OccHealth
Express
Get on board!
OCCHEALTH NEWSLETTER MAY 2009
The new approach to back pain
• You get depressed
• The pain feels worse
• It is harder and harder to get going again.
Back pain has always been very common and
we have learned a great deal about it. There
has been a revolution in thinking about back
care, and we now approach it in a different
way. Most people can and deal with back pain
themselves most of the time. However, the
less you do, the worse things can become, and
the quicker you may find yourself becoming
more pain focused and fear avoidant.
(SEE DIAGAM 1 - NEXT PAGE)
No wonder it didn’t work! We no longer use
bed rest to treat any other common condition.
It is time to stop bed rest for backache. The
message is clear: bed rest is bad for backs.
Of course you might need to do a bit less
when the pain is bad. You might be forced to
have a day or two in bed at the start. But the
most important thing is to get moving again as
soon as you can.
Back pain need not cripple you unless you let
it. About half the people who get backache
will have it again within a couple of years.
But that still does not mean that it is serious.
Between attacks most people return to
normal activities with few if any symptoms.
It can be very painful and you may need to
reduce some activities for a time. But rest for
more than a day or two usually does not help
and may do more harm than good. So keep
moving. Our back is designed for movement.
The sooner you get back to normal activity
the sooner your back will feel better.
The people who cope best are those who
stay active and get on with their life despite
the pain.
Causes of back pain
Your spine is one of the strongest parts of
your body. It is made of solid bony blocks
joined by discs to give it strength and flexibility.
It is reinforced by strong ligaments. It is
surrounded by large and powerful muscles
which protect it. It is surprisingly difficult to
damage your spine.
People often have it wrong about back pain.
Most people with back pain do not have any
damage in their spine. Very few people with
backache have a slipped disc or a trapped
nerve. Even then a slipped disc usually gets
better by itself. Most X-ray findings in your
back are normal changes with age.
In most people we cannot pinpoint the exact
source of backache. It can be frustrating not
to know exactly what is wrong. But in another
way it is good news – that you do not have
any serious disease or any serious damage in
your back. Most back pain comes from the
muscles and ligaments and joints in your back.
They are simply not moving and working as
they should. Or you can think of your back as
‘out of condition’. So what you need to do is
get your back working properly again. Stress
can also increase the amount of pain we feel.
Tension can cause the muscle spasm and
the muscles themselves can become painful.
People who are physically fit generally have
less back pain, and recover faster if they do
get it.
So the answer to backache is to get your back
moving and working properly again. Get back
into condition and physically fit.
Rest or active exercise?
The old fashioned treatment for back pain
was prolonged rest. But bed rest for more
than a day or two is the worst treatment for
backache, because:
•
•
•
•
Your bones get weaker
Your muscles get weaker
You get stiff
You lose physical fitness
Exercise is good for you - Use it or
lose it
Your body must stay active to stay healthy. It
thrives on use. Regular exercise:
• Gives you stronger bones
• Develops fit active muscles
• Keeps you supple
• Makes you fit
• Makes you feel good
• Releases natural chemicals which reduce
pain.
Even when your back is sore, you can make
a start without putting too much stress on
your back:
Walking, using an exercise bike, or swimming
all use your muscles and get your joints moving.
They make your heart and lungs work and are
a start to physical fitness.
When you start to exercise you may need to
build up gradually over a few days or weeks.
You should then exercise regularly and keep
it up – fitness takes time.
(SEE DIAGAM 2 - NEXT PAGE)
FAST FACTS
The fact is that back pain or ache is usually not
due to any serious disease. Most back pain
settles quickly, at least enough to get on with
your normal life.
10% of time is added to a
journey when driving and
making a phone call.
(University of Utah)
T: 02 9112 6000 F: 02 9633 9711 E: [email protected] W: www.occhealth.com.au A: L4, 34 Charles Street, Parramatta NSW 2150
The new approach to back pain continued…
Staying active - You may have good days &
bad days – that’s normal
If your pain is more severe you may have to
rest for a few days. You might need stronger
painkillers from your doctor, and you might
even have to lie down for a day or two. But
only for a day or two; don’t think of rest as
treatment. Too much rest is bad for your
back. The faster you get going the sooner
you will make your back feel better.
You should build up your activities and your
exercise tolerance over several days or a few
weeks. But the faster you get back to normal
activities and back to work the better, even if
you still have some pain and some restrictions.
If you have a heavy job, you may need some
help from your workmates. Simple changes
can make your job easier.
It’s your back
Back Pain is not a serious disease and it
should not cripple you unless you let it. So
remember:
• Back pain is common but is rarely due to
any serious disease.
