Your feet have to bear the weight of your entire body, so that puts more pressure on them as they impact on the ground. That means your feet and ankles are more likely to experience:
- bone pain at the top of the foot
- fractures from a small injury, or even just from walking!
In fact, the bones can become so brittle that if you see our Chiropodist for pain, redness, and swelling on your feet, she may detect a fracture and also determine if you might have osteoporosis. That’s right, some people find out they have osteoporosis because of a foot fracture!
There are a number of factors that can contribute to stress factors:
Gender – They are more commonly found in women compared to men, especially after Menopause. Since estrogen helps prevent bones from getting weaker by slowing the natural breakdown of bone, its reduction during menopause significantly speeds up bone loss.
Foot Problems – People with unusual arches in their feet are more likely to develop stress fractures.
Certain Sports – Dancers, gymnasts, tennis players, runners, and basketball players are more likely to develop stress fractures.
Lack of Nutrients – A lack of vitamin D and calcium may weaken the bones and make you more prone to stress fractures.
Weak Bones – Osteoporosis can weaken the bones therefore resulting in stress fractures.
As people age, we experience depleted circulation, dry skin, rough, brittle nails, and bone density loss. This can affect your foot health if steps are not taken to treat them. Proper foot health means that you can have a more active lifestyle, with less pain and increased circulation.
How a Chiropodist can help:
A full biomechanical analysis will be performed to see how your gait, muscles and tendons around the fracture are affected.
Custom made foot Orthotics may be recommended if muscles, tendons, ligaments and joints are not in an optimal functional position which can aggravate pain and discomfort. It is also important to reduce further strain on the fractured area. Our custom orthotics can be made from different materials to accommodate your needs, such as semi flexible, semi-rigid, rigid or additional cushioning and make a significant difference on your recovery and future prevention.
I think we can all agree it’s been a particularly rough 18+ months since the COVID-19 pandemic hit the world. It’s safe to say that we’ve all been affected in some way, whether it be through changes to work, finances, isolation, having to home-school the kids, or worst of all, losing a loved one. We wanted to take this opportunity to check in, say a big hello, and send best wishes to each and every one of you who are taking the time to read this message.
We know that lockdowns and isolation come with their fair share of baggage, and people respond to them in different ways. Some people become depressed and anxious at the prospect of not being with their loved ones. Others may enjoy the slowing down of life that a lockdown may bring. Either way, it can easily take its toll on you, whether that be quick, or progressively over a long period of time. Whether you are reading this having recently come out of (or gone into) a lockdown or period of isolation, it’s good to take a step back and have a long and hard think about how you may have been (or are still being) affected by it all.
You may think of us as the people you go to when you have a sore back or neck, and whilst that may be true, we are able to offer so much more than just hands-on and movement therapy. It’s a well-known fact that to be 100% healthy, you need to be physically and mentally well, and have a solid, social environment around you that offers you support.
To try and battle some of the negative effects that may have come about over this pandemic, this little check-in from us is designed to give some prompts about some aspects of life that may have fallen (or are continuing to fall) by the wayside as a result of lockdown. You can take as little or as much as you want from it, but even if you take just one point and act on it, it could make a huge difference to your life.
Do you need psychological support?
We’re going right into the deep end with this. Rates of depression and anxiety have increased dramatically during the pandemic, especially in adolescents and young adults. Are you feeling low? Alone? Have you asked your kids if they are OK? You or a family member may need some psychological support. Don’t ignore these feelings. Go straight to your doctor or a local psychologist or counsellor and get the help you deserve, today. We mean it, make this a priority.
Are you being kind to your body?
Nutritionally and physically? Diet and exercise are a key part to leading a fulfilling and healthy life. Lockdowns and increasing rates of mental health problems can open doorways to bingeing on fast foods that are extremely comforting, yet incredibly full of unhealthy fats and sugars. Put your foot on the brake and steer yourself away from diabetes and heart disease by cramming your diet full of nutrient-rich plant-based foods including fresh fruits, vegetables, nuts and seeds. We’re not saying don’t eat meat, we’re just saying keep it fresh and clean and predominantly… plant-based.
