In Singapore, the number of traffic accidents resulting in injuries increased slightly from 8,058 cases in 2015 to 8,277 cases in 2016. These injuries can have considerable impact on quality of life, and often carry with them not just significant economic costs, but also tremendous personal and social losses. They can diminish quality of life and lead to functional and occupational activity impairments, as well as psychological problems. Fractures of the lower extremities, in particular, have a major impact on functional status and health-related quality of life.The rehabilitation phase is crucial for a good quality of life and outcome among these patients. Even if the injuries are not life threatening and do not need hospitalisation, they can still make a huge impact on the life of the injured person.

How Physiotherapy Helps

Whether someone has sustained a minor injury or multiple fractures, the objectives of physiotherapy are to enable the patient to return to normal, or desired, levels of activity and participation, and to prevent the development of chronic complaints. One common injury resulting from traffic accidents is whiplash. Caused by the sudden back and-forth motion of the head, whiplash can lead to the damage of ligaments, muscles and joints in the neck and head, thus restricting motion of that part of the body. In acute cases, early physiotherapy has been shown to reduce pain and increase cervical movement. Another common injury from road accidents is bone fractures. A bone fracture that doesn’t need surgery will require rest to heal. Depending on the location of the fracture, you will need either bed rest (vertebral fracture) or a cast (arm and leg fracture). But rest means the muscles will atrophy and the connecting joints will stiffen.

Surgeons know that the faster a person can use the affected part of their body, the smaller these negative effects will be, so they will try to create a situation where the joints have room to move and the bone can bear some weight. A stiff joint can make daily life miserable — try brushing your teeth without bending your elbow or walking without bending your knee! Exercise is key to regaining strength, coordination and range of motion. Usually, your doctor will advise you to do some exercises, and which motions you can and can’t do. But when you are experiencing pain, it is difficult to exercise on your own. How often should I do it? How far can I go? Is it normal to feel this amount of pain? To get the best outcome, you need professional guidance from a physiotherapist in this early rehabilitation period. This is crucial if you suffered multiple fractures.

Exercise and Counselling

The most important physical therapy interventions for patients suffering the consequences of an injury after an accident are counselling and exercise.Counselling involves providing support, information and advice. Exercise, when used in rehabilitation, can start with passive movements and mobilization techniques, progressing towards active movement, then strength training and functional exercises.Don’t take lightly the impacts of a road traffic injury. Make sure you achieve optimal results and consult a physiotherapist, who possesses the right knowledge and experience for such rehabilitations.

 

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Ideal Posture

Good posture, or ”neutral spine” is the proper alignment of the body. Deviations from neutral alignment are identified as excessive curvature or reduction in curvature. Ideal posture indicates proper alignment of the body’s segments such that the least amount of energy is required to maintain a desired position and a minimum amount of strain is placed upon the tissues of the body. It is ideal to maintain a neutral spine whether its sitting or standing!

A Common Postural Imbalance

Most postural deviations occur because the muscles that work to hold a joint in place are imbalanced – one muscle group will be too tight and the opposing muscle group is too weak. Muscles that are in a prolonged, or stretched position can’t function properly and lose strength. A muscle in a shortened position will decrease in length, since it is not being used causing muscle tightness.

For example, people with shoulders that hunch forward often have tight pectoral muscles that pull the shoulders forward and rotate them in towards the midline of the body. Pair tight pecs with weak back muscles and you have an imbalance that pulls the shoulder girdle away from its ideal position. When imbalances like these occur, for a prolonged period of time, overactive muscles compensate for underactive muscles, which causes tension, fatigue, discomfort and injuries.

The above described posture – the forward head posture is one of the most common postures these days. This posture leads to a typical imbalance of the upper postural muscles, described by Czech Physician Vladimir Janda as the upper cross syndrome.

This posture starts a domino effect; the head shifts forward, the centre of gravity shifts forward, the upper body shifts backward, and to compensate that, the pelvis tilts forward. The entire spine responds to the change of the head position. The load on the cervical spine increases from 5.4 kg to 19 kg!