• Even when it is very painful that usually
does not mean there is any serious
damage to your back. Hurt does not
mean harm.
• Mostly it gets better with little or no
medical treatment.
• Bed rest for more than a day or two is
usually bad for your back.
• Staying active will help you get better
faster and prevent more back trouble.
• The sooner you get going, the sooner
you will get better.
• Regular exercise and staying fit helps
your general health and your back.
• You have to run your own life and do the
things you want to do. Don’t let your
back take over.
Diagram 1
PAIN
Muscular spasm,
reflex inhibition,
fear of pain
Impairment in
endurance, mobility,
strength and
co-ordination
DISUSE
DECONDITIONING
Diminished use
of the spine
Diagram 2
ACTIVATION
Relief of spasm
and decreased
fear of pain
Increased use of the
spine leads to muscle
hypertrophy and
improved
co-ordination
REDUCTION OF PAIN
RECONDITIONING
Improved endurance, mobility,
co-ordination, strength and
postural control
References
The Back Book, Sponsored by the Victorian WorkCover
Authority, September 1997
Back and Neck Advice
Information partly based on the Clinical Practice
Guideline, Acute Low Back Problems in Adults in the
United Sates;
The Royal College of General Practitioners Clinical
Guidelines for the Management of Acute Low Back Pain
in the United Kingdom;
A review article by Tulder et al: Conservative treatment
of acute and chronic nonspecific low back pain. A
systematic review of randomized controlled trials of the
most common interventions. Spine.
1997; 22(18):2128-56
FAST FACTS
Different exercises suit different people. Find
out what suits your back best. Rearrange
your life to get some exercise every day. Try
walking instead of going by car or bus. Some
of the easiest to get back to are walking,
swimming, cycling and smooth rhythmic
exercises. The important thing is general
exercise and physical fitness. Athletes know
that when they start training their muscles
can hurt. That does not mean that they are
doing any damage. The same applies to you
and your back. No-one pretends exercising
is easy. Painkillers and other treatments can
help to control the pain to let you get started.
It often does hurt at first, but one thing is sure:
the longer you put off exercise, the harder
and more painful it will be. There is no other
way. You have a straight choice: rest or work
through your pain to recovery.
48 adults with neck
pain who strengthened
their upper trapezius
muscles 3 times per
week reported 80% less
discomfort. (Lars Andersen,
National Research Centre
Copenhagen)
anatomy 101
Biceps Brachii
Some muscles have more than one
origin (immovable end) or insertion
(movable end). The “biceps brachii” in the
upper arm, for example, has two origins. This
is shown in its name, “biceps,” which means
“two heads.” It is attached to the scapula
(shoulder blade) in two places and extends
along the front surface of the humerus (upper
arm bone). It is inserted by means of a tendon
on the largest part of the radius (lower arm
bone). When it contracts, the movable end is
pulled toward the origin, and the arm bends
at the elbow.
There are 4 basic types of bicep tendon
injuries;
• The first is known as tendinitis/tendinosis,
which usually occurs or is brought on
by overuse or improper biomechanical
wear.
• The second is bicep tendon dislocations
• The third is bicep tendon tears
• Lastly is the bicep tendon impingement
syndrome
Biceps
Brachii
Triceps Brachii Muscles
The triceps brachii has three heads (connective
immovable muscle) and is the only muscle on
the back of the upper arm. It connects the
humerus (upper arm bone) and the scapula
(shoulder blade) to the ulna (longest of the
forearm bones) and is the primary extensor of
the elbow. The three heads are the “lateral,”
the “medial,” and the “long head.”
Basically, there are 2 main types of triceps
injuries.
1 Triceps muscle tear - A triceps tear is an
inflammation of the triceps muscle, or in
severe cases, the muscle is literally torn
away from the bone. You are likely to get
this type of injury from repetitively lifting
heavy loads.
2 Triceps tendonitis is a repetitive strain
injury. You will most likely get this type of
triceps injury from repetitive activities like
throwing, hammering or playing tennis.
Triceps
Brachii
T: 02 9112 6000 F: 02 9633 9711 E: [email protected] W: www.occhealth.com.au A: L4, 34 Charles Street, Parramatta NSW 2150
• >61% of workplace injuries resulted in sprains and strains at a cost of $348 million.
• Sprains and strains were the most common form of injury (53%) resulting in
permanent impairment costing $109 million in permanent impairment payments.
• Manual handling was the most common cause of injury (31%)
• The back was the most common location (26%) and permanent disability (13%)
• 95% of workers with back injuries resulting in permanent disability had suffered
the injury via a strain or sprain. (WorkCover Statistical Bulletin 2005/06)
FAST FACTS
(in 2005/06)
STATISTICS (In
The length from
your wrist to your
elbow is the same as
the length of your
foot.
