Author Archives: Leif Tunell

COVID 19 info

-Leif Tunell has been fully vaccinated for covid 19 with Pfizer.

-Acupuncture is part of AHPRA so considered an essential service, so can operate accordingly with government covid recommendations.

-Clinic is currently still operating

-Please follow government recommendations regarding mask wearing etc. when attending the clinic.

-Please be covid safe as per government/NSW health recommendation  

Take care in in the bushfire smoke.

Minimise exposure. Staying indoors is probably the most effective. Bushfire particles are extremely small, 2.5 microns.  Paper masks are pretty useless. They could give a false sense of protection so still keep exposure/outdoor activity to a minimum. Respiratory protection masks rated at P2 or higher offer some protection. The masks you buy at the hardware shop for protection against paint fumes. Note the seal needs to be air tight. If it leaks, it’s no protection.  Beards make it near impossible. Air pollution isn’t just a nuisance, it can increase mortality and impact health.   

https://www.abc.net.au/news/health/2019-12-03/face-masks-for-bushfire-smoke-haze-pollution/11760618

https://www.health.nsw.gov.au/environment/factsheets/Pages/bushfire-smoke.aspx

Dr Francesca Dominici – Life-Saving Data: How Breathing ‘Safe’ Air Can Kill

How to get the best out of reflux medication

If you take proton pump inhibitors for reflux the timing of the medication is quite important. Nexium (esomeprazole) is a commonly prescribed medication. To get the best result you should take the medication just before meal time. The reason for this is:- 

  • The medication works on inhibiting acid producing cells in the stomach
  • Between meals only about 5 % of the cells are active and become secretory with the ingestion of food.
  • By taking medication before meal you ensure you get maximal effect on the acid secreting cells with they are the most active during the meal.

If you take the medication during the more dormant phase you may experience less effect of the drugs and they may seem ineffective.

This simple tip may help you get the results you are looking for and save you hunting around trying different drugs.

However, if problems persist keep investigating and consult your treating physician  

https://en.wikipedia.org/wiki/Proton-pump_inhibitor

https://en.wikipedia.org/wiki/Nexium

Cow’s milk may provide better hydration and sports recovery.

If you can tolerate and digest cow’s milk it may be a better beverage to consume than a surgery sports beverage. Isotonic sport beverage like Gatorade do provide better hydration when the body has lost salts through sweating. However, the sweet content off these drinks can damage teeth if constantly sipping on them throughout workout. Also, refined sugars are generally best kept to a minimum in diet. Humble old milk has protein, natural sugars and amino acids perfect for post recovery hydration and nutrition. Further scientific study needs to be done for a definitive answer the question of sports recover is enhanced by cow’s milk… but in the meantime… why not try it and see how you respond? Get good quality organic non homogenised milk. 1 litre of top shelf milk probably costs the same as a Gatorade.   

https://time.com/3656660/workout-drink-milk/

https://jissn.biomedcentral.com/articles/10.1186/s12970-019-0288-5

5 ways to reduce risk of lower back pain and improve spinal health

elbow-knee-leverage-save-lower-back

Lower back pain is terrible and best avoided. With some careful techniques and correct lifting a lot off back pain can be avoided.  I’ve put together a short presentation video on how to better look after your back and some techniques and tips on avoiding lower back strain and damage to spinal discs

For video tutorial Click here 

Lifting something of the ground using the legs to squat down

Using the knee and elbow to divert load from lower back

Golfers pick up

Lunging

Splits (abducting legs to alter task height)

I have also included a better way of straightening up from a bent over slouched back.

The key feature in all these techniques is to keep the spine in a neutral / stable position and let all the limbs do the awkward work.

Video link
http://www.painreliefwellness.com.au/video/5-ways-to-reduce-lower-back-pain-and-improve-spinal-health/

Alternate link
https://youtu.be/5l5-7IlcSyg

Treat your back with love and it will love you back

CERVICAL NECK ROLL

CERVICAL NECK ROLL

 

This article is about a little at-home ‘life hack’ to remedy a sore neck.  All you need is a regular bath towel and somewhere comfortable to lie down.  It is a gentle relaxation exercise that encourages the neck to return to its normal lordotic (see diagram below) curve.  The rolled towel provides a curved surface for the relaxed neck to ‘stretch’ on.  It could be considered a myofascial release of sorts, to release the soft tissue of the neck and allow the neck to move in its normal range of motion.  It does require you to lie down for at least 10 minutes.  Once you feel comfortable with it you can progress incrementally up to 20 minutes.

Please note if you have severe neck pain or disc problems, seek appropriate medical attention before trying this technique.  This exercise/technique is gentle and should not be painful.  If you experience pain, please seek proper medical care. (Please see a professional, doctor google doesn’t quite cut it).

