(NC) – When Toronto orthopaedic surgeon John Theodoropoulos is talking to patients about shoulder surgery, he explains that the procedure will only get them 50-per-cent better.

what I do is only half the battle – physiotherapy will take care of the other 50 per cent

Not that he’s anticipating a poor outcome, “But what I do is only half the battle – physiotherapy will take care of the other 50 per cent,” he says.

Patients prescribed an antibiotic wouldn’t expect to improve if they skipped doses, or didn’t take the medicine for the full period. When it comes to bones and joints, says Angelique Berg, executive director of the Canadian Orthopaedic Foundation, physiotherapy is frequently the prescription.

“After surgery, the patients who aren’t doing well are invariably not going to physio, or doing the wrong things in it,” says Dr. Theodoropoulos.

Laying on the couch and just letting time heal won’t work, he says. Without exercise, you lose muscle tone and bulk, and your joints get stiff.

Before she even considers shoulder or knee surgery, Dr. Jennifer Fletcher, an orthopaedic surgeon in New Brunswick, sends her patients for physio.

“With rotator cuff strains, for instance, 80 per cent of people get better just with appropriate physio,” says Dr. Fletcher.

It’s vital, she says, to have a qualified physiotherapist instruct you in the appropriate exercises, and then to follow the regimen at rehab and at home – no shortcuts.

The other ingredient for success? Patience.

Dr. Stewart Wright, a Toronto orthopaedic surgeon, notes that acute injuries can “settle down” in two to three weeks, and broken bones in a cast can heal in about six weeks.

“But soft tissue injuries can take 12-to-18 months to heal completely,” he says. “You need to stick with rehab, and do your part for full recovery. The investment you make up front will pay off.”

Guidelines for comfortable portable computing …

“… While experts predict a steady increase in notebook sales through the end of 2010, consumers often don’t consider the compromises in comfort that are made when using such a computer. Based on academic research and years of manufacturing experience, Ergotron has published a white paper, Comfortable Portable Computing: The Ergonomic Equation, aimed at providing valuable, easy-to-use guidelines to help people achieve comfortable, more productive portable computing.

Using a portable computer improperly can increase one’s risk of future health problems from neuro-musculoskeletal disorders. “The purpose of the white paper is to educate people on the risks associated with portable computing, and to let them know that they don’t have to jeopardize their health and well-being when using a portable,” explained Pete Segar, Senior Vice President of Engineering and CTO of Ergotron. By applying basic principles set forth Ergotron’s “Ergonomic Equation,” anyone can achieve comfortable computing.

The Ergonomic Equation consists of three simple considerations: Neutral Posture, Voluntary Motion and Restorative Time.

First, one must consider Neutral Posture, which is the position the human body assumes naturally and comfortably. It expends the smallest amount of energy and results in the least amount of bodily stress and related fatigue.

The second consideration is Voluntary Motion, which works in conjunction with neutral posture toward maintaining a body in balance with itself and its surroundings. It refers to movements the body makes naturally to prevent strain and fatigue.

Finally, Restorative Time balances stressful activities with restorative activities. These could include a variety of actions, such as a walk to the water fountain, or deep-breathing exercises practiced periodically throughout the day.”

continued at ergotron.com »

Institute sets up shop in basement of continuing care facility

Jodie Sinnema, edmontonjournal.com
Published: Monday, February 25

EDMONTON – Lindsey Rayner first met Richard Boswell last year when she helped with his dinner at CapitalCare Dickinsfield.
Now, she’s hoping to become a licensed practical nurse and is being trained in the basement of the continuing care facility as part of a pilot project that better links nursing students with patients who need continuing care.
The project is part of a new partnership between CapitalCare, NorQuest College, Capital Health and the University of Alberta to create the Institute for Continuing Care, Education and Research.

We get the real opportunity to have one-on-one contact and the closeness with the residents

“We get the real opportunity to have one-on-one contact and the closeness with the residents,” said Rayner, 18, who now sees Boswell, 49, and other residents while on school coffee breaks. Students see trends and issues facing the residents and take that knowledge back to classroom.

Farther into the nursing program, she and 25 other students will move upstairs to practise their skills at the bedsides.
“We can ask them real questions,” Rayner said. “You get the real impact.”
She also believes the residents enjoy seeing young people going into the nursing profession.
“With the opportunity to see the students, they will be having a sign of hope that they will be better taken care of,” she said. Rayner began the diploma program in January.

Joan Crawford, 66, has even taken the opportunity to go into the basement to watch the NorQuest students.
“We know that there is continuing education going on and, hopefully, some of these will come work with us,” said Crawford, who used to be a licensed practical nurse herself. She said Dickinsfield is sometimes so short-staffed she helps feed other residents.
Iris Neumann, chief executive officer at CapitalCare, said she hopes the new institute will encourage more people to consider a career in continuing care.

