In simpler terms, the criteria for sciatica is leg pain plus one of the following:

• pins and needles, or a change in sensation 
• weakness in the leg
• decreased reflexes
• pain when your health professional performs a movement based test 

As mentioned, there is evidence that suggests that disc bulges or herniations may irritate sciatic nerve roots [1] however, this is not the only cause of sciatica. Even if the diagnosis is sciatica or lumbar (lower back) related pain due to a disc bulge, 60% of people are estimated to receive a good outcome within 3 months and 55-75% of people by 1 year [3]. I know it sounds like a long time, but unfortunately this type of pain isn't something that can be dealt with overnight. The most important part of seeing improvement in your symptoms is being consistent with your treatment, and staying confident that it will pay off in the end. This is supported by a recent study which suggested that having a positive mindset about your symptoms may help you see improvements in your pain symptoms when used alongside appropriate treatment [4]!
​

Low back pain, and specifically sciatica, can be a very tricky thing to not only diagnose, but to also treat. The best course of action for you to take when you've got low back pain is to visit your local health professional, so that they can provide you with tailored advice, and determine what the best course of action is for your specific situation! 

Each time we exercise, we are putting our bodies under a new load of stress to try to force it to change and adapt (i.e. get stronger, faster or fitter). While the long term results are the strength gains and weight loss that we are chasing, the immediate effects of exercise are often muscle soreness, fatigue, reduced muscle strength and overall reduction in exercise performance in the hours and days following our session. Ensuring we recover from our sessions properly can help accelerate our ability to overcome these effects so that our bodies are less likely to experience an injury, and also gets us back to top exercising condition quicker! 

​If you are an honest person, you will 100% admit to having skipped your cool down before. I mean, let’s be real, who wants to finish exercising, only to do more exercise… However, cooling down is an important part of your session as it helps your body gradually come back down to its normal resting state. Stretching and foam rolling play a key role in a cool down, as they assist in helping your muscles relax and stretch back to their normal length, ultimately reducing how tight and sore your muscles feel. Stretching and foam rolling are also important to do regularly to help maintain your flexibility and improve how well you can perform your exercises! 

​When we exercise, we begin to raise our body temperature which causes us to sweat as a way of cooling ourselves down. While sweating itself isn’t a problem, not replenishing the fluids we lose through sweating is. Ensuring that you are not only hydrated before and during exercise, but also after you finish exercising is important in minimising your risk of experiencing dehydration, and improving your bodies ability to restore itself. 

​Exercising requires energy, and energy comes from the food we eat. Eating a high-carbohydrate and high protein meal within the hour following exercise allows the body to restore the energy that has been used, as well as use the nutrients from the food to help repair the muscle that has been broken down while exercising.

​Last but not least: sleep. Possibly the single most loved thing in the world, and a crucial element in assisting with recovery. When we sleep, our body is working hard to release hormones that nourish/repair our bodies, as well as resetting our central nervous system to ensure we are bright, alert and functioning when we wake up. A poor night of sleep can decrease our muscle and cognitive function, making us even more sluggish and fatigued. 

Regardless of whether you're an exercise beginner or a seasoned athlete, recovery is an important part of every exercise routine! Developing good habits when it comes to stretching, eating and sleeping can ensure that you're body is restoring itself in an efficient manner, and get you back to top performance condition in less time! 

​While its not always possible to prevent our eyesight from deteriorating, or manage how even the ground is, it is possible to train our balance and make sure our bodies are strong and stable.  Exercise has been shown to be one of the most effective ways of reducing falls within the community, with more and more balance and strength programs being introduced, especially for the elderly. 

The more exercise and training you do per week the better (within reason), but a minimum of 2 hours per week is a good baseline to help develop and maintain the lower limb strength and balance you will need.
In terms of the type of exercise you should be doing, a combination of strength building lower leg exercises and balance exercises is the ideal. Below is an example of some of the exercises in each category: 

​Even though walking is often thought of as the easiest exercise that everyone should be doing, this isn’t really the case with people who have poor balance (especially people who have had a lot of falls while walking). If you find that you often lose your footing or balance while going for walks, its probably better to focus on strength and balance training first before deciding to do your usual walks again. 