Bingeing on fast foods is one thing, bingeing on TV shows and movies is a growing problem. We love a good show as much as the next person, but as the saying goes… all in moderation. Days on end in front of the flat-screen watching season after season of your favourite period drama may seem appealing, but your body will be crying out for movement. Noticed some pains and pangs creeping in? Feeling sluggish? Get yourself out, in the garden if necessary, and get moving. Squats, lunges, step-ups, jumping-jacks, jogging on the spot and many other exercises can all be performed in a space of about 2-3 square metres! You’ll feel great for it, we promise you that.
Lastly… have you been having a lot of coffee and alcohol? Remember, our bodies are 60-70% water. We need to feed our bodies water because we are unable to create it ourselves. Whilst we get some water from the food and drinks we consume, we need to ensure the majority of liquid we consume each day is fresh water. Our tip is to have a reusable water bottle with you each day, sip regularly each hour and re-fill as required. Don’t let yourself get thirsty. If you are thirsty, your body is letting you know you are dehydrated.
Are you allowing yourself to relax each day?
There are no rules for this, but we all need to wind down each day. Home-schooling the kids or back-to-back household chores is tiring and demanding on the body. What gets you into your chill-zone? Maybe some calming music, a walk along the beach, a puzzle, reading a fantasy novel, building Lego or colouring in? Whatever brings down the stress levels for you, always ensure you allow yourself to do it, each day. It’s easy to put it off until tomorrow. But don’t. You need it.
You may be thinking you have read all of this before, and you probably have. But are you following this advice? It’s well-known information, but many people do not follow this advice. Be different. Be healthy. Be the best version of yourself. And you’ll be truly happy and healthy. Stay strong out there, and as always, be safe.
P.s. If you do have a sore back or neck, please get in touch today… (416) 546-4887.
- Hawes, M. et al. 2021. Increases in depression and anxiety symptoms in adolescents and young adults during the COVID-19 pandemic. Psychological Medicine. 1-9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7844180/
- Harvard Health Publishing. 2020. How much water should you drink? [Online]. Available from: https://www.health.harvard.edu/staying-healthy/how-much-water-should-you-drink. [Accessed 17 Aug 2021]
Since the beginning of the Covid-19 pandemic, hospitals, health care workers, nurses, doctors, emergency responders and many others have been overwhelmed and under a great deal of stress. They’ve required our cooperation to limit the spread of Covid-19, prevent unnecessary deaths and to reduce the burden on our health system.
The foremost method of limiting this burden so far has involved social distancing, self-isolation, wearing masks, hand washing and sanitizing surfaces. All of which are valid and important to avoid contact and infection from the virus. But as Covid-19 variants continue to arise and evade vaccination efficacy, it is becoming clear that this virus may be around longer than we would all hope. Is there anything we can do that will reduce our chances of a serious, medical attention requiring, infection and allow us to get back to normalcy?
My hope with this post is to empower and give individuals a more active role in containing the virus and controlling their health by, first, showing the mechanisms of a viral infection and, second, the many ways lifestyle and dietary choices can help or hinder our response to it.
How does a virus work?
The mechanisms of viral infection.
- Implantation of virus at the portal of entry (in the case of COVID-19 this implantation occurs at the mucus membranes found within the mouth, nose and eyes. Specifically the ACE-2 receptors on the epithelial cells of these tissues. 1
- After the virus has implanted, it will begin to replicate
- Then the virus will spread to target organs (COVID-19 seems to affect the lower respiratory tract however there may also be multi-organ involvement. 2
- The virus then begins shedding into the environment and potentially infecting others.3 (For COVID-19 two modes for transmission exist – direct and indirect. The direct method includes transmission via respiratory droplets and aerosols when a person coughs, sneezes, shouts or talks. Indirect modes include transmission via fomites4 (picking up the virus from inanimate objects)
- Transmission through inanimate surfaces appears to be very small, and only in instances where an infected person coughs or sneezes directly on the surface, and someone else touches that surface soon after the cough or sneeze (within 1–2 hours). 5
- Outdoor risk of transmission of Covid-19 is very low. Research continues to suggest that the vast majority of transmission happens in indoor spaces; recent reviews considering data from several countries found very little evidence of outdoor transmission for SARS-CoV-2, influenza or other respiratory viruses.6,7
There are three factors that affect a virus’ ability to infect and a person and make them sick.
