Author: Michael Ranger

Rest is a crucial component of any fitness or training regimen, but the type of rest one chooses can significantly impact recovery and performance. While complete rest, or the absence of any physical activity, is often the go-to for many athletes and fitness enthusiasts, relative rest, which involves engaging in light sport/activity specific, low-impact activities, may offer several advantages.

1. Enhanced Recovery:

• Blood Flow: Relative rest, such as gentle stretching or light walking, helps maintain blood flow to muscles without causing additional stress. This can aid in the removal of waste products like lactic acid, which can accumulate during intense exercise and contribute to muscle soreness.
• Muscle Repair: Light activities can stimulate the production of growth factors and hormones that support muscle repair and regeneration, potentially speeding up recovery compared to complete rest. (Crampton et al., 2017)

2. Injury Prevention:

• Maintaining Mobility: Engaging in low-impact activities during rest periods can help maintain joint mobility and prevent stiffness, reducing the risk of injury when returning to full activity.
• Muscle Activation: Light activities keep muscles active without overloading them, which can prevent deconditioning and reduce the risk of strains or tears when resuming regular training. (Sato et al., 2015)

3. Psychological Benefits:

• Mood Enhancement: Physical activity, even at a low intensity, can stimulate the release of endorphins, improving mood and reducing feelings of fatigue or burnout often associated with intense training. (Biddle et al., 2018)
• Maintaining Routine: Relative rest allows athletes to maintain a sense of routine and discipline, which can be beneficial for mental well-being and adherence to long-term training goals.

4. Performance Maintenance:

• Skill Retention: Engaging in light activities that mimic sport-specific movements can help maintain skill proficiency and muscle memory, reducing the need for reconditioning when returning to full training.
• Cardiovascular Fitness: Light aerobic activities can help maintain cardiovascular fitness, reducing the cardiovascular detraining effects of complete rest. (Mujika et al., 2018)

While complete rest has its place, especially in cases of severe injury or overtraining, incorporating relative rest into a training regimen can offer numerous benefits. By maintaining blood flow, supporting muscle repair, preventing injury, enhancing mood, and preserving performance, relative rest provides a balanced approach to recovery that can help athletes and fitness enthusiasts stay healthy and perform at their best.

College President report

Submitted by: Tom McMillan FACP
College President

I trust this message finds you in good health and high spirits. As we commence the year with the first edition of the College e-communications for 2024, I am thrilled to share some exciting developments within our College.

New registrars joining the Specialisation Training Program (STP)

I am delighted to announce that we have four new registrars set to commence their STP journey in April 2024. We extend our sincere gratitude to all those who are supporting them on this transformative path. Your mentorship and guidance will undoubtedly play a pivotal role in shaping the future of these physiotherapists.

Welcome Vice President Wendy Nickson APAM

A warm congratulations and heartfelt thanks are in order for College Council member Wendy Nickson, who joins the College executive as Vice President. Wendy will be joining Vice President Gen McGlashan FACP and myself at the helm, bringing a wealth of experience in education and dedication to our leadership team. Together, we are poised to lead the College towards new heights of excellence.

Andrew Webster FACP joins College Council

We are pleased to welcome Andrew Webster, FACP to College Council and as the newly appointed Specialisation Training Program (STP) chief examiner. Many of you will know that Andrew has more than six years of experience on the College Council and has most recently been serving as Musculoskeletal group NSW chair. His expertise and insights will be invaluable as we navigate the challenges and opportunities that lie ahead. We look forward to his contributions.

Revised Specialisation Training Program (STP)

I am pleased to report that work on the STP is progressing diligently. This initiative aims to enhance the STP to ensure it evolves with the landscape of physiotherapy. The program design is underpinned by the Physiotherapy Competence Framework to ensure the highest rigour and standards are maintained.

Accreditation of the revised STP by the Australian Physiotherapy Council (APC)

We are excited to share that an expression of interest application for the accreditation of the revised STP was submitted and accepted by the Australian Physiotherapy Council in December 2023. The accreditation process is well-resourced, and we remain steadfast in our commitment to achieving accreditation for the revised STP.

