‘Have a Hmmm’ before you get stuck into DIY

Alongside lawnmowing injuries, ACC accepted 19,300 DIY injury claims in 2022. These injuries came at a cost of $30 million to help people recover. This was the highest cost over the past five years.

“We know many people will use spring as an opportunity to do some odd jobs around the house and garden,” James says.

“Our top tip for a safe DIY project is to slow down.  Many accidents in the home happen simply because people are rushing and not thinking about what they’re doing.

“We want everyone to have that satisfaction of completing their DIY project and also be injury free so they can enjoy their time with their whānau.”

Published on www.stuff.co.nz 21st March 2023.

A footwear favourite of some, the humble croc has cost the taxpayer $36,351 in the year to March 2023 with people literally falling over them, according to data made available by ACC.

With 51 active croc-related claims paid out in the past 12 months, the shoe was to blame for injuries sustained to all parts of the body. Of new claims made during this period, 15 injuries were related to the foot, eight related to the ankle and the remainder of injuries were suffered across the body. Soft tissue injuries accounted for 25 of the new claims made, with those in the 65-plus age group appearing in the data the most frequently. New croc related claims were made on ten occasions in Auckland, seven times in Canterbury, six in Wellington, four in the Bay of Plenty, and the balance elsewhere across the regions.

The inclusion of the term “croc” on an ACC claim, is down to whether the patient declares the footwear in their injury themselves. While crocs are not necessarily worse for your feet overall than other footwear choices, lead podiatrist at Hamilton-based Waikato Podiatry Clinic, Andrew Jones says it’s a matter of “horses for courses”. Practicing for more than two decades, he says that the shoe should suit the occasion, and while a croc might be good for “around the house,” it’s certainly not made for tramping in. The material used to produce crocs is also of a less durable construction, says Jones. “Some of the things I’ve seen with crocs: the manufacturing of them is reasonably cheap, although you wouldn’t think that now because they cost $85. They don’t have an outsole and a midsole, they’re just one material in themselves. That in itself is quite soft. There’s an inverse relationship between softness and durability.” A slippery surface can really put the croc to the test, Jones says. “They are bloody dynamite. If you have a worn croc on a polished concrete floor that is wet … it’s like skating on ice. That’s something people really need to be aware of.” Supported by the data, Jones says older croc wearers ought to beware.

“In the elderly population footwear is certainly a fall risk. That’s a big problem, because fractured neck of femurs and those things can be life changing injuries … They need to be probably a little more proactive in selecting shoes; if they have a fastening, if they have a midsole with a resonable level of density, an outersole, a heel counter.” Jones’ personal recommendation for a croc-like alternative is the venerable birkenstock. A moulded foot bed and buckle fastening offer better support and durability, he says.

Published on www.stuff.co.nz on 25th of October 2022. Our physio Anna is also a certified Pinc & Steel Cancer Rehab physiotherapist.

When cancer survivor Sarah Hutton walks into her physiotherapist’s clinic once a week she’s doing far more than rebuilding her physical strength, she says. With the help of Olivia van Schaik, she’s regaining her emotional strength and confidence and getting back to who she was before her diagnosis. Working from Windsor Physio, Van Schaik has personally raised funds through the Dry July campaign to be able to offer the Pinc Cancer Rehabilitation Program and Next Steps group classes to Southland women.

“The aim is to shift participants’ focus from illness to wellness,” she said. Van Schaik had been certified to offer the program in Tauranga in the past, so when she moved home to Southland and heard it wasn’t being offered in the region any more, she wanted to get it up and running again. The Pinc and Steel Cancer Rehabilitation Foundation funds programs for Kiwis with all cancers throughout New Zealand.

Like many Southlanders, Van Schaik has watched friends and families go through cancer and wanted to do something to help. Rehabilitation and exercise helps reduce the side effects of cancer and treatments, and can improve functional ability, quality of life and ultimately, survival for patients. The majority of the women Van Schaik works with have fought breast cancer and by the time they join the program “they’ve been blasted with ominous words, but most have finished the crux of their treatment journey”. Through the Pinc program, she helped women work towards their previous hobbies and goals and take back control of their bodies, she said.

Next Steps – the physio-led group exercise classes which she’s been hosting for about two months – offered a social aspect where women could find motivation and emotional support from each other, Van Schaik said. “It’s a super positive and inspiring place for them to come. It’s pretty cool to be able to offer that service.” Hutton recently arranged a morning tea to thank Van Schaik and the clinic for their work. “She has such a giving heart. I wanted to honour her and express how thankful I am,” Hutton said.

She started going to physiotherapy with Van Schaik after her mastectomy in late 2021 and said as someone who had been quite active before, it was important for her to keep moving after the operation. Hutton said the class meant a lot to her, because she’d found a group of women cheering each other on. “Walking through this journey with other women, it’s encouraging to see each of us gaining strength, forming beautiful friendships and supporting each other in our journeys of healing and wellness,” she said.

Published on www.pnz.org.nz on 16th of May 2022.