- Accessibility of virus to tissue, (How prevalent is the virus in our environment)
- Cellular susceptibility to virus multiplication, and
- Virus susceptibility to host defences. 3
Lockdowns, social distancing, hand washing and wearing masks, prevents our contact with the virus and reduces our risk of encountering the virus.
But what happens if we do encounter the virus? Is there a way to make our cells less susceptible to viral hijacking or ensuring our host defences (immune system) protects us more effectively?
It turns out that through our lifestyle and dietary choices we have a great deal of control in ensuring a COVID-19 infection doesn’t result in serious or critical outcome. 8
Covid-19 infection can present in a spectrum ranging from mild, moderate to severe illness. In severe cases of COVID-19 the respiratory distress comes not just from how the virus harms the infected, but from an exaggerated response of the individuals own immune system. The pneumonia which accompanies COVID-19 is not directly caused by the virus but rather through fibrosis caused by runaway cytokine storms within the respiratory system. 9
What is a cytokine storm?
Cytokines are a group of proteins that provide intercellular signaling and communication, which controls cell proliferation and differentiation alongside immune and inflammatory responses. The immune system, under normal circumstances, will respond to a pathogen with a regulated and proportionate amount of cytokines to remove the pathogen and restore homeostasis.
Failures in the body’s own feedback and regulatory processes are responsible for excessive cytokine production and can result in systemic damage that often outstrips the benefit from a ‘typical’ immune response. 8
The leading cause of death in patients infected with Covid-19 is acute respiratory distress syndrome or ARDS. It is now known that several proinflammatory cytokines will contribute to the occurrence of ARDS. 10
Risk factors for a severe infection
Poor nutritional status as well as pre-existing noncommunicable diseases (NCDs) such as diabetes mellitus, chronic lung diseases, cardiovascular diseases (CVD), obesity, and various other diseases that compromise immune function can increase the likelihood of a severe and fatal infection from Covid-19.
These diseases are characterized by systemic inflammation, leaving an individual pre-inflamed prior to viral infection. The inflammation caused by infection from the virus combined with this systemic inflammation can make a severe and medical attention requiring reaction more likely. 11
How to maintain a healthy well-functioning immune system
The good news is, adoption of healthy lifestyle, and dietary habits can have a considerable effect on improving nutrition status, reducing inflammation and preventing and even improving pre-existing conditions which can consequently safeguard us from severe viral infections.
Vaccines also appear to be more effective in individuals who fall into the normal/healthy body mass index (BMI) range for their body weight and height. 12
Below are some easy and effective strategies.
Adopt an anti-inflammatory diet
There is nothing complex or new about an anti-inflammatory diet. You don’t need to eat a variety of expensive and exotic superfoods or take a briefcase full of supplements. An anti-inflammatory diet is simply choosing whole foods consisting of whole vegetables, fruits, nuts, seeds and grains, healthy fats and oils, good quality protein sources, and small amounts of healthy treats. This combined with reducing consumption of refined and processed foods, including highly
processed sugar laden foods and beverages, processed meats, refined oils and deep-fried foods will be a huge step in the right direction.
A good example is found in this anti-inflammatory food pyramid.
Reduce your consumption of sugar
Poor blood sugar control, not only in people with diabetes, worsens the prognosis and increases the seriousness of COVID-19 infection.
- because a spike in blood sugar is accompanied by a large increase in inflammatory mediators.
- glycosylation – a process that can be caused by a spike in blood sugar, is needed by the virus to link onto a cellular receptor – this can favor the cellular intrusion of Covid-19, leading to higher severity of symptoms experienced.