Ways to Improve Your Posture

By understanding proper posture, you can learn about your own postural deviations and determine which corrective exercises will work best to improve your alignment. The easiest and most effective way to correct imbalances is to stretch the overactive, short muscles and to strengthen the underactive, weak muscles. With correct alignment and good posture, your muscles will work more efficiently. You can prevent pain and injury, look and feel better.

Pilates is a good form of exercise that can help with postural correction. You can get a postural assessment and work with your instructor to correct your muscle imbalances.

Posture can signal both the enduring characteristics of a person (character, temperament, etc.), and his or her current emotions and attitudes. So, if your health is not enough reason to improve your posture, then the way you look might be?!

The Physiotherapist from The Moving Body can assess your posture and check for imbalances. Contact us at The Moving Body if you feel that you need help with improving your posture or if your misaligned posture has already led to an injury.

All our physiotherapists at The Moving Body are Pilates trained. Pilates is a good form of exercise that can help with postural correction. Our Pilates instructors can also do a postural assessment and work with you to correct your muscle imbalances. The physiotherapists and instructors work closely together and can refer you to each other in case they feel you are better off with the other discipline, to ensure the most optimal outcome for you!

Article written by Nienke Assink, Physiotherapist

 

Image credit: Canva Pro

 

Physiotherapy dates all the way back to 460 BC, with Hippocrates advocating the use of massage, manual therapy and hydrotherapy to treat those with bone and muscle-related disabilities. Physiotherapists have come a long way since then, with specialists in neuro-muscular disorders, heart and lung-related disorders, and paediatrics. At the end of the day, we are experts in muscles, bones, their neurological connections, and exercises.

Physiotherapists are commonly consulted to rectify aches and pains. These may be secondary to an injury, or may have developed for no apparent reason. Interestingly enough, most patients complain of back and neck pains, which “just woke up in the morning”. Questions on their lifestyle (at home, work and recreation), coupled with a musculoskeletal assessment, give clues as to what may have happened.

Such “random” pains seem to be largely due to anomalies in posture and alignment. These irregularities may occur due to unequal forces applied on the skeletal system, for example, repeatedly using one side more than the other.

This got me thinking — what if the muscular imbalances were identified in advance? Addressing these differences would thus prevent seemingly innocent movements from triggering such aches and pains. Muscular weaknesses and tightness could be used to PREDICT the development of postural anomalies, misalignments and points of degeneration (in weight—bearing joints).

I believe that today, the role of the physiotherapist is not restricted to pain management alone. It is also to PREVENT the deleterious effects of an imbalanced musculo-skeletal system.

Over the next three months, we will discuss the concept of Preventive Physiotherapy in the following areas:

1. Degenerative diseases (osteoarthritis,spondylitis)

2. Slipped disc

3. Before pregnancy and postnatal

In the meantime, move holistically! Consult one of our physiotherapists to identify your muscle imbalances and rectify them.

Article written by Aparna Shah, Physiotherapist

 

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Fitness is an important aspect any sport, as much as nutrition and diet is. Sports therapy came into existence to cater to a need of sports professionals exclusively. Depending on the kind of sport, the possible injuries and their consequences are many. Hence, it is important to have specialized therapists who understand the injury, the why and how of it and what can be done to prevent or treat it. So, a sports therapist is a professional who specializes in preventing and treating sports related injuries.

The sports therapist job profile 

What all can a sports therapist help you with? They could guide you to excel in your chosen sport, by avoiding the possible injuries associated with it. If any injury happens, they are fully qualified to provide you first aid. They are also competent to provide you long term assistance in terms of training support, specialist advice and treatment to suit your sport, appropriate massages etc.

They can also help you get back to your normal training and competitive state, in case you are injured in any way as they know best, what’s good for you. In short, a sports therapist is like a true partner for a professional sportsman in order to keep going and be successful in their field of sport.

Why it is important to find the right ones? 

Many people mistake sports therapy for mere physiotherapy, whereas this is much beyond that. If you choose the wrong person as your sports therapist, then you could end up with more trouble than you bargained for. It could cost you more psychologically, physically as well as financially, if you make a wrong choice. It is important to find proper, certified and trained sports therapists who really understand the principles of sport and can guide you properly.