Research shows that as many as one in eight COVID-19 patients could get Long COVID, which means there are likely hundreds of New Zealanders still experiencing symptoms 12 weeks after testing positive. New Zealand physiotherapists have been working closely with their counterparts overseas to find out more about Long COVID and how best to support those suffering long-term effects.

Physiotherapy New Zealand (PNZ) spokesperson Dr Sarah Rhodes says it is understandable that patients with Long COVID are increasingly frustrated that their recovery is so slow as the symptoms can persist for months and years in some cases. PNZ calls on the government to support people’s access to effective treatment for Long COVID, just as they have supported people through the pandemic. “We know that COVID-19 affects people differently and it is the same with Long COVID. It doesn’t only affect those who are hospitalised with an acute COVID infection. It can also affect those whose initial symptoms are mild and even those who are asymptomatic with the acute COVID-19 infection.”

“The desire to get back to normal life after COVID-19 is understandably important for all of us. With today’s busy lifestyles, it’s often hard to be that person who needs to rest instead of going back to work, getting back into your leisure activities, and looking after children and/or older family/whānau members. However, rest is an essential part of managing an acute COVID-19 infection as it is likely to reduce the risk of developing Long COVID,” says Dr Rhodes.

Members of PNZ’s Cardio-Respiratory Special Interest Group have developed some general tips to help guide people through a prolonged period of symptoms.

Fatigue

This is the most common symptom of Long COVID. Undertaking daily activities which were easily managed prior to COVID-19, such showering, can be exhausting.

Be kind to yourself. Don’t take on too much. Ask for help.
Working out which tasks require more or less energy can help you prioritise your time and activities so that you stay within your available energy levels. Keeping a diary of how you feel after each activity can be useful in identifying which activities make you more or less fatigued.
Pace yourself by doing small tasks or breaking up activities and allowing yourself to take rests in between. Choose some activities that you give you pleasure to help support your mental well-being.
Plan out your week to allow for periods of activity and periods of rest and recovery.
Take regular breaks throughout the day and if you need a rest, listen to your body. Don’t push through the feeling of exhaustion.
When fatigue is worsened by physical or mental effort, this may indicate you have post exertional symptom exacerbation (PESE). Exercise is not recommended for rehabilitation of people experiencing PESE as it can worsen symptoms. A physiotherapist can help support you in managing your fatigue.
Remember that some activities, like being with friends, may contribute to symptom exacerbation. Connecting with others is important for your mental well-being so you may need to reduce the time you spend with others to conserve your energy for other activities in the day.
Adapt activities to make them easier. e.g., sitting down to prepare the vegetables for dinner.
Getting outside and spending time in nature can have benefits for both your mental and physical health.
Breathlessness

Breathlessness is another commonly experienced symptom in those with Long COVID.

Feeling breathless can be a frightening experience.
Seek support from a physiotherapist about positions and breathing techniques that can help alleviate feelings of breathlessness.
It is important to get an individual assessment of your breathing as a one-size-fits-all approach doesn’t work.
A physiotherapist can also screen for disruptions in your pattern of breathing that may contribute to some of the symptoms you are experiencing.
Muscle and Joint Pain

Some patients with Long COVID experience muscle aches and joint pain. Gentle stretching and yoga may help relieve these symptoms.
Check with your health professional before starting any exercises.
Return to exercise

Exercise is not recommended if it worsens your fatigue.
If you are not experiencing worsening symptoms, a cautious approach to commencing exercise is recommended. Your response to exercise should be monitored carefully. A safe return to exercise requires careful clinical decision making and a physiotherapist can support you through this.
Physiotherapy can help manage symptoms of Long COVID. However, for some patients a multi-disciplinary approach, involving other health professionals, is recommended.

The Physiotherapy New Zealand Cardio-Respiratory Special Interest Group represents cardio-respiratory interests among the physiotherapy profession. Cardio-respiratory physiotherapists are present in ED, the acute wards and ICU, where they are fully involved in the acute care of patients admitted to hospital with COVID-19 symptoms and help with their breathing and rehabilitation needs. Cardio-respiratory physiotherapists also work on rehabilitation wards in hospitals and in the community.

Published on www.stuff.co.nz on 6th of April 2022.

A new study into how Kiwi women are recovering from knee surgery involves a groundbreaking rehab programme especially tailored to sync with a woman’s menstrual cycle.

Knees are the bane of a sportswoman’s career. Just ask netballers like Monica Falkner, Georgia Heffernan and Bailey Mes, Black Stick Kelsey Smith or Football Fern Hannah Wilkinson. And Black Ferns Ruahei Demant and Ariana Bayler, who’ve both had their knees rebuilt three times. Each year, around 3000 New Zealanders undergo surgery on their anterior cruciate ligament, better known as ACL. Almost half of those knee reconstructions are on women. But the most worrying statistic is that it’s happening more to teenage girls than any other age group. Research in 2019 showed over the past decade, there’s been a 120 percent increase in the number of 15 to 19-year-old girls undergoing ACL surgery.