Individuals with well-regulated blood sugar (like those who regularly exercise and eat plenty of whole vegetables and fruits) are less likely to have high levels of inflammation and reduced binding capacity for the virus. 13
Supplement with Vitamin D
Two separate systematic reviews looking at the effects of vitamin D and Covid-19 show that a vitamin D deficiency is associated with increased severity and complications from Covid-19 infection and that optimal levels can reduce inflammatory markers and the negative immunomodul
ation of the inflammatory cytokine storm caused by COVID-19. Both studies recommend acquiring optimal blood levels of vitamin D through supplementation and/or sunlight exposure in order to reduce the severity of Covid-19 infection.14, 15
Make sure you’re getting enough Omega 3
There are various benefits of omega-3 fatty acids and taking it as a supplement might be associated with the prevention of the viral entry by changing the composition of fats in the membrane of our cells. Omega-3 fatty acids, such as DHA and EPA, perform their role by being incorporated in the cell membrane and affecting the clumping of toll-like receptors and thus preventing signals that activate nuclear factor kappa B (NF-κB) a regulator of innate immunity, and help to reduce the complications of COVID-19 by producing fewer pro-inflammatory mediators.16 17
Being physically inactive greatly increases the risk for severe Covid-19 outcomes, including greater risk of hospitalization, admission to the ICU, and death for adults compared to individuals constantly meeting physical activity guidelines. 18
Respiratory viral infections, such as SARS-CoV-2, cause a systemic inflammatory response that places increased demand and substantial burden on the cardiopulmonary system.
Regular use of exercise positively affects the cardiorespiratory system allowing for greater cardiopulmonary capacity to deal with a respiratory infection and has been shown to diminish the risk for adverse outcomes. Routine exercise has also been shown to improve immune function, reduce the risk of respiratory infections and lower chronic low-grade inflammation. 19
The benefits to exercise don’t stop there. Exercise also helps you;
- Sleep better 20
- Manage blood sugar more effectively 21
- Reduce chronic pain 22
- Reduce the risk of dementia 23
Exercise doesn’t have to be going to the gym and lifting weights or going to spin class three times a week. Exercise in its most sustainable form can be doing any form of physical activity that you enjoy, such as dancing, gardening, hiking, swimming, cleaning, playing with kids or any kind of hobby that gets you moving.
Try meditating or start a gratitude journal.
In a time where our immune systems need to be functioning optimally the news and information being given by media outlets and our government institutions has been a driver for fear, stress and included instructions (social isolation) that are known to, unfortunately, reduce immune function.24
Meditation, visualization and gratitude practices can be extremely helpful at reducing the stress and fear associated with a global pandemic as well as help combat the negative effects of social isolation.
The isolation caused by repeated and prolonged lockdowns are an unfortunate consequence of the medical community’s strategy to control the virus. Fortunately the negative immune system effects of loneliness and isolation have been proven to be improved by specific meditative practices.25
Meditation has been shown to counteract at least 60% of the inflammatory mechanisms that COVID-19 triggers. This could lower the likelihood and severity of the body’s inflammatory load, diminishing the damage the body takes and accelerating the clearing of the virus.26
Improving the resilience and recovery rates of the sick in quarantine reduces the duration of their stay in the hospital and improving the immune efficiency of the healthy in isolation can reduce their likelihood of requiring hospitalization in the first place.
There are many helpful mediation/visualization apps and programs to be discovered – check out a couple of the options below
Get enough sleep
Sleep provides essential support to the immune system. Getting sufficient hours of high-quality sleep enables a well-balanced immune defense that features strong innate and adaptive immunity.
Sleep plays a role in promoting inflammatory homeostasis through its effects on several inflammatory mediators, such as cytokines. Prolonged sleep deficiency can lead to chronic, systemic low-grade inflammation and is associated with inflammatory diseases, like diabetes, atherosclerosis, and neurodegeneration.27
Immune function works in a synergistic manner with our circadian rhythm and sleep/wake cycles, where differentiated immune cells with immediate functions, peak during the wake period and undifferentiated or less differentiated cells peak during the night, when the more slowly evolving adaptive immune response is initiated.28
Implementing new behaviours and changing dietary patterns can be challenging, so start out small. Many small changes can amount to a big shift in your wellbeing.