Evidence Portfolio Pathway roll-out

In 2024, we will witness the rollout of the Evidence Portfolio Pathway (EPP) to titling, creating more opportunities for College membership titles with equitable access and the opportunity for flexible and individualised learning.  It is important to note that this currently does not alter the existing academic pathway to titling and we want to reassure universities on the APA-recognised list, that there will be significant consultation and lead-in time before any changes are implemented.

Acknowledgement to the Board of Censors

I would like to take a moment to express our sincere gratitude to the Board of Censors. Debra Shirley FACP has been confirmed as chief censor in 2024, with Anne Daly FACP serving as deputy chief censor. We extend our deep thanks to Alisa McLachlan FACP and Marg Sherburn FACP for their dedication and service in acting positions during 2023. Your commitment has been invaluable in ensuring the smooth functioning of our critical processes, and we are grateful for your support.

As we embark on another year of excellence, let us continue to uphold the College values. Together, we can achieve great things and elevate the practice of physiotherapy to new heights.

Warm Regards,

Tom

• Tom McMillan FACP, Specialist Musculoskeletal Physiotherapist (as awarded by the College of Physiotherapists in 2010)
• Gen McGlashan FACP, Specialist Women’s, Men’s and Pelvic Health Physiotherapist (as awarded by the College of Physiotherapists in 2010)
• Andrew Webster FACP, Specialist Musculoskeletal Physiotherapist (as awarded by the College of Physiotherapists in 2015)
• Debra Shirley FACP, Specialist Musculoskeletal Physiotherapist (as awarded by the College of Physiotherapists in 2007)
• Anne Daly FACP, Specialist Pain Physiotherapist (as awarded by the College of Physiotherapists in 2021)
• Alisa McLachlan FACP, Specialist Musculoskeletal Physiotherapist (as awarded by the College of Physiotherapists in 2019)
• Marg Sherburn FACP, Specialist Women’s, Men’s and Pelvic Health Physiotherapist (as awarded by the College of Physiotherapists in 2010)

Longitudinal Extensive Transverse Myelitis (LETM) is a rare neurological condition characterised by inflammation spanning multiple segments of the spinal cord. This condition leads to varying degrees of sensory, motor, and autonomic dysfunction. Understanding its diagnosis and treatment options is crucial in managing LETM effectively.

Diagnosis:

Diagnosing LETM involves a comprehensive assessment by medical professionals. Physicians often begin by reviewing the patient’s medical history and conducting a thorough physical examination. Common symptoms include progressive weakness or paralysis in the limbs, sensory disturbances such as numbness or tingling, and bowel/bladder dysfunction.

Diagnostic imaging, like magnetic resonance imaging (MRI), plays a pivotal role in identifying LETM. The MRI reveals characteristic features such as spinal cord swelling and abnormal signal patterns across several spinal segments. Additionally, lumbar punctures may be performed to analyze cerebrospinal fluid for signs of inflammation or infection.

To differentiate LETM from other similar conditions, doctors may conduct neurological tests and blood work to rule out alternative diagnoses like multiple sclerosis or spinal cord tumors.

Treatment:

Treating LETM focuses on managing symptoms, reducing inflammation, and preventing further neurological damage. The approach typically involves:

1. Corticosteroids: High-dose intravenous corticosteroids, such as methylprednisolone, are often the first line of treatment. These medications help reduce inflammation in the spinal cord and alleviate symptoms.
2. Plasma Exchange (Plasmapheresis): For individuals who do not respond well to steroids, plasma exchange may be considered. This procedure involves removing and replacing blood plasma to eliminate harmful antibodies or proteins contributing to the immune response.
3. Immunosuppressants: In cases where steroids and plasma exchange aren’t effective, immunosuppressive drugs like azathioprine, mycophenolate mofetil, or rituximab may be prescribed to modulate the immune system’s response and reduce inflammation.
4. Pain Management and Rehabilitation: Addressing pain and managing associated symptoms is crucial. Physical therapy, occupational therapy, and assistive devices may be recommended to enhance mobility and functional abilities. Pain medications or interventions like nerve blocks may also be utilized.
5. Long-term Care and Monitoring: Patients with LETM require ongoing monitoring to track their condition’s progression and manage potential complications such as urinary tract infections, pressure sores, or respiratory issues.

Prognosis:

The prognosis for LETM varies widely among individuals. Some patients experience partial or full recovery, while others may have persistent disabilities. Early diagnosis and prompt initiation of treatment often contribute to better outcomes.