QUIZ
1. A microtrauma refers to which of the
following statements?
a. An injury
b. Detectable
c. Small
d. a and c
2. Occhealth Network first opened its
doors in which year?
a. 1994
b. 1997
c. 2000
d. 2007
3. Deep squatting is dangerous due to:
a. Pressure on the spine
b. The knee is placed in hyperflexion,
stretching the ligaments
c. The ankles being out of alignment
d. None of the above
4. Occhealth Networks new address is?
a. 1 Harold St Parramatta
b. 201a Woodville Rd Villawood
c. Suite 402, Level 4, 34 Charles St Parramatta
d. Level 2, 507 Kent St, Sydney
5. Standing toe touches are questionable
due to:
a. The pressure put upon the hands
b. The pressure upon the neck
c. The stretching causes back pain
d. All of the above
6. Occhealth Network specialises in:
a. Work/Physical Conditioning Programs
b. Hydrotherapy
c. Workplace based programs
d. Home programs
e. All of the above
7. Inversion boots that allow people to
hang upside down have resulted in:
a. Raising blood pressure
b. Raising eye pressure
c. Proper back alignment
d. a and b
8. Occhealth Network service which
areas?
a. Sydney Metropolitan
b. Wollongong
c. Blue Mountains
d. All of the above
9. Regarding the outcome of whiplash
injuries, which of the following
statements is most accurate:
a. Majority of whiplash injuries resolve in
about 6 weeks
b. Majority of whiplash injuries resolve in
12 weeks
c. About 25-50% of whiplash injuries fail
to resolve completely
d. Whiplash injuries rarely resolve completely
10.A s well as providing functional activity
based programs, Occhealth Network:
a. Facilitates medical certificate upgrades through
individualized tailored active rehabilitation
programs, attendance to medical case
conference and excellent communication
b. Incorporates a cognitive behavioural approach
with the focus on return to pre-injury
function/work, which includes; goal setting,
pacing strategies to gradually improve activity
levels despite pain, problem solving, flare-up
strategies and positive reinforcement
c. Workplace/Home based sessions to problem
solve correct technique during work/domestic
tasks and to ensure transfer of skills practiced
during the functional conditioning program.
d. All of the above
EMPLOYEE PROFILE - JOHN COSENTINO
4. Have you worked in any other industries
strong relationships. I feel I excel at providing cognitive
besides the health industry?
behavioural principles during my programs, which makes
I played soccer semi-professionally from the age of 16,
all the difference in the end.
which paid my way through university. I also worked in a
gymnasium through that time, but began working in the
health industry in 1994.
1. When did you join Occhealth Network?
I have been with Occhealth Network since its inception in
1997. That seems such a long time ago now.
I love my golf. Although I’m only an 18 handicapper, it
definitely helps me relax. I love travelling and have been
5. What are your thoughts on Occhealth
to places such as Italy, France, USA, Canada, Thailand and
Network as a company?
some of the Pacific Islands. I love exercising and try to
Although being around since 1997, I still see Occhealth
get to the gym as often as possible and although I enjoy
Network as a progressive company, always looking for
the occasional big night out, I’m happy just lazing at home
new ways to expand and improve its services. We have
watching my Wests Tigers play or a good DVD.
settled and happy staff, which makes for an excellent
2. What is your current position?
working environment. The Vision & Values are a good
Currently I am the Program Services Manager for both
match with my own and make this company a great place
Workers Compensation and CTP Insurance. I am also a
to work.
practicing Exercise Physiologist.
7. What are your interests outside work?
8. What advice would you give to a graduate
considering applying for a role with Occhealth
Network?
Any work experience is helpful to enable you to gain a
6. What is your area of specialty?
competitive advantage to secure a graduate role, as the
3. What is your typical day like?
I have been providing functional upgrading programs
compensation industry and its expectations are different
The great thing about my role is that there is never really
for about 15 years now so I would say musculoskeletal
to anything a graduate would have been exposed to
a ‘typical’ day! Common things I do include obviously
rehabilitation. My experience has enabled me to
before. I volunteered to work and gain experience related
managing staff, treating injured parties, attending meetings,
achieve excellent outcomes for all parties involved
to my degree with a number of organizations, which
liaising with other health professionals and servicing client
through communication and regular hands on contact
helped me secure my first permanent role
needs.
with my clients where I find it imperative to build
T: 02 9112 6000 F: 02 9633 9711 E: [email protected] W: www.occhealth.com.au A: L4, 34 Charles Street, Parramatta NSW 2150
EQUIPMENT REVIEW - THE SWISS BALL
The Swiss Ball has the unique quality of allowing
a huge range of movement that simply cannot be
achieved on the floor. For most exercises, only body
weight is required for resistance, and the same
exercise can be very easy or extremely challenging,
depending on the individual’s position on the ball.