This is where The Moving Body Group can make a huge difference. The sports therapists here are fully qualified to help you out and guide you and help you with your training and rehabilitation needs. They can efficiently handle all the common muscular complaints such as mobility problems, back pain, postural issues, etc. They can work out your fitness schedule that is meant to get you back to your full performance in the optimum time. It is important not to do it a rushed manner and many athletes may end up making this mistake, thus worsening the injury.

The benefit of engaging with a sports therapist

Here is a list of specialized treatment options that sports therapists Singapore can help you with for your fitness and performance benefits.

• Specialized sports massage
• Muscle strengthening and stretching techniques
• Taping (Strapping)
• Core stability training
• Proprioception training

To know more about these and how you can sign up and benefit from these, visit contact us here and talk to the experts. They are highly customer centric and can listen and guide you to choose the best possible way forward.

 

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A top-notch physiotherapist in Singapore is invaluable to improve the well-being of every patient. For physiotherapy centre, having a professional physiotherapist can help boost the reputation of the business. But the question remains, “what makes a first-rate physiotherapist?” Physiotherapists are specialists in the body movement, helping patients recover from joint or muscle dysfunction caused by wear and tear, disability, ageing or accidents.

Being a physiotherapist is not only about completing a diploma or undergoing several training programs, though these are very important. Aside from excellent skills, a good physiotherapist must have an engaging manner, patient-centred focus and dedication to the profession in order to provide the best result to all their patients.

The following attributes make a quality physiotherapist stand out from the rest.

Balanced approach

Just like other health practitioners, a physiotherapist should have the right balance of firmness and care to each of his or her patients. A top physiotherapist will be caring and sensitive in approach while adhering strictly to the treatment processes which need to be taken for the patient to recover faster. For some lazy patients, these types of physiotherapists can be annoying or uncomfortable to work with since they will seriously stand firm on the right steps of the treatment. However, they will ensure that the patient will get the best possible results of the treatment.

Works as part of a network

A reliable Singapore physiotherapist fully understands that most of the patients require a strong support framework around them. Depending on the case of the patients, some might require allied health professionals, medical specialist, and general practitioner throughout the course of physiotherapy treatment. The support of any of these health professionals is very important to monitor the improvement of the patient. Being a good team player is likewise important for any physiotherapist working within a health practice to ensure proper communication with colleagues, admin, and reception in order to operate with great efficiency. If a physiotherapist doesn’t communicate with other staff, how can they provide the best treatment?

Patient-centred focus

Sometimes, you might find physiotherapists who are not that dedicated to helping their patients get well, especially if the patient doesn’t have the motivation to do the treatment. If the patient says he or she doesn’t want to perform a particular exercise, the physiotherapist will just nod and follow what the patient wants. Meanwhile, a good physiotherapist works with the “whole person” and not just on areas where the problem exists like back, shoulder or leg. To diagnose properly and come up with the right solution, the physiotherapist will be keen to know more about other factors in the patient’s life which can contribute to the problem. It is essential for a physiotherapist to investigate the problem instead of just treating the symptoms, which might return if not addressed properly. In general, the primary focus of the physiotherapist is to find the best possible solution to his or her patient’s problem and help them recover in less possible time.

Dedicated to professional development

Ongoing professional development is one key to becoming a successful physiotherapist. This is why many physiotherapists in Singapore continue taking up training and seminars in physiotherapy to stay at the top of their field. They grab further training opportunities and seek mentors or more experienced professionals who can help them in their career development.

 

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It’s a common misconception that physiotherapy is a treatment option reserved for elite athletes or people who are recovering from an injury. In fact, hiring a physiotherapist in Singapore can help improve one’s health and wellness in many surprising ways. When people think of physiotherapy, they often imagine patients who are struggling out of a wheelchair to learn to move after a serious accident, illness or injury.

An individual doesn’t have to be badly debilitated to experience the benefits of physiotherapy. If you are bothered by consistent pain or discomfort, these are enough signs that you should hire a physiotherapist. Here are the most common signs you may need physiotherapy.

Pain doesn’t go away

Are you suffering from neck or back pain? Or do you have sprains, strains or muscle imbalances? You don’t have to suffer in silence and keep the agony to yourself. Since pain may come and go, many people tend to keep quiet and handle it themselves. However, if the pain doesn’t subside even after taking medications or after several weeks, this is the time to consider undergoing a physiotherapy treatment. A physiotherapist can help ease the pain by specifically targeting the pain while increasing patient’s mobility. This type of therapy aims to eliminate pain while improving mobility.