Longitudinal Extensive Transverse Myelitis is a challenging neurological disorder that necessitates a multidisciplinary approach involving neurologists, physical therapists, and other healthcare professionals. While there’s no definitive cure, timely and appropriate management strategies can significantly improve patients’ quality of life and functional abilities. Research into new therapies and a deeper understanding of LETM’s underlying mechanisms continue to offer hope for enhanced treatments and outcomes in the future.

In the hustle and bustle of modern life, amidst the demands of work, social engagements, and personal commitments, one fundamental aspect often takes a backseat: sleep. However, the significance of sleep health cannot be emphasised enough. It stands as a pillar of overall well-being, impacting physical, mental, and emotional health in profound ways.

Sleep is not merely a state of rest; it’s a complex biological process essential for the body’s rejuvenation and repair. Quality sleep plays a pivotal role in various bodily functions, including cellular regeneration, immune system regulation, and hormone balance. It acts as the body’s natural reset button, crucial for optimal functioning.

The impact of sleep on physical health is undeniable. Adequate sleep is associated with a lower risk of chronic diseases such as heart disease, diabetes, and obesity. During sleep, the body regulates vital functions, including blood pressure and inflammation, reducing the risk factors for these ailments.

Moreover, sleep plays a significant role in immune function. Deep sleep stages contribute to the production of cytokines, essential proteins for immune response, aiding the body in fighting infections and illnesses. A well-rested body is better equipped to defend against pathogens and maintain overall health.

In the realm of mental health, the correlation between sleep and cognitive functions is striking. Sleep is instrumental in consolidating memories, enhancing learning, and promoting mental clarity. Insufficient sleep disrupts cognitive processes, impacting attention, concentration, and decision-making abilities.

Furthermore, the impact of sleep on emotional well-being cannot be overlooked. Sleep deprivation can lead to heightened emotional reactivity and mood disturbances. It contributes to increased stress, irritability, and feelings of anxiety or depression. Conversely, adequate sleep fosters emotional resilience, enabling individuals to navigate challenges with a clearer mindset.

The modern lifestyle, characterized by round-the-clock connectivity and demanding schedules, often leads to a culture of sleep deprivation. Factors such as excessive screen time, irregular sleep patterns, and high-stress levels contribute to the erosion of sleep quality. Prioritizing sleep health has become more crucial than ever in counteracting these effects.

Practicing good sleep hygiene is pivotal in promoting optimal sleep health. Establishing a consistent sleep schedule, creating a relaxing bedtime routine, maintaining a comfortable sleep environment, and limiting stimulants like caffeine and electronic devices before bedtime are integral steps in fostering quality sleep.

Addressing sleep disorders promptly is equally important. Conditions like insomnia, sleep apnea, and restless leg syndrome can significantly impair sleep quality and overall health. Seeking professional help and adopting appropriate treatment strategies can mitigate the impact of these disorders on sleep.

Sleep health should be a non-negotiable aspect of a healthy lifestyle. It serves as a cornerstone for physical repair and vitality, cognitive sharpness and emotional resilience. Recognising the profound impact of quality sleep on overall well-being encourages individuals to prioritise and nurture their sleep health, unlocking a pathway to a more comfortable, vibrant and fulfilling life.

We human beings are inherently social creatures, wired to seek connection and interaction with others. The value of socialisation in maintaining sanity and mental well-being cannot be overstated. Our interactions with friends, family, colleagues, and communities play a pivotal role in shaping our emotional and psychological health.

At its core, socialisation fulfills our innate need for belongingness and companionship. Meaningful social contact provides a sense of support, understanding, and validation. Engaging in conversations, sharing experiences, and forming bonds fosters a sense of connectedness that acts as a buffer against stress and loneliness.

Studies consistently highlight the profound impact of social interactions on mental health. Meaningful relationships are associated with lower rates of depression, anxiety, and various mental health disorders. The emotional support derived from social connections serves as a protective factor, offering resilience in the face of life’s challenges.

Moreover, socialisation acts as a catalyst for cognitive stimulation and emotional regulation. Interacting with diverse individuals exposes us to different perspectives, ideas, and ways of thinking, enhancing our cognitive flexibility. Discussions and debates with others stimulate our minds, sharpening our intellect and problem-solving abilities.