It can be very frustrating and sometimes scary when our balance isn't what it should be. The most important thing is not letting it stop you from trying to get better. Making even a small change in your routine to focus on your balance will certainly help you on your journey to feeling more stable and safe. 

If you’re concerned about your balance and not really sure where to start, you may like to book in for a session with us. Each one of our practitioners is able to provide you with guidance on what could be contributing to your poor balance and what first step you should take to improve it. 

Tiana is arriving in Townsville later this week and is excited to settle in and enjoy our consistent weather and sunshine.  She is also particularly keen to go camping and hiking, exploring all that our region has to offer. Thankfully, she isn’t afraid of bugs or wildlife, and we have now dubbed her chief of spider catching in the clinic because the rest of us are horribly useless when it comes to those creepy little buggers (Thanks in advance for your service Tiana!). Tiana also likes to carry a film camera with her wherever she goes, and she’s looking forward to having to spend a fortune on replacement film to capture all the wonderful memories she is no doubt going to make up here in sunny Townsville. Some examples of her incredible photography are shown below! 

​What a crazy year the last few weeks have been! With new government restrictions, quarantines, social distancing measures, health advice and calls to work from home where possible, COVID-19 (Coronavirus) has definitely shaken up the way we all live our lives. This has also changed the way that we operate as a clinic at NExT Osteo & Rehab, but we are glad to be able to keep our doors open and continue taking bookings for both existing and new patients. We are glad that we can help take some strain away from GP clinics and hospitals by remaining an option for injury management and to aid with chronic condition management. Mostly though, we are glad to be able to continue helping all of you who choose to come and see us for your injuries.

While Carly and Liam will still be providing Exercise Physiology and Osteopathy services, Alice has unfortunately had to stop work for the moment as massage therapists are not currently allowed to practice. We wish Alice all the best while she bunkers down at home away from the ‘Rona, and we look forward to welcoming her back once all this has passed… and it WILL pass.

While Carly and Liam continue working, some hygiene and social distancing changes have been made to the clinic to help adhere to the new normal that we have found ourselves in. Most importantly, we have made these changes to help minimise risks for all of you who come here, as well as ourselves.
Changes we have made include:

• Disinfecting all doors, desks, chairs, treatment tables, exercise equipment, HICAPS/EFTPOS machine, etc after each use, as well as at the start and end of each work day.
• Spacing out waiting room chairs and reducing the number of chairs in the waiting room to aid social distancing measures.
• Getting you to swipe or tap your own cards in the HICAPS/EFTPOS machine to reduce card handling.
• Checking body temperature with a no-touch thermometer for anyone who enters the clinic, including staff.
• Having all patients sanitise their hands as they enter the clinic, prior to their appointment.
• Increased frequency of our own hand-washing and sanitising.
• Removal of towels in the bathroom, replaced by single use paper towels instead.
• Performing osteopathic sessions on a wipeable table surface, which will be thoroughly disinfected between each patient.
• Asking patients to each bring their own bath or beach towel to their appointment, to reduce our handling of towels and linen.
• Observing all social distancing measures in our own lives and ensuring we remain at home if we are unwell.

We ask that you do not book an appointment, or to reschedule an existing appointment if:

• You or someone at home has returned from overseas or interstate in the last 2 weeks.
• You are at all unwell (fever, cough, sore throat, chest tightness, etc), and to contact your GP if symptoms persist, or you have these symptoms and have returned from overseas or interstate in the last 2 weeks.
• You have been in direct contact with someone who has been diagnosed with COVID-19 or has a suspected case of COVID-19.
• You are waiting on a COVID-19 test result

While we will not exclude you from receiving care if you feel you need it, we ask that you consider whether your appointment is necessary at this point in time if you are in one of the following 3 groups that has been asked to remain home where possible by the government:

• Anyone over 70 years of age.
• Anyone over 60 with a chronic medical condition – particularly heart conditions, lung conditions, diabetes, autoimmune diseases, cancer and high blood pressure.
• Indigenous people over 50 years of age.