Mobility issues

Keep in mind that even a simple injury can impact the entire body. If you have ever had an injury, then you obviously know how it feels when a certain part of your body doesn’t function the way it should be. Many people are suffering from mobility issues and they just accepted the fact that they have restrictive movement. This should not be the case as physiotherapy can help correct mobility issues. While it may take some time to see the result of getting a physiotherapist, the thought of being able to move freely again is already a great motivation.

Loss of balance

When someone loses a sense of balance, it can be a result of an inner ear problem. A lot of people might not know that the structure inside the ear plays an integral part of the body’s balance system. When a problem occurs inside the ear, it can leave you feeling different symptoms, like vertigo, dizziness, and balance disturbance. All these are difficult to live with, so you need to correct them as soon as possible. A physiotherapy treatment can help you overcome these symptoms related to inner ear issues. The therapist can design a series of exercises to help alleviate the problem.

Flare up problems

If you have an old injury that doesn’t seem to heal completely, this should prompt you to consider seeking the help of a physiotherapist. Some people who have had an injury may feel okay for a while, but when they engage in certain activities, the pain tends to rear up again. If an injury was not attended properly when it was fresh, the healing process will likely be prolonged, and sometimes the injured part will never be the same again.

However, if you choose to hire the service of a Singapore physiotherapist, he or she will be able to address the recent physical problems you experience as well as the issues that have accumulated over time. After a period of time, you can move freely without worrying about the pain of your old injury.

The Moving Body Group offer Physiotherapy service in Singapore for those who have experienced acute injury, post-surgery, or for those with chronic or progressively degenerative conditions. Our physiotherapy services mainly include the treatment of musculo-skeletal disorders using muscle stretching & strengthening, soft tissue releases and mobilisation, joint manipulation and mobilization, and money more. Feel free call our physiotherapist or fill the contact form here.

 

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Sometimes it’s a little confusing where to start when searching for a physiotherapist in Singapore. With so many physiotherapists available, you will surely wonder which one is suitable for you. There are different ways you can look for a physiotherapist such as asking your doctor or health care professional, asking for recommendations from friends, and searching over the internet. Word of mouth referral is more powerful than the other means since the person has had experience with the service or the physiotherapist.

So, what should you take note of when looking for a physiotherapist in Singapore?

Below are the most important things you must consider in finding the most suitable physiotherapist.

Area of specialisation

Physiotherapists are required to complete years of study and undergo training to acquire their qualifications. But they can further their expertise in various areas of specialisations, such as mental health, sports injury, care of the aged, ergonomics and office set up, stroke rehabilitation, respiratory problems, spine and head injuries, and recovery after surgery. You should choose a physiotherapist who specialises in your needs. For instance, if you have an injury, you may need to see a physiotherapist who specialises in injury. However, physiotherapists don’t have to have a specialisation as they can have a general practice that caters to a range of conditions. It would be ideal to work with a physiotherapist that is AHPC registered.

Methods of treatment

Traditionally, physiotherapists train in movement and exercise, manipulation and electrotherapy, and massage. It is essential to know their methods of treatment in case you have a preference for a particular treatment type to relieve your pain. Some physiotherapists may offer alternative treatments to replace the traditional methods of relieving pain like reflexology, hydrotherapy, reiki, shiatsu, different types of massage, and others. Ask the physiotherapist if your preferred method of treatment is available in their health centre or clinic.

Some health centres or clinics may have alternative health care professionals to treat patients aside from the physiotherapist, which include a massage therapist, life coach, Pilates coach or osteopath.

Qualifications and Accreditation

Since a physiotherapist in Singapore is required to finish a degree, you should check the qualifications and accreditation. This ensures that the physiotherapist has met the necessary standards to promote the best health practice. You should check the codes of conduct, history, insurance, accreditation, and continuing professional standards. The practice may also obtain further accreditation, which can provide more professional accountability and excellence in this field of expertise. Furthermore, their qualifications will justify the quality of service they offer.