Furthermore, social contact contributes to the release of neurotransmitters like serotonin and oxytocin, commonly known as the “feel-good” hormones. These chemicals play a crucial role in regulating mood, reducing stress, and promoting overall well-being. The simple act of laughter or sharing a heartfelt conversation triggers the release of these neurotransmitters, fostering a sense of happiness and contentment.

However, the digital age has introduced a paradox: while we are more connected than ever through social media and technology, genuine human interaction has often taken a backseat. The quality of socialisation matters significantly. Meaningful face-to-face interactions hold unique benefits that cannot be replaced by virtual communication.

The COVID-19 pandemic further underscored the importance of socialisation. Isolation and limited physical contact during lockdowns and social distancing measures took a toll on mental health worldwide. The absence of regular social interactions highlighted the essential role they play in maintaining emotional balance and psychological well-being.

Recognising the value of socialisation prompts us to prioritise it in our lives. Engaging in group activities, volunteering, joining clubs, or simply spending quality time with loved ones are ways to foster meaningful connections and nurture our mental health.

With socialisation standing as a cornerstone of mental health it is important to do your best to work on this as you would your physical health. The impact of human connection on our sanity and well-being cannot be overstated. Cultivating meaningful relationships and nurturing social bonds is not just a choice; it’s a vital component in leading a fulfilling and mentally healthy life.

Torticollis, often referred to as “wry neck,” is a condition characterised by the involuntary contraction or tightening of the neck muscles, leading to the tilting or twisting of the head to one side. This condition can be uncomfortable, limiting mobility and causing pain. It can manifest in different forms, each with its own causes and treatment approaches.

There are two primary types of torticollis: congenital and acquired. Congenital torticollis is present at birth and typically results from the positioning of the fetus in the womb or from injury to the neck muscles during childbirth. This type often leads to tightness in the sternocleidomastoid muscle, which connects the collarbone and the skull.

On the other hand, acquired torticollis can develop later in life due to various factors. It may result from muscle spasms, injury, inflammation, or underlying medical conditions such as cervical dystonia (a neurological movement disorder). In some cases, prolonged poor posture or repetitive strain injury can also contribute to acquired torticollis.

Symptoms of torticollis can vary from mild to severe and may include:

1. Persistent tilting or turning of the head to one side
2. Stiffness or tightness in the neck muscles
3. Pain and discomfort in the neck and shoulders
4. Difficulty moving the head freely
5. Headaches, particularly related to muscle strain

Diagnosis of torticollis typically involves a physical examination by a healthcare professional, evaluating the range of motion in the neck and identifying any underlying causes. In some cases, imaging tests like X-rays or MRIs may be recommended to rule out other potential issues.

Treatment for torticollis depends on the underlying cause and the severity of symptoms. For congenital torticollis in infants, gentle stretching exercises and physical therapy are often effective in improving muscle flexibility and mobility. In more severe cases or when conservative methods fail, surgery might be considered to release tight muscles.

Acquired torticollis may require a combination of treatments, including:

1. Physiotherapy: Stretching exercises, massage and mobilisation of the effected joints to relax the affected muscles and improve range of motion.
2. Medications: Muscle relaxants, pain relievers, or injections of botulinum toxin (Botox) to reduce muscle spasms.
3. Heat or cold therapy: Applying heat or cold packs to the affected area can help alleviate pain and reduce muscle tension.

Living with torticollis can be challenging, but with proper medical guidance and treatment, many individuals can manage their symptoms effectively and improve their quality of life. Seeking early intervention and following a tailored treatment plan can significantly alleviate discomfort and enhance mobility for those affected by torticollis.

Walking, an activity often overlooked in its simplicity, stands as a powerful tool for enhancing overall health and well-being. Beyond being a basic mode of transportation, walking offers a plethora of benefits that positively impact both physical and mental health.

Physical Health

1. Cardiovascular Health: Regular walking contributes significantly to cardiovascular health. It strengthens the heart, improves circulation, and lowers blood pressure. It reduces the risk of heart disease and stroke, making it a simple yet effective way to maintain a healthy heart.

2. Weight Management: Walking plays a crucial role in managing weight. It burns calories, helping to maintain a healthy weight and prevent obesity. Combined with a balanced diet, regular walks can support weight loss goals.

