There is a phrase that is relatively well known now. It is one of those cliches that get thrown around now and then. To make a change to someone, or to connect to someone, ‘you have to meet them where they are’. This is used a lot in a psychology context, in a business or leadership context, but it is something that I live by within physio as well.
There is value to medical jargon as a health professional. It adds to the cognitive biases of the patient that you are an expert, and hopefully just that will translate into adherence and compliance to your program. But what research tells us is that rapport building and creating a robust and strong relationship with the client is more important to clinical outcomes (Leach, 2015; Klaber, 1997), and that use of medical terminology can actually serve as a barrier to patient understanding and therefore compliance.
I’m not saying the throw the baby out with the bath water. There is a time and a place to show off your fancy lingo, explaining just exactly what the zygo-apophyseal joints are, and using the word nociception, but to me it isn’t where understanding is formed. This is one place where the ‘meet people where they are’ idea comes into it. If the patient is that way inclined, go for it, but a majority of our patients (or at least mine) just want to know in lay terms, what is happening.
Now this isn’t ground-breaking, it isn’t anything new and if it was my main contention, this piece would be relatively pointless and frankly quite an arrogant blog post to share.
What I have found is the value of physically meeting someone where they are. The value of taking the time constraint out of the patient’s hands of dropping the kids off, or getting someone to look after their elderly parent while they go for a physio session. The time of organising, driving, parking, waiting for the physio to be inevitably 5 minutes late, then paying, booking another appointment and driving home doesn’t always equate to the time in the physio’s care. Especially if we are talking about 20-minute appointments.
During my time doing home visits, I have found patients to be generally much more receptive to information, much more adherent to programming and grateful for the effort being made to come to them. Like above, this doesn’t apply to everyone, and there are times where I recommend people go to a rehab specialist with larger facilities.
But for those that find it difficult or find going to a facility a barrier to entry, the ‘meet people where they are’ principle is a huge tool in rapport and trust building. As they are in their own comfort zone, I have found patients to feel much more in command of the journey of the program, which is what client centred practice aims for everyone.
Community based work, can create a massive boost in rapport and relationship building, and therefore, trust, compliance and ideally, good client outcomes.
Nathan Orenstein B.Physio (Hons)
I know this may be a fairly controversial post for some, and welcome news for others. I’m not interested in the social discourse of what you believe is right or wrong, this is not the purpose of this post. I’m here to convey information only, as ethically I am comfortable with keeping our business open to those in need. We do 1-1 home-visits for physio and Exercise Physiology if you haven’t heard of our company.
Scomo, our governing body the APA, together with the NDIS has told us that if we need to continue face-to-face appointments we can, but encouraged Telehealth for non essential consults. We give patients this choice. Lots of our patients have chronic conditions, and for them to not have their regular physio appointments for significant conditions such as Parkinson’s disease, MS, stroke, etc could have significant consequences for them both in the short and long-term.
We are not forcing any of our physios to do face-to-face appointments, as we understand the risks involved. We respect and support any choice they make. For those on staff that do want to continue, we provide them with the tools they need:
- Hospital grade infection wipes, masks, gloves, thermal infrared (contactless) thermometers.
- All pathogen-control measures the dept of health recommends (hand-washing etc)
- 5kg of hand sanitiser coming this week
- We also practice social distancing in homes, standing 1.5m from them or even outside a window, to be their patient reflection.
Just yesterday I had one of our physios tell me this:
"I saw a patient yesterday with fairly significant physical and mental health issues who said thanks for seeing her, because no-one else will, and what is she supposed to do?”
I will do whatever I can to help, given I’m a single mum trying to juggle spending time with my kids while knowing I need to work..home life is chaos!! But my kids are happy and adapting fairly well, so I am grateful for that and the support I’ve had so far."
I am also happy to say that as of tomorrow we will be placing 10% of the total of each and every visit we receive from consults to go towards helping those on the front-line, nurses, kitchen-staff, pathologists eg, anyone who will be directly effected by the shit-show that is upon us. This will come from our company bottom-line, not the brave physios and exercise physiologists who will keep working.
What I don’t know is, how or where to give this? Please recommend if you know...
We are happy to chat for free at any point if you have simple questions. We will providing you with a medical waiver to sign to do so, as we may not know your other docs, physios, reiki-masters etc, and we do need some protection.
We also offer Telehealth for more in-depth needs. “What is Telehealth?”, asked nobody in the last week.