We will remain open for as long as we are allowed to continue running our Osteopathy and Exercise Physiology services, or until it seems to unsafe to continue working should local case numbers rise to a high level. We are also exploring the option of telehealth services for those who may benefit from this, and will update you more over the coming weeks.

We would like to thank you all for your support over our opening 12 months. It was such a hectic first year, and we are so happy to turn 1 that we might... hmmm... I know! Celebrate at home on our own as we are practicing responsible social distancing! But seriously, as challenging as this next period will be, we look forward to seeing many of you over the next 12 months. You can always reach us by on 0450 062 223, or by our emails listed below for any appointments, advice, health tips, or even just for a chat if you feel the need during this uncertain time.

Otherwise until we see you next, be kind to each other, look out for your neighbours (especially if they are elderly or at higher risk), stay healthy and keep safe.

Take care everyone!
​
Liam (liam@nextosteorehab.com.au)
Carly (carly@nextosteorehab.com.au)
&
Alice (alice@nextosteorehab.com.au)

Unless you have been living under a rock, you've almost definitely heard of the current pandemic sweeping the world known as COVID-19 (or coronavirus). While it is definitely something to be aware of, it is not necessarily something we all need to be panicked and stressed about. In this post, we're going to run over some of the information that everyone needs to know about what coronavirus is, who is at risk, and how we can all help prevent it from spreading!

​Coronaviruses are a large family of viruses which may cause illness in animals or humans. Within humans, several coronaviruses are known to cause respiratory infections including the common cold, and more severe diseases such as Severe Acute Respiratory Syndrome (SARS).

The coronavirus outbreak that we are currently dealing with is a recently discovered strain known as COVID-19. Up until the outbreak began in Wuhan, China, in December 2019, this virus and disease was unknown. 

​It is important to note that not everyone who has these symptoms has COVID-19, as these symptoms can be brought on by numerous other illnesses! 

Oftentimes there are many people who may become infected, but do not develop any of these symptoms, nor do they feel unwell. ​

Everyone is at risk of becoming infected with COVID-19 and there is currently no information to suggest that it discriminates between gender or race. However, there are a number of people who are at a higher risk of developing more serious symptoms if they were to become infected. These include:

• Older people
• people with underlying medical conditions such as immune deficiency (low immunity); respiratory conditions (COPD, emphysema, etc.), cardiac problems and diabetes. 

These people who are at a higher risk should take extra pre-cautions to ensure they are not being exposed to an infected person, and should engage in behaviours that are going to reduce their risk of becoming infected, which we will cover below. 
​

COVID-19 is spread through the droplets of saliva that are expelled when an infected person sneezes or coughs. These droplets land on surrounding objects, surfaces or people, which can then be transferred to someone else through them touching the contaminated surface/object, and then touching their eyes, nose or mouth. It is also possible to inhale (breathe in) these droplets when you are in close proximity with an infected person. 

As we mentioned earlier, there are some people who can become infected but do not display symptoms. In these cases, it is very difficult to become infected by them as they are often not coughing or sneezing and thus are not producing these infected droplets. 

There are many different things that can be done to help protect both yourself and others from becoming infected. These include:

• Handwashing
• Social Distancing 
• Avoiding touching your face
• Good Respiratory hygiene
• Regular cleaning and disinfecting

It is especially important to engage in these behaviors if you are likely to come in contact with someone who is of a higher risk! 

Handwashing:
Cleaning your hands regularly with soap and water, or an alcohol based hand sanitizer, is the most effective way of reducing the spread of infection. As we mentioned, COVID-19 is spread by droplets of saliva from an infected person. Regular washing of the hands helps kill off any of the virus that you may come in contact with, and prevents you from then transferring it to your eyes, nose or mouth. 
Some of the more important times to wash your hands is after going to the toilet, before and after eating, and after sneezing or coughing. 