There’s also growing concern that females aren’t recovering from their surgeries as well as males are. And a big part of that problem is, as most sport science has been dominated by male-based research, most rehabilitation programmes for ACL injuries are tailored for men. What hasn’t been studied well is the role a woman’s menstrual cycle can play in her recovery. So physiotherapist Emma O’Loughlin has created a study as part of her PhD thesis at the Auckland University of Technology to better understand how the menstrual cycle affects rehabilitation after ACL surgery. With the help of physiotherapy professor Duncan Reid and renowned female athlete physiologist Dr Stacy Sims, she’s designed a rehab programme specifically for women, now being trialled around New Zealand.

“Women are more likely to not be doing as much activity after their surgery as men do, and are not as likely to return to sport afterwards,” says O’Loughlin, who’s also an ultra runner. “And on a more simple level, they aren’t as strong, so they don’t have as much recovery of their muscle strength after surgery. “So that’s what we’re looking at. We’re gathering women from all around the country, then working with surgeons and physios to give them a female-specific rehab programme. “Every woman who does her ACL – whether they’re a sportswoman or a mum who’s hurt her knee bouncing on the trampoline with her kids – should be engaging in high quality rehab. And that’s what we’re providing.” It’s a strengthening programme, working in combination with phases of a women’s menstrual cycle.

O’Loughlin is still looking for women who are aged over 16 and have a regular menstrual cycle. Six weeks after their surgery, they engaged in the 12-week rehab programme through a physio. “We’re working with their physiology to get them do strengthening exercises, measuring before the trial and after, then comparing them with people who are engaging in normal physiotherapy,” she says. So far into the trial, the evidence points to women returning stronger having done their exercises timed with their menstrual cycle.

“From day 1 to 14 of your cycle, you’re building levels of oestrogen – which is like a female version of testosterone, an anabolic that helps to build muscle. Once you release the egg, for the second half of your cycle, you’re releasing progestin that opposes the oestrogen, and stops it working so well to build muscle,” O’Loughlin says. “What the evidence says so far is that, by and large, if you carry out a lot of your resistance training – your squats, leg presses, lunges, knee extensions, bicep curls – in the first half of your cycle before you release your egg, and you repeatedly do that for three to four months, at the end of the trials women have an increased strength through menstrual cycle-based rehab training.

“There are stages of our cycle where we feel better, or a bit grotty. It may be a good time based on how we’re feeling to carry out those high intensity sessions between the first day of your period and ovulation. “Alongside that, there’s some evidence that it might increase lean body mass – actual muscle bulk.” O’Loughlin is quick to point out that cycle-based rehab isn’t “the golden ticket” that patient wants – a quicker rehabilitation. Most athletes take between nine and 12 months to return to sport. “We look at whether the injured leg has the same strength as the other leg, or if there’s less than 10 percent difference around the six to nine-month mark. What we expect is women are better placed to pass the criteria tests at that time,” O’Loughlin says.

Duncan Reid says O’Loughlin’s study is critical for developing rehab programmes that work for women. “Women are not only behind the eight ball because they’re not as strong as men. The programmes developed for ACL rehab are all based on men, which is a problem,” Reid says. “And if you don’t get the strength back in your knee even though you’ve had it repaired, you’re predisposing yourself to quite significant osteoporosis further down the track. “Women are going to be more likely to have a knee replacement at a younger age. You’d expect women in their 70s, but I’m seeing women in their 50s because of injuries they sustained as young people.”

Some sports, like netball, have developed injury prevention plans in partnership with ACC. NetballSmart, for example, has reduced the incidence and severity of injuries by getting players to do a 15-20 minute dynamic warm-up. “Netball is really interesting because there’s a lot of really good work being done to reduce the number of injuries,” says Reid. “But netball is also the perfect storm for rupturing your ACL because you only take two steps and you twist and turn. Even with the best intentions, as you see at our elite levels, people will still rupture their cruciate. “The other part of this puzzle is the second rupture. If you’ve done it once you’re predisposed to the second one. But we’re hoping across the world better designed rehab programmes will reduce the chance of having a second or third event.

“Because they cost hugely – both financially and the personal cost. After nine to 12 months rehabbing with the first one, the thought of going through that for a second time is just depressing.” In the study to help women return from knee surgery stronger, there’s another hurdle facing both patients and physios – talking about periods. “When we designed the trial, we learned physios see the menstrual cycle as something they don’t know a lot about, but it’s something they’re super interested in learning about,” O’Loughlin says. Some cultures still consider it taboo to talk about menstruation, but technology is helping.

“A lot of the female athletes are now tracking their cycles through apps on their phone, like FITR Woman, Flo and Clue. A lot of the female physios are too,” O’Loughlin says. “It’s become more normalised to talk about it in the last few years.” There are now more than a dozen women involved in the trial, with numbers increasing in Auckland since sport and elective surgeries have returned, after been cut during the Covid lockdowns. O’Loughlin hopes to have around 50 women rehabbing to their menstrual cycles by the end of the year.