For those of you that have been too busy watching re-runs of Seinfeld, or eating more calories than you need (🙋🏻♂️), Telehealth allows is us to see you on a screen a home. It can be a face-time call, or a Skype-call, or in our case it’s a program that allows us to do exercises with you in real time, whilst giving you feedback along the way #howcoolisthat?
With every allied health practitioner and their dog, offering telehealth at the moment, what’s our point of difference you may be asking? Probably not much..but our exceptional software #physitrack allows you to view exercises in real-time (with someone much better looking than myself...that’s our point of difference).
The good thing is, as of tomorrow, Medicare can reimburse you for the visit, much like you may have done in the past with an EPC visit. Some Private health insurers are coming on board April 14th.
So if you need physio, and have the benefits, why not use them? There is a plethora of evidence showing telehealth is as useful as in person physio, for a variety of conditions. Not all, but some.
To get a referral for Telehealth for Medicare purposes, you need a GP visit which can now also occur via Telehealth. You can use GP2YOU to have a consult with your GP or call your local GP to see if they can do a Telehealth consult. Ask specifically for a Telehealth plan to see your physio.
Private health insurance visits do not require you to get a Medicare referral.
We also are still doing home visits, for those patients that require.
We are open, we want to help..we are Home Physio Melbourne.
+61413 677 222
Arthritis affects about 1 in 10 Australians, and people living arthritis tend to report having poorer general health than people who don’t have it. While arthritis tends to affect the hands, wrists, spine, hips and knees, it appears to be the most disabling when it occurs in the hips and knees. In fact, over the past 10 years, the number of Total Knee Replacement surgeries has increased by 36%.
So what is arthritis?
Arthritis is actually an umbrella term for over 100 different diseases, but for this article we mean “Osteoarthritis” which is the most common type (about 60% of all cases of arthritis). Osteoarthritis is the breakdown and thinning of the smooth cartilage that lines our joints. It can happen as a result of injury (such as fractures), overuse (such as doing manual labour for many years) or as part of our body’s natural ageing process. While not everyone who has Osteoarthritis will have pain, the most common symptoms are joint stiffness (especially in the morning), pain, restricted movement and sometimes swelling. These symptoms can vary from mild right through to severe, depending on the person.
In people with osteoarthritis in the knees, they can often have difficulty and/or pain with walking for long periods, kneeling, climbing stairs and getting up from a low chair.
So if it’s part of the ageing process, does that mean it will only get worse?
False! We know from research that the symptoms of osteoarthritis can be reduced by different treatments, and some people with moderate to severe arthritis can even have no pain at all!
So what can I do?
There are quite a number of different ways to treat knee osteoarthritis. Here is a short list of the things that current research has found to be most effective.
There are quite literally thousands of studies that have been done looking at various different types of exercise and how they help (or don’t help) with managing knee arthritis. The general consensus is that any regular consistent exercise that you do for more than 6 weeks in a row will reduce pain, improve movement and improve quality of life, even up to 6 months after stopping exercise!
According to the Arthritis Foundation in the USA, people will have an average of 40% less pain with regular physical activity (of any kind). Another study found that regular exercise has a better effect on knee arthritis than taking anti-inflammatory medications (such as Nurofen or Volatren).
Not sure where to begin? That depends on two main things. First, how much pain and disability you already experience because of your knee. Second, what do you enjoy doing? We’re much more likely to stick to an activity that we like than one that we don’t!
If you’re currently in a lot of pain or have a lot of difficulty moving, why not try swimming or hydrotherapy? Other low-intensity options include walking, Tai Chi and (some) Clinical Pilates. Try starting with 15-20 minutes 1-2 days per week, and slowly build up to longer and more frequent sessions as your knee becomes more comfortable with exercise.
If you have very little pain and difficulty, studies have shown that high intensity exercise (such as resistance training, jogging, aerobics) have the largest improvements for pain, disability and quality of life. And these improvements last for much longer than doing lower-intensity exercise.
Lots of people who suffer from arthritis swear by using heat packs or cold packs for pain relief. But which one should you use? Generally cold is recommended for acute (new) pain and swelling, while heat is recommended for chronic (long-term) pains and muscle aches.
Several studies have shown that cold packs help reduce any swelling caused by knee arthritis. Other studies have found improvements in pain whether or not there is swelling. For the best effect, you should apply the cold pack for 10-20 minutes 3-5 days per week.
Heat packs, warm showers and swimming in heated pools are more popular for managing arthritis. Multiple studies have shown that applying heat to the knee on at least 3 days in the week improves pain, range of motion and everyday functioning of the knee. Other studies have shown that heated water (such as hydrotherapy pools, warm baths or spas) is very effective for managing pain and movement.