Anatomy of the neck and spine

The spine forms a long column that creates the base structure to our frame and can be thought of as a central building block of the body.  It provides structure and protection for organs and the spinal cord.   It also provides additional features such as shock absorbers in the vertical plane (up and down).  If you look at the body from the side view (lateral anterior/posterior view) you will see three distinct curves in the spine.  The lower back has a lordosis curve, the middle back has a kyphotic curve (thoracic) and the neck also has a lordosis curve.  It is because of these curves that we can deal with stresses going up and down in the body.  For example, running would be problematical if the body could not absorb the up/down (vertical) shock of striding and landing on our feet.

The neck has seven small bones called vertebrae that stack up on each other. These are the cervical vertebrae and form the cervical part of the spine.  The normal curve of the neck should be similar to that of the lower back, in that it curves anteriorly forward.  For some people the curve can be reduced or even straight, which tends to lead to neck pain and complaints.  Also, the smaller facet joints can become stuck or immobile, which will also cause pain and discomfort.

Cervical towel roll technique 

The use of a simple rolled-up towel can encourage the natural lordotic curve of the neck.  If there are stuck facet joints the towel roll exercise can help free these up.  Usually when mobility returns to these joints they feel much better and movement much improved.  If you have ever cracked or adjusted your neck, it is usually these joints that have shifted and make the pop or click noise.

-You will need 1 regular bath towel

-A flat soft area to lie down.

YouTube clip explanation : http://www.painreliefwellness.com.au/video/at-home-cervical-roll-for-sore-neck/

1.  Prepare the towel. You need to make a roll out of the towel. I like to fold it in half (longways), then half again. From here simply roll the towel up till you get a nice firm cylinder. I find a firmer roll works better and has more effect.

2. Lie down somewhere flat and soft. On the bed works fine, or carpeted floor, yoga mat.  A couch is suitable if you can lie completely flat and not have your head and legs sticking out in awkward directions.

3. Lie on your back face up looking at the ceiling.  Putting something soft such as a pillow under the knees is relaxing and it softens the spine a bit.  You can have the head unelevated or use a flat pillow.  Now place the rolled-up towel under the neck.  The neck should feel comfortable and supported, but also like it’s getting a little stretched out.  Everyone is unique so you will need to experiment with the rolled towel by making it smaller or larger to find the appropriate size for you. Make the towel cylinder smaller by simply unrolling it a bit with the flappy part under the skull and not down near the shoulders.

4. Once you have found your support posture and everything feels good, you just need to lie there for 10 to 20 minutes. Very simple.
I hope you find some value in this home help technique and it comes in handy one day.

Sleeping on a towel roll

I you think your pillow may not be suportive and causing your stiff neck / pain you can incorporate the towel roll with your pillow and sleep on it. The Video below demonstrates this.

http://www.painreliefwellness.com.au/video/towel-roll-with-pillow-to-sleep-better-with-neck-pain/

The importance of the gluteal muscle (buttock)

gluteal-muscle-and-ITB

 

Your gluteal muscles have some important features:

• are the main muscles used for walking, when moving legs from hips
• essential for the stability of the hips when walking. Without them you would topple over to one side.
• allow you to extend your back
• allow you to stand from a sitting position
• Gluteus maximus supports the extended (straight) knee. It does this via the iliotibial tract (ITB). This is the fibrous band of connective tissue that runs down the outer side of the thigh.

Gluteal dysfunction and weakness can have quite a large effect on the functional physiology of the body. Glute weakness can cause some of the following:

• lower back pain – over-using lumbar muscles to compensate
• hamstring over-use (tightness and pain) –> can also then lead to pelvis rotation –> pressure and pain in lower back
• knee pain from reduced stability
• tight hip flexor
• ankle problems
• plantar faciitis

As humans, we tend to find the easiest and laziest way to do things. Perhaps this is energy conservation. For example, when picking something up from the ground we tend to lean over with a flexed back instead of bending the knees and squatting down. The gluteal muscles can simply just get deconditioned and weak through lack of use. The simple solution is to wake them up again and do a few exercises. Even doing something as simple as squeezing your butt cheeks together while waiting for the bus can help (try 3 sets of 10 reps) or whenever you remember during the day, for example whilst waiting for the jug to boil. Something this simple can help the brain and glutes make a better neurological connection and “switch on” better for movement patterns.

Pain can also be a limiting factor. There could be any number of pathologies in the hips and back creating a painful situation that limits movement. Pain is remarkable in that it causes an inhibitory effect on muscles in the affected area. Hence, once the pain has subsided the muscles can still be inhibited or have decreased motor response (“switched off”). Again, doing a few floor-based gluteal exercises can help to retrain the connection with the brain and the bum muscles.

For example, the correct firing order for leg extension (lying on tummy and raising leg up towards ceiling) is:

Glute -> Hamstring – > quatratus lumborum and lumbar muscles.

However, with a dysfunctional glute it can become:

Hamstring + lumbar muscles.
Hence, much more strain is placed on the surrounding structures.