If you would like more information on how to implement these strategies or have a health concern, contact Beachealth today.
Written by: Jared Cox
- Lu C wei, Liu X fen, Jia Z fang. 2019-nCoV transmission through the ocular surface must not be ignored. Lancet. 2020;395(10224). doi:10.1016/S0140-6736(20)30313-5
- Gavriatopoulou M, Korompoki E, Fotiou D, et al. Organ-specific manifestations of COVID-19 infection. Clin Exp Med. 2020;20(4). doi:10.1007/s10238-020-00648-x
- Samuel Baron MF and TA. Viral Pathogenesis. Med Microbiol Bookshelf ID NBK8149. Published online 1996.
- Harrison AG, Lin T, Wang P. Mechanisms of SARS-CoV-2 Transmission and Pathogenesis. Trends Immunol. 2020;41(12). doi:10.1016/j.it.2020.10.004
- Goldman E. Exaggerated risk of transmission of COVID-19 by fomites. Lancet Infect Dis. 2020;20(8). doi:10.1016/S1473-3099(20)30561-2
- Bulfone TC, Malekinejad M, Rutherford GW, Razani N. Outdoor Transmission of SARS-CoV-2 and Other Respiratory Viruses: A Systematic Review. J Infect Dis. 2021;223(4). doi:10.1093/infdis/jiaa742
- Weed M, Foad A. Protocol for a rapid scoping review of evidence of outdoor transmission of COVID-19. medRxiv. Published online 2020. doi:10.1101/2020.08.07.20170373
- Arena R, Bond S, Calvo IR, et al. Shelter from the cytokine storm: Healthy living is a vital preventative strategy in the COVID-19 era. Prog Cardiovasc Dis. Published online June 2021. doi:10.1016/j.pcad.2021.06.008
- Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R. Features, Evaluation and Treatment Coronavirus (COVID-19) – StatPearls – NCBI Bookshelf.; 2020.
- Ye Q, Wang B, Mao J. The pathogenesis and treatment of the `Cytokine Storm’ in COVID-19. J Infect. 2020;80(6). doi:10.1016/j.jinf.2020.03.037
- Zabetakis I, Lordan R, Norton C, Tsoupras A. Covid-19: The inflammation link and the role of nutrition in potential mitigation. Nutrients. 2020;12(5). doi:10.3390/nu12051466
- Painter SD, Ovsyannikova IG, Poland GA. The weight of obesity on the human immune response to vaccination. Vaccine. 2015;33(36). doi:10.1016/j.vaccine.2015.06.101
- Ceriello A. Hyperglycemia and the worse prognosis of COVID-19. Why a fast blood glucose control should be mandatory. Diabetes Res Clin Pract. 2020;163. doi:10.1016/j.diabres.2020.108186
- Pereira M, Dantas Damascena A, Galvão Azevedo LM, de Almeida Oliveira T, da Mota Santana J. Vitamin D deficiency aggravates COVID-19: systematic review and meta-analysis. Crit Rev Food Sci Nutr. Published online 2020. doi:10.1080/10408398.2020.1841090
- Yisak H, Ewunetei A, Kefale B, et al. Effects of vitamin d on covid-19 infection and prognosis: A systematic review. Risk Manag Healthc Policy. 2021;14. doi:10.2147/RMHP.S291584
- Hathaway D, Pandav K, Patel M, et al. Omega 3 fatty acids and COVID-19: A comprehensive review. Infect Chemother. 2020;52(4). doi:10.3947/IC.2020.52.4.478
- Hariharan A, Hakeem AR, Radhakrishnan S, Reddy MS, Rela M. The Role and Therapeutic Potential of NF-kappa-B Pathway in Severe COVID-19 Patients. Inflammopharmacology. 2021;29(1). doi:10.1007/s10787-020-00773-9
- Sallis R, Young DR, Tartof SY, et al. Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients. Br J Sports Med. Published online 2021. doi:10.1136/bjsports-2021-104080
- Brawner CA, Ehrman JK, Bole S, et al. Inverse Relationship of Maximal Exercise Capacity to Hospitalization Secondary to Coronavirus Disease 2019. Mayo Clin Proc. 2021;96(1). doi:10.1016/j.mayocp.2020.10.003
- Banno M, Harada Y, Taniguchi M, et al. Exercise can improve sleep quality: A systematic review and meta-analysis. PeerJ. 2018;2018(7). doi:10.7717/peerj.5172
- Buresh R. Exercise and glucose control. J Sports Med Phys Fitness. 2014;54(4).