3. Weight Management
A large proportion of people with knee arthritis are overweight or obese, which can actually make symptoms of arthritis worse. The good news for those who are in that category is that losing 5% of your current body weight can significantly reduce your pain and improve your movement. If you’re not sure where to begin with this, an Exercise Physiologist is a great person to speak with, as well as a dietitian.
4. Make sure any other medical conditions are under control
People who have arthritis often have other medical conditions such as Type 2 Diabetes, Cardiovascular Disease or Depression. Many of these conditions can have a big effect on the symptoms of arthritis. Make sure you are regularly seeing your GP, Physiotherapist or Exercise Physiologist to make sure these conditions are being well-managed as well as your arthritis.
Did you know that knowing more about your condition, how it works and how to manage it actually helps you to experience less pain and disability? Speak with your Physiotherapist or Exercise Physiologist with any questions you have, and for resources you can use to learn more. A great place to start is Arthritis Australia (https://arthritisaustralia.com.au/), as they have evidence-based information as well as practical tips from other people living with arthritis.
Knee pain from arthritis is a very common issue, but with some simple lifestyle changes, we can see big improvements in pain, disability and quality of life. This list is definitely not exhaustive, but it should be a very good start.
If you have any concerns about your knee, make sure to speak with one of our Physios or Exercise Physiologists to get specific advice to manage and treat your specific issues. Remember, the longer you leave an issue, the longer it takes you to recover!
B.Physio, APAM Physiotherapist
Neck pain is such a common issue in Australian adults that roughly 1 in 6 people reading this will be suffering from it! Across your lifespan, the chance of having an episode of neck pain is close to 50%. It is common for people suffering from back pain to develop neck pain. Neck issues are also a common cause of headaches.
The good news is that many types of neck pain can be prevented through simple changes to our lifestyle. Here are a few simple ways you can look after your neck and prevent injury.
1. Move every 30-45 minutes
When we stay in the one posture for long periods, we have to keep tension in the muscles to maintain that posture, as well as putting pressure through the joints in our neck. Even the “perfect” posture held for too long can tire our muscles and stress the joints!
Try to get up from your chair every 30 minutes and stretch, walk or move your neck, head and shoulders.
If you do work that involves prolonged sitting, or a lot of leaning forward/bending, then it is a good idea to stretch your upper body to minimise strain on your neck and upper back. Here are some examples, which should be held for 30-60 seconds and completed on at least 3 days per week to be effective.
For those who work at a desk, or who study, it’s important to make sure that your office environment isn’t putting unnecessary stress on your neck, shoulders and back. Here are a couple of tips on desk ergonomics:
Use a good pillow
We spend 6-8 hours of our day in bed, so it’s important to make sure that your pillow supports your neck properly. There are many different types of pillow on the market. Contoured pillows can support your neck and head to maintain a neutral position when we sleep. People who sleep on their side should use a thicker pillow, and people who sleep on their back should have a thinner pillow.
Talking on the phone
Avoid cradling your phone between your ear and your shoulder. This is especially important if you repeatedly have to use your phone, or use it for long periods (such as people working in admin). Doing this can tighten the muscles and compress the joints on one side of the neck, while overstretching the opposite side.
Don’t use a laptop on your lap!
Despite their name, it’s better for your neck and back to use your laptop on a desk or table. If you use your laptop for long periods (>30mins at a time) then it is a good idea to have a separate mouse and keyboard so that you can elevate the screen to eye level. This will prevent you looking down for long periods, which can put a lot of pressure on the discs in your neck and stress the muscles in the back of your neck.
Ladies – make sure your bra fits!
Wearing a bra which doesn’t fit properly can put extra strain on your shoulders and neck through the straps. It’s important to be properly fitted for your bras and replace them when they become too loose.
Try to keep your bags light, as carrying heavy bags regularly or for long periods can overwork your neck/shoulder muscles. Backpacks put much less stress on the neck and shoulder muscles than handbags or satchels, as the weight is spread evenly across both sides.
Keeping active will help to keep your postural muscles strong, and help to minimise stiffness in your neck. It also helps you get a better night’s sleep, which is important for keeping our muscular system healthy.
Neck pain is a very common musculoskeletal issue, but with some simple lifestyle changes, we can prevent a large majority of cases. This list is definitely not exhaustive, but it should be a very good start.
If you have any concerns about your neck, make sure to speak with one of our physios to get specific advice to manage and treat your neck. Remember, the longer you leave and injury, the longer it takes you to recover!