“Continuing care is not about the glamour of saving lives but helping people live their lives,” Neumann said.
The Institute for Continuing Care, which does not yet have a physical space, will first find an interim director to coordinate grant proposals and build a knowledge base. It will start up research projects, such as one that is placing physiotherapists and physiotherapy assistants in the same clinical practice together to enhance interdisciplinary teams.
Eventually, the institute plans to have its own building with a continuing care centre where student nurses learn under the best teachers.

By Team Mangalorean
Photographs: Rajesh Shetty

Mangalore, February 23, 2008: Various group of students including the ones that study Physiotherapy and members of Dakshina Kannada branch of Indian Association of Physiotherapists (IAP) have appealed to the Union Minister of State for Labour and Employment Mr. Oscar Fernandes to amend the physiotherapy council Bill introduced in the Parliament and which will be soon coming to Rajya Sabha.

Mr. Fernandes was in the city to inaugurate the students convention organised by the district unit of National Students Union of India (NSUI) to commemorate the centenary of Satyagraha movement by Gandhiji here today February 23, 2008.

Asking him to amend the bill the groups stated that major sections of the bill, especially the one pertaining to definition, had to be corrected. They stated in a memorandum to the minister that the definition in the bill was not helpful for growth of physiotherapy Instead they wanted the minister to help set up a common council for physiotherapists and occupational therapists. The memorandum observed that both were different professions and needed to be governed by independent councils.

Dr. U.T. Ifthikar Ali, convener of the Mangalore branch who spoke to the minister stated that these issues were before the Government for a long time and they should be acted on now he added.

The bank pigmy collectors association who also put forward their problems told Mr. Fernandes that the pigmy collectors, under the aegis of All India Bank Deposit Collectors Workmen Union, were not given the workmen status on collectors working for banks as per a Supreme Court order in this regard. H.D. Ashok Kumar, general secretary of the Dakshina Kannada unit, said some bank managements were thinking of closing down the pigmy scheme. The State Bank of India had approached the Apex Court in this regard, they said.

DCC President Ramanath Rai, NSUI former president Ramesh Chennithala, Vinaya Kumar Sorake, Jayaram Shetty, B.A. Moideen, Vijay Kumar Shetty, UT Khader, District Congress President MA Gafoor, President of Youth Congress wing Bondala Jagannath Shetty, DCC Minority wing president Moideen Bawa, INTUC President Rakesh Malli, DCC Vice President Ivan DSouza and other congress leaders including Kallige Tharanath Shetty, Sadashiv Ullal and MG Hegde were present.

One of the least talked about concepts in massage school is the therapeutic relationship that occurs between the massage therapist and the client. Cidalia Paivia in her book “Keeping the Professional Promise” says:

When a massage therapist and a patient come together, the therapist and patient enter into a therapeutic relationship. What distinguishes the therapeutic relationship from other relationships is its very special purpose and goal, which is to serve the needs and interests of our patients.

The Therapeutic relationship’s primary function is to facilitate the health and well-being of our patients, ensuring that we bring our full presence and commitment to this experience.

When people come to us seeking help with their condition or distress, what happens is that a power differential is created. People come to us thinking we can ‘fix’ or help them. They think that we hold the answers to relief from their symptoms. They are vulnerable because they are in pain or under stress. The act of seeking help recreates an old pattern of relating to someone in power which is based on our early relationship with our parents or major caregiver. Since no caregiver is perfect and able to provide for all of our needs we are left with holes in our essence and we seek to fill these in most relationships especially one where a person is actually seeking help.

On the other hand the “helpers” have their own issues and reasons why they feel compelled to be the helper. While on the surface many help because it brings more meaning to the helpers lives, helping is also a great way to really learn more about oneself. Rachel Remen in her article “in the Service of Life” talks about helping in this way:

Serving is different from helping. Helping is based on inequality; it is not a relationship between equals. When you help you use your own strength to help those of lesser strength. If I’m attentive to what’s going on inside of me when I’m helping, I find that I’m always helping someone who’s not as strong as I am, who is needier than I am. People feel this inequality. When we help we may inadvertently take away from people more than we could ever give them; we may diminish their self-esteem, their sense of worth, integrity and wholeness.

Because the nature of touch can bring up so many deep and unconscious feelings and emotions in clients and the massage therapist, it is important that a massage therapist have an understanding of what happens in a therapeutic relationship and understand how what they do and say can influence the relationship.

The therapeutic relationship is based on the massage therapists ability to stay present with a client and not judge, fix or otherwise hinder the client’s process of healing. It requires that the massage therapist have a clear idea of what their own needs are and learn to get their own personal needs for appreciation, validation and to be needed met in other areas of their lives so that they can become and stay more present with the client for the clients healing process. Working within the therapeutic relationship requires that you be able to give empathy for the client. To be able to give empathy, one needs to have met their own needs for empathy first by doing the grief work that is related to not getting your needs met and working with a skilled peer supervisor or mental health counselor to rewire the brain and body for empathy.