Availability

It is usually the case that we wish to see a physiotherapist to provide quick relief of the pain we are experiencing. This is why it is critical to determine the availability of the physiotherapist. Is the physiotherapist available right away? Be sure to book out your preferred physiotherapist weeks in advance to ensure your slot. If the physiotherapist you choose is a popular one, chances are, there are many patients who have scheduled an appointment with him or her. Thus, a physiotherapist who is able to see you as soon as possible should be booked out immediately.

Clinic location

Where is the physiotherapist in Singapore located? Do you need to travel for an hour or so to get to the clinic or health care clinic? Or is the clinic very accessible? If you are catching public transport, is the clinic situated close to a bus station or MRT station? The location is a crucial factor that you should take into account when choosing a physiotherapist. Ideally, you must opt for a physiotherapist who is nearby your home or work so you won’t find it difficult to visit the clinic every scheduled appointment.

 

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You go for a run and halfway you feel a slight pain in your knee. The next morning it feels a bit stiff, but not too painful. The next day you go out for a run again, but even before halfway you feel your knee again. You head home, disappointed and decide to rest for a week. The following week the knee feels fine and you start your run hopeful. You realise at the halfway point that your pain in the knee isn’t gone. It is still there. You start to wonder ‘should I see a physiotherapist? Or maybe a sports physio?’

With an acute (sports-)injury, like a sprained ankle, it is clear you can’t continue with running. But with a dormant injury it is more difficult.

Inflammation and how to overcome it

If you have signs of inflammation, like pain, redness, swelling, an increase in temperature and/or decreased function, it is wise to stop your sport activities. In the first 48 hours, the RICE principles should be applied; Rest, Ice, Compression, Elevation. In the next 10 days (the phase that follows the inflammation phase is the proliferation phase and this phase lasts approximately 10 days) you try to use your extremity as normal as possible for daily life activities. After this period the signs of inflammation should have completely disappeared. The next phase of the healing will start, the early remodeling phase (10 till 21 days). You can try to build up sports activities again, starting with low impact. In the late remodeling phase, which starts after 3 to 6 weeks and can last up to a year! It is important to restart to use the extremity is the desired function. Since in this phase the connective tissue will build up its strength depending on the load you place upon it.

Find the root cause of your injury

It is important to know the cause of your sports injury (knee injury) to find the solution. How about your running shoes? Are they old and worn out? Did you build up the run in a smart way? Or did you not run for 6 months and just restarted your old pace and distance without building it up? In a normal situation our body should be able to heal itself because of the earlier described phases of wound healing. But maybe something is obstructing the healing process, causing repetitive strain on the injured tissues and therefore preventing it from healing. Maybe you have tight, or weak muscles? Or a misalignment? These are issues your sports therapist can help you with.
The physiotherapists from The Moving Body will do a full assessment and after which give you advice on the best treatment. Depending on the cause of the injury and the severity of the symptoms you have, the physio might have to see you again for several sessions. A sports physio will always give you a clear explanation and a time frame when you should be able to return to sports. Because, in the end, that’s what it’s is all about… When can I resume my sports again?!

In the second part of a series of three articles, we will talk about how the concept of ”Preventive Physiotherapy” can be used to possibly prevent a slipped disc.

 

 

Slipped disc is the colloquial term for a herniated disc, or prolapsed disc. These can be traumatic in nature (due to accidents), or due to general wear and tear.

Intervertebral discs are found between the bones (vertebrae) of the spines. They function as shock absorbers, and maintain the space between vertebrae. It is important to maintain this intervertebral disc space in order to prevent compression of the nerves present here. Excessive pressure applied on any part of the disc will cause its gel—like contentsto ooze out. This gel may in turn apply pressure on the nerve root, resulting in pain along the course of this nerve.

There are two factors affecting the size of this space (and therefore, the amount of pressure on nerve roots):

1. The health of the intervertebral disc
2. The balanced activation of the muscles supporting the spine

The concept of “Preventive Physiotherapy” will preserve the health of the disc by ensuring optimal activation of spinal stabilisers. Analysis of muscle strength, posture and lifestyle, can be used to identify the following:

1. Weaknesses in the muscular system supporting the spine
2. Incorrect movement patterns (which may place excessive force on the disc)
3. The cause of these weaknesses and incorrect movement patterns

Early intervention, in the form of specific exercises targeting the weak muscles and functional training, may prevent excessive force being placed on the disc. It is thus possible to prevent non-traumatic slipped discs.