3. Bone and Joint Health: Contrary to common misconceptions, walking is gentle on the joints and promotes bone health. It helps in strengthening bones, reducing the risk of osteoporosis and improving joint flexibility.

4. Improved Respiratory Health: Regular walking enhances lung capacity and improves breathing. It promotes better oxygen flow throughout the body, aiding in overall respiratory health.

Mental Well-being

1. Stress Reduction: Walking is a natural stress reliever. It triggers the release of endorphins, the body’s natural mood-lifting chemicals. A stroll through nature or even around the neighborhood can significantly reduce stress levels.

2. Enhanced Mental Clarity: Engaging in regular walks can sharpen cognitive abilities and boost creativity. It clears the mind, enhances focus, and fosters mental clarity.

3. Mood Enhancement: Walking has a profound impact on mental health by reducing symptoms of depression and anxiety. It offers a chance for reflection and relaxation, promoting a positive outlook on life.

Tips for Effective Walking

1. Consistency Matters: Aim for at least 30 minutes of brisk walking most days of the week to reap the maximum benefits.
2. Vary Your Routes: Explore different walking paths, parks, or neighborhoods to keep your walks engaging and enjoyable.
3. Proper Footwear: Invest in comfortable, supportive shoes to prevent injury and ensure a comfortable walking experience.
4. Stay Hydrated: Carry water to stay hydrated, especially during longer walks or in warmer weather.
5. Good Posture: Maintain an upright posture while walking to prevent strain on your back and neck.

Walking, an activity that requires no special equipment or membership, stands as a powerful tool for improving both physical and mental health. Its simplicity belies its incredible impact. Embracing a daily walking routine can significantly contribute to a healthier and happier life. So, lace up those shoes, step out, and let each stride bring you closer to a healthier you!

In the last year as the rise in cost of living has pinched all our pockets, I’ve noticed a trend in patient’s history. It is quite common now for me to hear a patient say they have been living with pain for months and sometimes years before deciding to bite the bullet and see a professional. Typically the solution to these problems is relatively simple and effective, easing pain quickly. Hence, my surprise at my patients for living with their pain for so long. When I’ve asked why they’ve waited so long to get help, the answer is almost always, “money is a little tight at the moment, and I was hoping it would go away.”

This is completely valid logic, at least on the surface. Trying to stretch your budget to reach each area of your life is difficult and I understand that the subtle but persistent ache in your hip feels less important than paying for your rent or spending quality time with loved ones over a delicious meal. However, the more I’ve thought about this, the more I’m convinced that putting off seeking care for your niggles and injuries is a false economy. Let me explain..

Like I’ve said, there are almost always simple, straightforward solutions to your pain. That, or there is necessary rehab that rears best results when done in the initial phase of your recovery. Being proactive with your pain reduces the time you spend worrying about your pain and empowers you with the tools to self manage your symptoms. More often than not we want to promote your continued participation in your exercise routine, sport or daily activities. When you delay your visit, it’s common to begin to avoid things that hurt in an effort to help yourself. As you are more than already aware, stopping the things you love wears you down. Lack of regular exercise and participation in normal daily activities impacts your mental and physical wellbeing and your confidence. The combination of your pain with these other factors can result in a more complex and chronic clinical presentation. Now, a simple problem is not so simple and requires more time and costs to resolve. 

Looking at your life from this holistic perspective, delaying medical attention for your pain will likely cost you a lot more. Definitely financially, but also in its impact on your participation in the best parts of your life, as well as the mental toll all of this can take on you. Getting in to see your physio sooner rather than later is absolutely your cheapest option.

So what now? Cost of living is a real struggle that we all feel. I understand the need to tighten your spending. And so here are some questions to help you decide whether to call your physio:

1. Is it a new injury that you don’t have prior wisdom on how to manage?
2. Is it bruised and swollen?
3. Is it making it difficult for you to walk/ participate in your regular activities?
4. Has this niggle lasted for longer than 1 week?

If you’re answering yes to these questions, it’s probably time to see your physio. A good physio should be able to work with you and your budget constraints. They will be able to give you as many tools to manage your pain and help your recovery independently at home, requiring a minimal amount of visits. We are here to empower you to help yourself and to get you back to your peak performance.

Hope this helps you make money conscious decisions about your pain.

Mo

https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2800006