- Leung A, Gregory NS, Allen LAH, Sluka KA. Regular physical activity prevents chronic pain by altering resident muscle macrophage phenotype and increasing interleukin-10 in mice. Pain. 2016;157(1). doi:10.1097/j.pain.0000000000000312
- Ahlskog JE, Geda YE, Graff-Radford NR, Petersen RC. Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging. Mayo Clin Proc. 2011;86(9). doi:10.4065/mcp.2011.0252
- Campagne DM. Stress and perceived social isolation (loneliness). Arch Gerontol Geriatr. 2019;82. doi:10.1016/j.archger.2019.02.007
- Pandya SP. Meditation program mitigates loneliness and promotes wellbeing, life satisfaction and contentment among retired older adults: a two-year follow-up study in four South Asian cities. Aging Ment Heal. 2021;25(2). doi:10.1080/13607863.2019.1691143
- Black DS, Slavich GM. Mindfulness meditation and the immune system: a systematic review of randomized controlled trials. Ann N Y Acad Sci. 2016;1373(1). doi:10.1111/nyas.12998
- Besedovsky L, Lange T, Haack M. The sleep-immune crosstalk in health and disease. Physiol Rev. 2019;99(3). doi:10.1152/physrev.00010.2018
- Besedovsky L, Lange T, Born J. Sleep and immune function. Pflugers Arch Eur J Physiol. 2012;463(1). doi:10.1007/s00424-011-1044-0
Knee pain in the middle to late decades of life is a common complaint amongst patients presenting to osteopathic clinics across the globe. Osteoarthritis (OA) is a common cause of knee pain in this age group of people. Research suggests approximately 654 million people aged 40 years and over were living with knee OA in 2020 around the world. This comes at an incredible cost to healthcare services worldwide, with figures in the billions of dollars!
What is osteoarthritis?
Osteoarthritis is just one of a number of forms of arthritis… Essentially a disease which affects the joints in our body. OA is the most common form of arthritis, with Rheumatoid Arthritis (RA) being the second most common form. This blog will focus on OA, a potentially debilitating disease that most commonly affects the weight-bearing joints of the body (i.e. the knees, hips and lumbar spine), but can affect any joint in the body where the joint surfaces are covered in cartilage.
The characteristics of OA include loss of the cartilage that covers the ends of bones that come together to form joints. The underlying and surrounding bone, as well as other joint structures (including joint capsules and other tissues) are also susceptible to degenerative changes that ultimately lead to poor functioning of a joint. The process usually occurs over a long period of time, often starting early in life (interestingly with little to no symptoms at all) and progressing into the latter years. The severity of the disease varies from person to person with some people only experiencing mild symptoms throughout their life. Other people experience more severe symptoms and may require joint replacement surgery as a last port of call to ensure they can continue to live their life as pain-free as possible.
Osteoarthritis of the knee can affect either of the two main joint components of the knee… The joint between the ends of the thighbone and the shin-bone (called the tibiofemoral joint), and the joint between the thigh-bone and the knee-cap (called the patella-femoral joint).