Social Distancing:
​Social distancing (i.e. maintaining a minimum 1.5m distance from others) is a great way of staying out of the 'blast zone' of an infected person when they sneeze or cough, as the droplets that get expelled do not generally travel further than 1.5m. Avoiding large gatherings, unless absolutely essential, is also another way of implementing this social distancing and avoiding the risk of infection. This unfortunately means you should also avoid hosting large gatherings or parties. 

It is also important to note that social greetings or interactions where you come in contact with another person (i.e. a hand shake, hug or kiss) should be avoided. Alternative ways of greeting someone include:

• The wave
• The elbow bump 
• The Namaste or Thai 'wai'
• The butt bump 
• The footshake 
• The Spock

Avoid Touching your Face:
The droplets that transmit this disease cannot be absorbed through the skin, and can only infect someone if it comes into contact with the eyes, nose or mouth. As such, by avoiding touching your face, you significantly reduce the risk of these droplets coming into contact with those susceptible areas. 

Good Respiratory hygiene:
Good Respiratory hygiene includes covering your mouth and nose when you sneeze or cough using:

• a tissue that you immediately dispose of after use
• your bent elbow 

You should also wash your hands immediately after coughing or sneezing to kill any of the droplets that may have been missed. 

Many people have also taken to wearing masks to help prevent the spread of droplets through coughing or sneezing. HOWEVER, there is currently no evidence to support that wearing a mask reduces your risk of becoming infected with the COVID-19. As such, masks should only be worn by people who are actually displaying symptoms. 

Regular cleaning and disinfecting:
Regular cleaning of your environment at home, work and in your car is essential in minimizing the spread of COVID-19. In particular, regular touched surfaces such as door knobs, tables and light switches should be regularly cleaned. 

As with any other disease or illness, ensuring that you are actively working towards being the healthiest version of yourself possible is important in minimizing your risk of developing severe symptoms if you were to be infected. Healthy behaviors that you should engage in to achieve improved health include:

• Regular exercise
• Good quality sleep
• a balanced and nutritious diet

​

There is currently no information or evidence to suggest that you can become infected with COVID-19 from your pets, mosquito bites or from food. However, you should not share food with anyone as this is an easy way for you to ingest potential droplets that may cause infection. You should also ensure that all food is prepared safely and properly to minimize your risk of developing other illnesses that come with ill-prepared food. 
​

The likelihood of you becoming infected is mainly dependent on your location, and whether there is an outbreak occurring there. If you are living in an area where there is an outbreak spreading, or you are visiting an area like this, you are at a higher risk of becoming infected.
​

Antibiotics only work to treat bacterial infections, not viral infections such as the COVID-19. As such, antibiotics should not be taken unless prescribed to you by a relevant Health Professional for the management of some other illness. 
Regarding current medicine or home remedies. While they may help alleviate symptoms, there is currently no evidence to suggest that they are able to prevent or cure this disease. There are a number of clinical trials being performed which are testing possible vaccines and drug treatments, however, none of these have been confirmed to prevent or cure COVID-19. 
​

The short answer: No. There is no reason for anyone to be stocking up on excessive amounts of food and toilet paper. If for some reason you need to go into quarantine or self-isolation, then it may be beneficial to do a bulk shop of groceries so that you do not need to go back to the shops again, but for people who are not displaying any symptoms, there is really no need to buy excessive amounts of groceries or toilet paper. If anything, the excessive purchase of items like toilet paper, hand sanitisers, soap and food make it difficult for everyone in the community to have access to things that are going to help maintain their health and prevent the spread of disease, which effectively increases the communities risk of an outbreak spreading. 
Moral of the story: don't go crazy...  buy an appropriate amount of groceries and necessities.
​

If you develop symptoms such as fever, dry cough, sore throat or excessive fatigue, you should:

• Stay at home and practice standard infection control precautions/ treat yourself the way you would any other illness
• Seek medical advice (ensure you call ahead of time)
  go to www.healthdirect.gov.au; or
  ​call the National Coronavirus Information and Triage Line (1800 020 080); or
  call your usual health care provider
  
• Inform your workplace of the situation
  

The COVID-19 is definitely something to be aware of, but it is not necessarily something we all need to be panicked about. While yes, it is important to be aware and prepared for a potential outbreak in your area, you do not need to stress out and go overboard in your precautionary measures. 
Ensuring that we practice good hygiene and engage in behaviors such as hand washing and social distancing can help minimize our risk of spreading the disease or becoming infected, especially if we are interacting with people who are at a higher risk of infection. Everyone should also aim to continue to live their normal lives, and maintain their health as best as they can through regular exercise, good nutrition and quality sleep, and approach this disease like they would any other illness.
​If you feel unwell, stay home from work and seek medical advice from a professional. 

We hope this clears up any questions you had about COVID-19. If you are curious about something, have a question you want answered, or are just wanting clarification about something, please feel free to contact us via phone (0450 062 223) or email (manager@nextosteorehab.com.au), and we will be happy to help. 

It is reported that up to 50% of expectant mothers experience some kind of back pain during their pregnancy. This is mainly due to changes in posture and one’s centre of gravity: if you imagine picking up a heavy box and holding it in front of you for a long time, you are slowly going to start leaning back and your shoulders will begin to roll forward. This causes certain muscles to become shorter and tighter, resulting in muscle pain. Pregnancy has the same effect but over a much longer period of time. Massage works to relax and lengthen muscles, and improve their ability to repair, thereby reducing pain.

Are you at risk?
The cause of T2DM remains largely unknown, however, it is associated with several modifiable risk factors. i.e. lifestyle factors and behaviours that we can willingly change to improve our health.
Modifiable risk factors that can contribute to the development of T2DM include:

• High Blood Pressure
• High Cholesterol
• Overweight or Obesity
• Poor Nutrition
• Poor exercise habits
• Smoking
• Poor drinking habits

In saying that, there are also genetic factors that play a role in T2DM development, as well as non-modifiable risk factors. i.e. things that are out of our control.
These include:

• Family History of T2DM
• Age: People over the age of 45 are at a higher risk
• Ethnicity: Aboriginal, Torres Strait Islander, and people from pacific islands, Indian subcontinents or Chinese cultural backgrounds are at an increased risk.
  
  

If you are unsure of whether you are at risk of developing T2DM, the Diabetes Australia website has a Risk Calculator which can help provide you with some insight.
The link to that is:

Back pain. We’ve all had it at one stage or another, and can range from a small, annoying niggle to a searing pain that keeps you bed-ridden for days. It’s frustrating, painful, and often the result of something very trivial that leaves you thinking “you cannot be serious?!” As always, prevention is better than cure, so to prevent you from asking this question, here are five ways to help you protect your back and continue to be able to do the things you love.

Rule #1: Limber Up
Yes, rule #18 from Zombieland has been promoted with a bullet to rule #1 here, and despite Woody Harrelson’s lion comments, limbering up is very important. Before any task involving your back, whether it is lifting, bending, pushing, pulling, gardening or even sitting at your work desk all day, a simple stretching and warm-up routine can help loosen your muscles and joints to help prevent injury. The following 7-step routine may help to loosen and relax your back, aiding in the prevention of activity-related injuries.

​1. Cat and Camel

Perform with slow, deep breaths for 5 repetitions. Image courtesy of whyiexercise.com

​2. ‘Do the Twist’

Hold this position for 30secs. Repeat on the other side. Image courtesy of westvalley.edu
 
​3. The ‘Merv Hughes’

Hold this position for 30secs. Repeat on the other side. Image courtesy of au.pinterest.com
 
​4. Heel to bottom

Hold this position for 30secs. Repeat on the other side. Image courtesy of popsugar.com.au
 
​5. Toe Touch

Hold this position for 30secs. Image courtesy of thotdoc.org
 
​6. ‘Let me see your hips SWING’

Swing legs outward and across your body repeatedly for 30secs each side, then back and forward for 30sec each side. Images courtesy of workoutlabs.con

​7. Windmills

Gently perform in a fluid motion at around 1 second per count. Perform 10 repetitions. Image courtesy of armyprt.com
 
This routine can be done before any planned exercise, before you sit at your desk all day, or even first thing in the morning as a way to help energise your day.
​
Rule #2: Do You Even Lift?