Consult one of our Physiotherapists to maintain the health of your intervertebral discs.

Article written by Aparna Shah, Physiotherapist

 

Image credit: Unsplash, Sasun Bughdaryan

 

What is a painful radiculopathy?

Low back pain is one of the most common musculoskeletal complaints encountered in a physiotherapist’s clinical practice. Painful lumbar radiculopathy is a type of back pain that is associated with symptoms of shooting or burning pain travelling down the leg, weakness and numbness. Previously it has been referred to as ‘Sciatica’. It has an incidence of 5-12% amongst the general population. Radicular lower back pain is a debilitating and frustrating condition; however, it can be managed together with your physiotherapist. 

The nerves in our body transport messages from the body to the brain, and from the brain back, to initiate and control movement and sensation. The nerves enter and exit via the spine and travel along the spinal chord. Painful radiculopathy occurs when there is impaired nerve insulation which disrupts the transporting of function from the nerves to the body parts. It can occur due to compression, damaging the nerve root which can cause loss of nerve function (leading to weakness or numbness), or due to a chemical irritation within the spine, leading to inflammation (causing pain). Radiculopathy can happen at any portion of the spine, but it is most commonly seen in the lower back (lumbar) region. 

Signs and symptoms of painful lumbar radiculopathy include back pain with unilateral leg pain. The leg pain can be dull, piercing, shooting, tingling or burning sensation radiating down as far as the knee or towards the ankle. It usually occurs in the area that the affected nerve supplies (dermatome). It can often be much worse that the lower back pain itself, and can occur both at rest and during activity.  Patients often report numbness or weakness in the leg and can sometimes present with an altered gait pattern, depending on the severity of symptoms.  

Why does painful radioculopahty happen?

There are many reasons for the onset of this type of pain. Predisposing factors are obesity, smoking, heavy manual labour, extended periods of sitting e.g. while driving and job dissatisfaction. More acute factors that contribute to radicular low back pain (usually triggered by trauma of twisting or straining the back or wear and tear) include 

• A disc bulge: where over 25% of the disc (cushioning between the vertebrae) extends beyond its normal margin impinging on surrounding structures including the nerve root.
• A disc herniation: where under 25% of the disc herniates beyond its normal margins margin impinging on surrounding structures including the nerve root.
• Spinal stenosis: narrowing of the joint spaces within the spine due to degenerative changes of the spine.
• Spondylolisthesis: when one of the vertebrae slip forward onto the bone directly beneath.
• Spinal tumours or infections. 

In cases under 50 years old, a herniated disc is the most frequent cause, while for those aged over 50 years old it can be caused by stenosis or degenerative changes in the spine. It is important to note, that often, people can have these findings on an MRI and experience no symptoms as well. 

What is the treatment for painful radiculopathy?

Overall, the majority of cases of painful lumbar radiculopathy are not severe, and will resolve with time, and thus conservative management is the first line of treatment, however approximately 30% of cases will continue for a year or longer. Treatment is varied and includes a combination of physiotherapy and medical management. 

Contacting your local physiotherapy clinic can be the first step. After a detailed assessment with the physiotherapist, we can guide you towards a program of manual and exercise therapy that suits your personal needs and goals. There is much evidence to show that staying active with a structured routine of guided exercises is an effective form of management. In certain cases, we may refer you onward for further medical management. 

At The Moving Body, our physiotherapists are well equipped to manage your radicular lower back pain whether you are in the acute stages of pain, or if this has been an ongoing issue for months or years. We utilize a wide variety of treatment techniques including Pilates and modified resistance training to manage pain and optimize lumbo-pelvic strength. In severe cases, we may refer you onwards for an X-ray or MRI. We work hand in hand with GPs and orthopaedic consultants to ensure that you recover as soon as possible. While it is never too late to start, the sooner this issue is addressed, the better the outlook is. Contact us today to arrange your physiotherapy consultation.

 

Image credit: Unsplash, Toa Heftiba