There are certain factors associated with higher rates of knee OA. These include:
- Age: Rates of knee OA increase in the elderly
- Obesity: Rates of knee OA increase with higher levels of obesity
- Gender: Females slightly out-do the males with this one, being approximately 1.5 times more likely to develop it
- Trauma: A trauma to the knee can increase your likelihood of developing knee OA
- Smoking: Smoking is associated with higher rates of knee OA
Signs and symptoms
The signs and symptoms of knee OA include:
- Reduced range of motion
- Difficulty performing functional movements including squatting and kneeling
Pain associated with tibiofemoral OA commonly affects the inside region of the knee first, where the two bones meet at the joint line. Patella-femoral related pain is often felt deep behind the kneecap. Pain will vary from one person to another, and the severity of pain does not necessarily relate to the severity of degeneration. Although if you speak to a person who is about to have a joint replacement surgery (i.e. their joint has degenerated to the point of needing a surgical intervention to keep the person functioning well), they will likely tell you that the pain is extremely debilitating.
Pain and stiffness are regularly felt first thing in the morning and late at night. OA tends to respond well to movement of the joints, and so people often find their pain and stiffness improves once they are up and moving, for it to return once their day has finished and they are relaxing at night.
So, you’ve been diagnosed with knee OA. What to do? Call your osteo… Ta-dah!!!! Given we are experts in how the human body moves (we study human biomechanics at uni), we’re good at picking up how the body should and shouldn’t move. There are no magic pills for treating OA of the knee, and no practitioner can claim to treat the disease itself, as there is unfortunately no cure for OA. It is a progressive, degenerative disease, but there are ways of stunting the progression of this condition if the risk factors leading to its presence are attacked head on.
Poor movement resulting from daily postural repetitive strain, or an old injury that wasn’t treated to resolution is a big factor in the maintenance and development of OA in the knee. Poor movement or dysfunction occurring in the low back, hip or ankle can all lead to excessive load being placed through the knee joints, which can exacerbate the disease process. This is where we come in. We can watch you move during an assessment and work out what is causing the excessive loads through the knee and put a plan in place to improve range of motion and flexibility, strengthen muscles and return you to (hopefully) pain-free daily activities. We will use a combination of soft tissue manipulation, joint mobilization and progressive exercise programs to restore life to your body. Returning to efficient movement patterns after years of neglect, poor movement and a de-conditioned body part will take time, but with determination from both you and your practitioner, it can happen.
As previously mentioned, some cases of knee OA can end up requiring surgical intervention to replace either part of or the whole joint. The good news is, if you do have to go through this process, we have your back (well… in this case, your knee) and can help you through rehab and recovery. Many people who have a knee replacement return to full daily activities and live a long and pain-free life.
Knee pain? What are you waiting for? Call us today on (416) 546-4887 or book online to schedule your appointment.
1. Cui, A. et al. 2020. Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. EClinicalMedicine. 100587. 29-30. Available from: https://www.thelancet.com/action/showPdf?pii=S2589-5370%2820%2930331-X
- Arthritis Australia. 2016. Counting the cost. [Online]. Available from: https://arthritisaustralia.com.au/wordpress/wp-content/uploads/2017/09/Final-Counting-the-Costs_Part1_MAY2016.pdf. [Accessed 09 February 2021]
- Centres for Disease Control and Prevention. 2020. Cost statistics: The cost of arthritis in US adults. [Online]. Available from: https://www.cdc.gov/arthritis/data_statistics/cost.htm. [Accessed 09 February 2021]
Vertigo: symptoms and treatment
Benign Paroxysmal Positional Vertigo (BPPV). In simple terms, a non-serious sudden attack of
dizziness brought on by a change in head position.
What is vertigo?
Vertigo is a type of dizziness where a person experiences the sensation of whirling, spinning or swaying. A person will usually feel that they, or objects around them are moving when they are not. There are several causes of vertigo, with the most common cause being BPPV. Other common causes include Ménière’s disease (vertigo with hearing loss and ringing in the ears) and labyrinthitis (inflammation of the inner ear). The ear is made up of an outer, middle and inner section. The outer ear is the ear that we see on the head and the opening that leads into the head itself. This connects to the middle ear — a small area inside the head which houses the ear bones, connects to the inner mouth and also the inner ear. The inner ear is the section which houses our hearing and balance organs — the cochlea and the vestibular system. It is this most inner section which is involved with BPPV.