Since so many of our needs are really unconscious, it is important to begin to become aware of our own needs and learn to take care of them outside of the therapeutic relationship so that we can become more present to witness the healing process in clients.

So often massage therapists find themselves crossing the boundaries between friendship and clients, wanting to fix a client, wanting to give more, getting paid less, giving advice and acting in other ways that will actually foster a client’s dependence on the massage therapist. The massage therapist will often start sacrificing their time and energy in order to help a client or so they think. There is such a fine line between helping and when helping is actually hurting that it is near impossible to distinguish until it is too late. The massage therapist will end up feeling resentful, burned out, facing physical injuries/illness which may lead to career ending events.

The presence of a massage therapist depends on their own awareness of themselves and the reasons why they feel compelled to help. Our early childhood is where it all starts. Our self esteem is developed at an early age. We begin projecting our unrecognized feelings on others shortly after birth. When our early needs for nurturing, appreciation and acceptance were not met, we see ourselves as less than worthy and it is reflected in all of our actions and reactions. When our own needs for empathy and mirroring are left unmet from early childhood, they often get in the way when we try to help others. We can learn to be of service more when we take the time to receive the empathy that we need for ourselves.

As a massage therapist, we owe it to our clients to do our own personal growth work and fill in the holes left by the wounds of our past. Learning about ourselves and setting clear boundaries in a massage practice can take you much farther in building your practice than any marketing plan. The clearer you get about who you are, what you are doing and why, the clearer your relationships with your clients and potential clients.

Which would you rather be touched by? A human being or a machine?

Recently I ran across this article…

http://www.charlotte.com (archived)

It was suggesting that robots are beginning to replace human beings at certain spas. And that a new invention could be paving the way. Makes for a nice story and PR release, but give me a break.

As a professional massage therapist, I have tried and used many machines for ‘relaxation’ and NONE of them come even remotely close to the value of two warm hands and the rest of the human being attached to those hands. The electromagnetic distortion alone created by those machines is enough to cause me more stress, not less.

I have sat in those massage chairs that are designed to heat, vibrate and shake and cajole you, and they can begin to allow for the physiological relaxation response, but that’s about it. I certainly don’t feel like I do after a REAL live massage.

It’s quite ironic, one of the reasons we carry so much stress is that the majority of us sit behind machines all day. Now we’re going to go to a machine and have that machine work our muscles and relax us? Not me. Give me a real live person any day. You can feel the energy or resonance of compassion and caring and universal love from another human being. A machine doesn’t care.

When two people touch each other, there is an exchange of energy. Literally. In one of my classes I show people the energy ball. It’s a little plastic ball with two metal strips on it. I stand in a circle of about a dozen people all holding hands. Except I have one finger on one strip of this little energy ball and instead of holding hands with the person next me, they are also touching a strip on the energy ball. Guess what?? It lights up and makes a noise. In fact, one person anywhere in that circle can stop holding hands with the person next to them and the energy ball light goes out. It’s a great metaphor to show that we’re all connected. And that we transfer energy to and from each other.

And in complex ways that we certainly don’t understand and shouldn’t have the arrogance to think we do. Considering all the different possible frequencies and harmonics involved in that energy exchange, that we don’t even think about or for the most part aren’t even aware of, it’s truly a mind boggling experience. Just simple human touch. And actually we transfer energy just being close to one another, but that’s a different topic.

If you’ve ever had a massage and paid attention to the exchange of energy flow between you and your therapist, then you have an idea of what I am referring to. You can tell, even with your eyes closed, what your therapist is sensing, whether or not they are paying attention to you, whether or not they are focused, whether or not it’s going to be a great massage or they’re still working on the basics. You can feel how well the energy is flowing through them and where the restrictions are in them. Try it and see for yourself, next time.

Massage is so much more than a mechanical response. It’s one of the oldest healing art forms. It truly does involve body, mind and soul. And the information and energy you can perceive through your hands is and always will be more than a machine could even begin to offer.

So my vote might be a little biased, but for my money, give me a real live person any day of the week.

The Economic Times writes about the common back-pain and how to treat it.

This isn’t on the back of your mind always but is capable of putting your back against the wall. Puzzled? Read how: In a recent study conducted across eight cities, the combined data surveillance reveals that around 67% of white collar Indians suffer from hideous pain vibrations that cause the achy backs.

The report further finds a good 15% increase in young professionals suffering from the pains which, doctors feel, can be ascribed to the growing number of young men joining the IT and BPO sectors. A majority of the complaints, however, was seen in the age group of 25-40 years.