Unique to the ball is its unstable base of support,
so that balance is required for any exercise that is
performed on the ball.
Ball size is determined by patient height and weight,
intended exercise position (prone, supine, sitting,
etc.) and the goals of treatment. A smaller ball
has less surface area, requiring more energy to
maintain balance.
Benefits
•
•
•
•
•
•
•
•
•
Increased range of motion
Increased core strength
Increase overall strength
Increase balance reactions
Increase coordination
Increase endurance
Increase proprioception
Increase flexibility
Increase cardiovascular fitness
Technique tips
• Always keep the head in a neutral position.
This is when the cervical spine maintains its
natural curve. This is to minimize unwanted
pressure on the neck.
• Activate the transverse abdominals before
any movement commences.
• Only progress when the individual is capable
of achieving the desired exercise with correct
stabilization and technique
• Always exercise caution when working with
a ball, as it is unstable and can cause injury if
abused or used incorrectly
• When exercising on the ball, it is important
to find the natural rhythm to coordinate
breathing with each movement. It is
important to make a conscious effort to
breathe out on the exertion phase of the
movement. Usually when a deep breath is
inspired, air is sent to the abdominal area.
On the ball however, in order to maintain
an abdominal contraction for neutral spine,
the breath needs to be sent to the back of
the lower ribcage. This is known as lateral
breathing.
Precautions
• It is highly recommended that you work with
your exercise physiologist when considering
using an exercise ball to ensure the ball fits
you properly and that you learn proper
technique.
• Like any piece of equipment, follow all the
manufacturer’s instructions for care and use.
• Always do exercises in a controlled manner
and speed; start slowly and build confidence
to quicker than expected fatigue.
Ask your physician about conditions that can
be aggravated by this form of exercise before
proceeding
OCCHEALTH HAS MOVED!!!
Please send all correspondence to: Suite 402, Level 4, 34 Charles St, Parramatta NSW 2150
Phone: 9112 6000 Fax: 9633 9711 E-mail: [email protected] Web: www.occhealth.com.au
Please contact us if you would like further information on our services or wish to make a referral
just for fun
physical activity
30.Spin class
31.Good Nutrition gives you this
DOWN
1. The ability of a joint to move through
its range of motion
2. Structure which connects muscles to
bones
3. Arm joint
5. E.g. Heart, lungs, liver
7. Taste Organ
11.Leg joint
13.PNF and static are types of
14.Team game
15.Physical Activity
18.Abdominals (Abbrev)
23.Jealous
25.Rim
26.On an athletics track, runners
become disqualified if they run
outside of this
28.Height to weight ratio used to
determine body fat
FAST FACTS
ACROSS
1. Longest bone in the human body
2. Three headed muscle forming the
back of the arm
4. Largest artery in the body
6. Leave
8. Opposite to off
9. Common form of arthritis
10.Foot coverings
12.Allows you to smell
14.Breathe heavily while asleep
16.Blood vessels which return blood to
the heart
17.A limited variety or amount of food
you eat for medical reasons or
because you want to lose weight
19.Consume food
20.Health and strong, especially because
you do regular physical exercise
21.Ill
22.Affirmative response
24.Wellbeing
27.Swallow these whole
29.A place with equipment for doing
Researchers in Austria found that drinkers of 100mg of
caffeine (amount of an espresso) had higher levels of activity
in regions of the brain responsible for short-term memory,
attention and concentration functions than those who drank
a placebo. Researchers speculate that caffeine may improve
brain blood flow, keeping you word perfect. The benefit
wears off in about 45 minutes though.
14. Sport - 15. Exercise - 18. Abs - 23. Envy - 25. Edge - 26. Lane - 28. BMI
ANSWERS TO QUIZ: 1a. 2b. 3b. 4c. 5c. 6e. 7d. 8d. 9c. 10d.
Answers to cross word
ACROSS: 1. Femur - 2. Triceps - 4. Aorta - 6. Exit - 8. On - 9. Gout - 10. Socks - 12. Nose 14. Snore - 16. Veins - 17. Diet - 19. Eat - 20. Fit - 21. Sick - 22. Yes - 24. Health - 27. Pills - 29. Gym 30. Cycle - 31. Energy
DOWN: 1. Flexibility - 2. Tendon - 3. Elbow - 5. Organs - 7. Tongue - 11. Knee - 13. Stretching -