Anatomy:
Gluteus maximus – the largest muscle in the body – forms the buttock cheeks.

glute-maximus

Gluteus medius and minimus – lateral stabilisers. These muscles are located on the sides of the hips. They wrap around the bony part of the thigh bone (trochanter of the femur).

glute-medius

glute-medius

Gluteus minimus

gluteus_minimus_muscle

Training the glutes

Strong, healthy glutes are important for proper movement and health maintenance. However, there can be other problems that are present in the pelvic/lumbar region that need to be addressed before any rehab training and exercise should be performed. Muscular fatigue (“feel the burn”) is ok but acute and neuralgic pain is telling you some damage is going on. Please always train being mindful and respectful of your body’s abilities.

Below are a few glutes floor-based exercises to get you started.
Lying on the side, back should be straight (neutral spine), and all the movement should be occurring in the leg that is facing the ceiling. You can support your head and neck with one arm, and have something soft to lie on. You can use a yoga mat or towels. Please note it should not be painful to do these exercises. After a while you should feel muscular fatigue. However, if you experience any acute pain or nerve pain please stop and get assessed by a health professional.
Do each exercise 10 times then roll over to other side and complete 10 times on other leg. Repeat this for each exercise. Once you have done them all, go back to the top and re-do them. Try doing 10 minutes in total first. Then as you progress you can extend the time to 20 mins. Aim to do the exercises daily or every second day.

Clam : Open your legs just like a clam would open its shell
glute-exercise-clam-1
glute-exercise-clam-2

Side lift : Point your toes towards the ground. It helps activate more of the glute muscle. Then move your straight up as high towards the ceiling as you can. Then move it down again. Repeat.
glute-exercise-leg-raise-1
glute-exercise-leg-raise-2

Toe taps: Point your toes towards the ground. It helps activate more of the glute muscle. Tap your big toe in front of you and then swing your straight leg back and tap behind you. Repeat.
glute-exercise-toe-tap-2
glute-exercise-toe-tap-1

Kick: Just like kicking a football with a straight leg.
glute-exercise-kick-1
glute-exercise-kick-2

Bike circles: Like peddling on a bicycle. Move your leg in a circular fashion as you would when riding a bike. Go forwards 10 rotations then backwards 10 rotations.
glute-exercise-bike-pedal-1
glute-exercise-bike-pedal-2

How many acupuncture sessions do I need ?

How many acupuncture sessions do I need ?

This is a fair and often-asked question.   If you have a problem, you will want to fix it.  Generally, you will want to know how long it’s going to take or how many sessions of treatment are needed before a solution is reached or the problem is rectified.   To be frank,  this question is not an easy one to answer.  It would be nice to be able to say:  headache, that is 2 treatments; tired muscles from exercise = 1 treatment; lower back pain for 2 months = 7 treatments.

Unfortunately,  it’s not possible to be that exact.

The body is a constantly changing and adapting organism.  Some patients respond quickly and need only 2 treatments.  Others are very different and may need 6 sessions for the same problem.

However, it can be exasperating to hear “it depends” or “how long is a piece of string” in regards to how many treatments you need, so I’ll try and summarise some general factors that indictate a rough estimate of how many sessions.

Acute problems = 1 – 4 acupuncture treatments

If the problem is acute (1 week) or short term (less than a month), then the body should respond to a certain degree after the first session.  This change may occur immediately or more usually a day or two later as the acupuncture effect is a bit like exercise – it takes a little while for the stimulus to be absorbed and take effect.

In this case, the treatment range would be between 1 – 4 treatments.  After 4 acupuncture treatments, I would expect there to be a significant beneficial effect to alleviate the problem.  If not, then perhaps acupuncture is not the right treatment course in this situation.


Chronic problems = 4 – 10 acupuncture treatments

If the problem has been present for 2 or more months, then it will require a series of up to 4 treatments to gauge the response.  At the end of the 4 sessions, progress will be assessed and if indicated, another 4 to 6 treatments will be recommended.  This would allow acupuncture an appropriate chance to address the problem.

You could also view the treatments as occurring in different stages:

Corrective stage – Treatments to bring the body back to homeostasis (balance)

Maintenance stage – top up treatments to keep the problem in check

Frequency

In my experience,  acupuncture is needed at least once a week in the corrective stage. This keeps the momentum going forward as the sessions build on each other.  To speed things up, you can come multiple times a week.  This can be a beneficial way to make a stronger impact on the problem at the start of treatment course.

Maintenance phase – this can be done every 1 to 3 months to keep the body from slipping back into the previous negative habits and to pre-empt a return of the problem.

Response to acupuncture treatment is also dependent on many factors, but here are just a few:

Age
General health
Fitness level
Diet
Work type/amount/intensity
Attitude to recovery

Patients will heal at different rates even if it is for similar problems.  Having said that, I hope the above summary gives a rough indication of how many treatments may be required to alleviate or remedy a health problem.