Now, these may be mere numbers for many of you. But the figures portend ominous for those glued to their seats in routine work on a regular basis with wrong posture. What’s worse, most of the backaches are often dismissed as arising out of fatigue. A doctor’s advice is only sought when the pain gets nagging and affects normal activities.

Let’s understand this in detail. Simply referred to as lower backache, this stimulating pain aggravates around the lower spinal region (lumber region) and is one of among the fifth leading cause that calls for a doctor’s visit. It is also one of the major reasons for absenteeism in jobs.

Explains Dr Sanjay Sarup, orthopaedic surgeon, Max Healthcare: “Almost everyone has suffered such an attack at some point in their lifetime. Poor postures are the triggers in many cases that afflict the patient with this excruciating pain.

Poor postures stress the back. When a person slouches, sits or stands with a swayback, it exaggerates the backs natural curves. Hence, such postures lead to muscle fatigue and an injury if left untreated for long. Moreover, a body can resist a single dormant position only for 20 minutes. After that, the toleration limit ends and causes pain.”

Backaches are caused mainly due to poor muscle tone that comes with a sedentary lifestyle. A poor muscle tone results in abnormal strain transfer to the smaller load bearing joints of the back, which leads to pain. Also, the back becomes susceptible to strains of ligaments and soft tissue structures. Once painful, the muscles get inhibited and loose more strength, and eventually a pain cycle develops with recurrent back pain and more and more muscle wasting.

The lack of strength in the spinal joints — that leads to an enormous pressure built upon the nerves, muscles and the discs in the region — is the root cause of this paralytic pain effect that detaches a person from his regular routine at one point of time or the other. “Normally, our backs are quite strong and can easily take the rigours of daily activity.

However, we must remember that even normal daily routines do exert a huge strain on our lower backs. So, additional unhealthy loads such as bending forward and lifting heavy weights, twisting and lifting or maintaining poor postures for a prolonged period of time — as computer professionals usually do — can all lead to back pain. Ignoring back pain can aggravate the problem and leave a person crippled,” warns Dr Sarup.

Another common cause of radiating back pain is a slipped disc. A simple clinical examination usually pinpoints the problem, which is then easily detected by an MRI scan. Minor slipped discs settle down with conservative treatment.

But sometimes, slipped discs (also called disc prolapse) can press on the nerves to such a degree that there are neurological problems. Patients may develop numbness in the feet, weakness of leg and foot muscles. In cases of severe symptoms, a surgery performed through the use of an advanced technique called endoscopes results in rapid recovery and minimal pain.

In fact, doctors say that if the back pain persists beyond three days or if it radiates into one or both legs, it is advisable to consult an orthopaedic specialist. Usually, the doctors recommend painkillers, muscle relaxants and physiotherapy.

An MRI may be recommended if the doctor suspects anything more serious. Sure, there’s a way out. But a correct posture, healthy lifestyle and basic prevention will go a long way in avoiding the complications. But should you have a nagging backache, don’t ignore it for long. See a doctor at once for relief.

When was your last massage? I recently just had a massage and I gotta say, everytime I do get a massage I remember how good they feel. AND how much better I feel afterwards.

Massage Therapy is truly an amazing thing. It’s so easy to let stress and tension just sneak up on us. I didn’t realize I was THAT stressed out. But it isn’t until you get a massage that you realize that. At least for me anyway.

So my latest thing is to try to get a massage weekly, and at the very least monthly. You wouldn’t think it would be that tough of a commitment, but like all of us, time and scheduling becomes a factor.

I guess it’s all a matter of priorities. Feeling good vs. working all the time? Tough choice, right?

An electronic devise normally used to ease labour pains is being trialled on people with osteoarthritis.
Patients are to use a TENS machine, combined with exercise, as part of a trial being conducted across the West of England.

The machines send electrical impulses to muscles that override pain and distract from discomfort, making it easier to exercise. Almost half of all over-65s suffer from osteoarthritis.

also on BBC Bristol: Arthritis drug licence suspended

Sports Injury Clinic writes:

Herbert, R.D. and de Noronha, M. (2007)
Researchers have suggested that stretching before or after exercise in young, healthy athletes has little or no effect on Delayed Onset Muscle Soreness (DOMS) – that painful ache many people feel the day after taking part in vigarous exercise.

The researchers assessed whether stretching could reduce stiffness, and concluded from numerous research projects that the estimated effects of stretching were extremely small, and that the studies were all remarkably consistent, suggesting that stretching before or after exercise does not prevent muscle soreness in young healthy adults.

Please note this study does not consider the potentially beneficial effects that stretching may have on injury prevention, or on improving flexibility in athletes with reduced flexibility.

Cochrane Database of Systematic Reviews (2007) Issue 4. Art. No.: CD004577. DOI 10.1002/14651858.CD004577.pub2

Link to Abstract », or to Full Text »