What causes BPPV?
The structure of the inner ear is quite complicated. It is a maze of hollow chambers and canals
all connected together and filled with fluid. There are three semi-circular canals which are
expertly positioned to detect movement in the 3 planes that our head can move (nodding up and
down, tilting left and right, and looking left and right). Inside the chambers live tiny crystals
which, when movement of the head occurs, move and send important information to the brain
about what type of movement is occurring. Sometimes these crystals become detached from
the chamber and move into the canals where they can play havoc.
Basically, the crystals move through the fluid which stimulates nerve endings in the canal. The
nerves then send a message to the brain which the brain perceives as movement, even though
the head isn’t actually moving. Because this information doesn’t match with what the eyes are
seeing and the ears are detecting, we experience vertigo. It is one big mismatch of information
which is tricking the brain. And the effect is quite unpleasant!
An attack of BPPV can be brought on by a quick change in head position, when rolling over in
bed, sitting up from lying down, or when looking up to the sky. A recent head injury or
degeneration of the inner ear system can precede episodes of BPPV.
Signs and symptoms
The main symptoms as discussed include a sensation of spinning or swaying. People may also
experience feelings of light-headedness, imbalance and nausea. Attacks will usually only last a
period of a few minutes and may come and go. It is not unusual for a person to have a period of
symptoms followed by a period of no symptoms for months at a time. If symptoms persist for
longer than a few minutes at a time, then it is likely the vertigo is from a different cause.
Some conditions that cause vertigo can also give symptoms of headache, hearing loss,
numbness, pins and needles, difficulty speaking, and difficulty coordinating movements.
Episodes of vertigo may also be much longer or constant. If you experience any of these
symptoms they should be reported immediately as they could be signs of more serious issues,
which will need to be investigated.
Can it be treated?
BPPV is very treatable. Many people with dizziness end up seeing their GP first, but it is
common for a GP to refer these cases to us here at Beachealth for ongoing
management. After a thorough session of questioning and assessment, if we are happy with our
diagnosis of BPPV, then we can get to work right away.
BPPV can affect any of the semi-circular canals mentioned above. For treatment, we need to
first bring on the symptoms. It sounds sadistic, but it is necessary to ensure we resolve the
symptoms for you. Treatment for BPPV consists of a series of head and body movements
where you start seated, move into a lying down position and end sitting upright again. This
series of movements is known as the Epley Manoeuvre and is used to treat the most common
form of BPPV. If the source of the problem is coming from a different canal, then the treatment
will be slightly different.
We then send you away with some general do’s and don’ts. You may have to keep your head
relatively still for the rest of the day (sorry, heavy exercise is not recommended at this stage)
and to sleep propped up for the first night after treatment. We will then organise for you to come
back in within a few days to reassess and if necessary continue with another treatment.
Interestingly, we often get patients come in who think they have vertigo, but in fact, it’s other
structural issues contributing to their dizziness (which we diagnose and treat). That’s why it’s so
important that we have a thorough consultation, to ensure we develop the right treatment plan
for you. If you think you are experiencing vertigo, please come in and speak to us. Osteopaths
are highly trained medical practitioners who can help treat more than you think. Call us today on
(416) 546-4887 to book your consultation.
Vestibular Disorders Association. 2020. Benign Paroxysmal Positional Vertigo (BPPV).
Available from: https://vestibular.org/understanding-vestibular-disorders/types-vestibular-
Healthline. 2018. Benign Positional Vertigo (BPV). Available from:
HANDI project team. 2013. The Epley Manoeuvre. Australian Family Physician. 42 (1). 36-37.
Available from: https://www.racgp.org.au/afp/2013/januaryfebruary/the-epley-manoeuvre/