​Image courtesy of freemusclebuildingtips.com
 
No, I don’t mean hitting the gym until you turn into Wolverine, though there are many health benefits to weight training, including injury prevention, but that is best saved for another blog. I’m talking about lifting properly. Many times people bend too far, twist through their back or carry heavy, bulky items on their own. Turning by using your legs, squatting to pick up items and lifting heavy loads with other people are all ways to protect your spine from injury.

PRO TIP: Always remember to use lifting equipment to help you if it is on hand.... it is there to help!

Image courtesy of efoza.com

​​Rule #3: Shouldering the load
People carry bags for many different purposes: school, work, fashion or just generally taking items from one place to another that would look ridiculous if you tried to juggle it in your hands… unless you are a professional juggler then, by all means, disregard this rule! But if the world of circus performance is not for you, then the right bag can make all the difference. Ideally, a backpack works best, as the load is even throughout your back, providing balance. Notice it is called a backpack, not a shoulderpack. Too many people wear their backpacks only on their shoulders, treating the waist and chest straps as nothing more than a waste! However, these straps, when properly adjusted, can help to improve your posture when carrying your backpack, saving your spine from undue stress.

This backpack guide works well for adults too! Image courtesy of wellnessmediaresources.com
 
If you are carrying a satchel or a bag that only goes over one shoulder, try to limit the items you put in your bag to the necessities only, and purchase a lightweight bag. Also, train yourself to comfortably carry your bag on both shoulders so the same side isn’t under pressure all the time. Alternatively, an airport-style luggage bag with wheels that you can push or pull along can remove a great deal of stress from your back, helping you to transport heavier items with minimal pressure through your spine.

​
Rule #4: Learning how to Sit Down
OK. I’m not suggesting you’ve forgotten how to sit down. Everyone knows how to do that, and if it is on a couch or watching a movie it can be quite relaxing. But how we sit down, particularly at our desks, is often the cause of a world of tightness and pain arising from poor posture. Whether this is when you’re hard at work or casually browsing through videos on YouTube, the wrong seated posture can leave your back sore and sorry. Below is a simple diagram to help you set up your desk both at work and at home.

Image courtesy of fitness.stackexchange.com

​​As well as following the diagram, remember to take breaks to stand, walk around, have a drink and do the Merv Hughes, Toe Touch, Windmill and Hip Swing exercises every 45-60mins. This breaks up your day, helping to prevent your posture from creeping forward under the effect of our friend gravity. At work you could even ask your manager or human resources department if they provide ergonomic assessments, to help tailor your work environment specifically to you.
 
Rule #5: Put your Best Foot Forward
Feet. The tyres of the body. Many of us try to work towards that magical '10,000 steps per day' mark, not realising the stress we are putting on our spine if we do this in the wrong footwear. Yes, it’s lovely to strut around in stilettos, easy to slip on some flats, and relaxing to bum around in some thongs, but, long-term, heels and shoes with a lack of support can lead to back pain. I’m not saying to ditch these shoes altogether, but having a supportive pair or two for when you’re on your feet the most can help to reduce stress through your back. Visiting a shoe store and having a professional recommend a shoe type for your foot can help. Talking to a podiatrist or osteopath if you have a history of foot pain or injuries can also help, providing orthotics, exercises and advice on footwear to suit your needs.

​The perfect fit is so important! Image courtesy of au.pinterest.com
 
So, remember: limber up, lift correctly, choose the right bag, sit up straight and make sure your shoes are the perfect fit. This will help you on your way to save your spine, keeping you able to do the things you love.