means that it will mandatory for ALL Victorians to wear a face covering when they go outside of their homes from next Monday.

    What type of face covering?
    If you haven’t been able to get a surgical or cloth mask, Premier Andrews has said: “It need not be a hospital-grade mask. It need not be one of the handmade masks … it can be a scarf, it can be a homemade mask.” He admits “nothing is perfect” and a “face covering is just as good”. (4)

    What else do you need to know? 

    • Wearing a face covering protects you and your community by providing an additional physical barrier to COVID-19.
    • Keeping 1.5 metres between yourself and others and washing your hands are still the best defences against COVID-19.
    • There will be some reasons not to wear a face covering. For example, those who have a medical reason, kids under 12 years of age, those who have a professional reason or if it’s just not practical, like when running. However you’ll still be expected to carry your face covering at all times to wear when you can.
    • The fine for not wearing a face covering will be $200.
    • Face coverings in regional Victoria continue to be recommended in situations where maintaining 1.5 metres distance is not possible – however regional Victorians will have to wear a mask when visiting metropolitan Melbourne or Mitchell Shire for one of the permitted reasons. (4)
    • Read the full Department of Health and Human Services update.

    The advice from the New South Wales Government

    The NSW Government now recommends wearing a mask if it’s difficult to stay 1.5 metres away from other people. For example, on public transport, when caring for vulnerable people or when indoors.

    Find out more on the NSW Government website.

    The evidence for using face masks

    Up until recently the evidence for the use of face masks to protect against COVID-19 has been conflicting. But over the last several months the evolving evidence has come down firmly on the side of wearing masks.

    Many people cite an article published in The Lancet in June 2020 as the turning point in the debate for wearing masks in public. It provided robust evidence for the benefits of face masks. It reported on a systematic review and meta-analysis that investigated a range of measures used to prevent person-to-person virus transmission. It looked at physical distancing, eye protection and the use of face masks.

    Researchers analysed hundreds of studies involving SARS-CoV2 (the virus that causes COVID-19), as well as SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome), across 16 countries in healthcare and non-healthcare settings, including more than 25,000 people.

    They conclude that “wearing face masks protects people (both healthcare workers and the general public) against infection by these coronaviruses”. (5)

    However the authors also state that “none of these interventions offers complete protection and other basic protective measures (such as hand hygiene) are essential to reduce transmission.” (6)

    While there were several limitations with this study, it does provide good evidence for the use of masks by the general public.

    So if you choose (or are required) to wear a mask there are some things to keep in mind:

    • Follow the latest guidelines from your state/territory health department. There’s no ‘one size fits all’ when it comes to face masks or coverings in Australia.
    • Don’t let wearing a mask give you a false sense of security. Masks will provide some level of protection – depending on what they’re made of, how porous the fabric is, how well you use them – but they’re not a magical, virus-repelling shield (though how cool would that be?)
    • Use masks correctly:
      • Wash or sanitise your hands thoroughly before you put a mask on and when you take it off.
      • Only touch the mask by the straps.
      • Make sure it covers your nose and mouth and fits snugly under your chin, over the bridge of your nose and against the sides of your face.
      • Don’t touch the front of the mask when you wear it. That means no pulling it down to talk to someone, to eat or drink or to smoke a cigarette.
      • And don’t touch the front of the mask when you remove it. If you do accidentally touch it, wash or sanitise your hands immediately.
        Basically imagine the front of your mask is covered in something messy or gross – like paint or a virus (!) – that you don’t want to get all over yourself and the things you touch (e.g. your phone, your kids).
    • If it’s a disposable, single use mask, only use it once and then dispose of it properly.
    • If it’s a cloth mask, wash it thoroughly in warm, soapy water and allow it to dry properly before you use it again.
    • Don’t wear a mask if you have breathing difficulties or when you’re exercising strenuously.
    • Don’t put a mask on a baby or small child.
    • Replace the mask if it gets damp or wet, or if you sneeze inside it.

    The World Health Organization (WHO) has some great videos to help you learn how to use a mask correctly.

    And finally, remember to keep doing all the other important things: stay home when you can, wash your hands regularly and thoroughly, use hand sanitiser when you don’t have access to soap and water, physically distance yourself from others, cough and sneeze into your elbow and stay at home and get tested if you feel even the slightest bit unwell.

    Stay safe and be kind.

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to Explore

    References

    (1, 5)  Face coverings mandatory for Melbourne and Mitchell Shire
    Victorian Department of Health and Human Services, 19 July 2020

    (2-3) Use of masks by the public in the community
    Australian Government Department of Health, updated 11 June 2020

    (4) Face masks will be mandatory in Melbourne and Mitchell Shire to combat coronavirus. What about regional Victoria? Do children need to wear them?
    ABC News, 19 July 2020

    (6-7) Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis
    The Lancet, 1 June 2020

    (8) Face masks
    NSW Government, 28 July 2020

     

    Photo by visuals on Unsplash

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