Coronavirus (COVID-19): Notice for patients coming to Bridge 38 Physiotherapy for face to face consultations.

Bridge 38 Physiotherapy 2020.

As Bridge 38 Physiotherapy gets ready to re-open on September the 1st 2020, a number of  measures have now been put in place to minimise the risk of transmission of Covid -19, to keep you and the practitioners as safe as is reasonable practicable.

Please read the below policy prior to your attendance at Bridge 38 Physiotherapy.

Covid-19 is highly contagious and in the community,  it can be transmitted in two ways;

  1. Contact with contaminated surfaces.
  2. Respiratory droplets traveling within a 2m radius from the infected person and making contact with a mucosal surface of another individual.

Therefore, only those whose symptoms cannot be treated remotely, and are having a significant impact on their life and may otherwise cause the patient to attend primary care are being seen for face-to-face appointments. Due to the nature of these appointments, there will be an element of contact and social distancing that will not be able to be followed at all times.

As such, we have implemented measures throughout the clinic to minimise the risk of transmission or exposure to the virus by following the advice by the CSP (Chartered Society of Physiotherapy), Public Health England, HSE (Health and Safety Executive) and the UK Government. The below guidelines outline what you can expect and what is expected of you before and during your attendance at the clinic for a face-to-face appointment.

These guidelines are in place to ensure the safety of all visitors and practitioners here at Bridge 38 Physiotherapy.

COVID-19 symptoms?

Patients and chaperones (see below for more details on chaperones) must ensure they are fit to attend their scheduled Physiotherapy appointment.  The day before your clinic appointment you will receive a reminder email with a COVID-19 screening questionnaire. This must be filled out before attending your appointment.  If you are unable to fill out this online,  a paper screening questionnaire will need to be filled out and signed before you can have a face to face consultation.   You will also receive a triage call before your appointment to determine whether a face to face of video consultation is the most appropriate at this stage.

PLEASE DO NOT ATTEND YOUR APPOINTMENT IF YOU ARE UNWELL OR HAVE ANY OF THE SYMPTOMS LISTED BELOW:  Please advise the clinic to cancel or re-arrange your appointment and if you need further advice dial 111 or telephone your GP.

  • a high temperature– this means you feel hot to touch on your chest or back (you do not need to measure your temperature)
  • a new, continuous cough– this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)
  • Change in sense of taste (Dysgeusia)
  • Change in sense of smell (Anosmia) 

Please advise the clinic to cancel or re-arrange your appointment and if you need further advice dial 111 or telephone your GP.

 

Clinically extremely vulnerable/shielding?

If you have been asked to shield by the government or your GP, you should notify us immediately.  It is advisable that your appointment should be carried out via video consultation.

Returned from abroad in the past two weeks?

If you have returned from abroad in the past two weeks, please notify us and not attend the clinic for a period of two weeks from the date you returned.

What to expect when attending the clinic:

Physical distancing:

Although the 2m social distancing policy has now reduced to 1m in the UK Bridge 38 Physiotherapy will continue where possible to remain at a 2 m distance in both the public areas of the clinic as well as the treatment rooms.

If you require any specific hands-on for assessment and treatment this will be discussed with you to ensure you consent to proceed. In order to maintain social distancing, fewer appointments will be carried out or maybe staggered with the option to wait outside the clinical building.

  • Do not attend the clinic without a pre-booked appointment.
  • Please do not enter the clinic before your appointment time, but please attend on time as your appointment will not run overtime, as the time between patients is specifically designated for cleaning and to provide time between you leaving and the next patient arriving.
  • The external doors to the clinic will be closed to avoid people coming in and out of the building freely, so customers will need to use the intercom system for entry to the building.

Chaperones:

  • Please attend appointments alone, where this is not possible due to travel to and from the clinic then please ask whoever is attending with you to wait in the car or outside the clinic.
  • If you require a personal chaperone or you are attending with children, they must also follow hygiene and social distancing procedures and must also comply with the health screening and consent to contact tracing in order to attend in the clinic room.

 

Hygiene:e

  • As a patient, you must use the provided sanitation gels to disinfect hands on the entrance to the practice and on departure.
  • Between patient appointments, time will be allowed for sanitisation of seating, beds, tables and public waiting area.
  • Please be mindful of unnecessary contact of surfaces during your visit to the clinic.
  • Tissues, foot-operated bins, and handwashing facilities or hand sanitiser will be provided in all clinic rooms and within the waiting room. In the event of a cough or sneeze please follow the ‘catch it, bin it, kill it’ guidance by disposing of your tissue in the bin provided, and sanitising/washing your hands immediately.
  • Use of reusable equipment (such as gym equipment) within your appointment will be avoided as far as reasonably practicable in order to minimise surface contact. If it is not possible to avoid it, the use of this equipment will be kept to a minimum and the equipment will be cleaned thoroughly prior to and after use.

PPE:

  • Physiotherapists will be wearing face masks and possibly face visor shields. Due to the close proximity of hands-on treatment, this can minimise the risk of infection to them or yourself.
  • Physiotherapists will also be wearing plastic disposable aprons which they will dispose of after each patient.
  • The Physiotherapists will adhere to a rigorous and stringent handwashing routine between and during each appointment and, therefore, may not be wearing gloves for your treatment.
  • It is recommended that you wear a mask during your treatment. If you do not have your own, a disposable mask will be available for you to purchase for £1 which will be added to your appointment charge. Exceptions will be made If you are unable to wear a mask for a specific reason.

Contact Tracing:

  • If you or your chaperone test positive for Covid-19 within 14 days of your attendance at the clinic you must notify us as soon as possible so that we are able to trace and advise all those who may have been affected.
  • In order to attend, you and your chaperone will be asked to consent to contact from ourselves via a telephone number that you provide on the day of attendance. This means that, in the event that you may have been exposed to someone who has tested positive, we can inform you and provide you with guidance on the next steps.

If you have any questions prior to your appointment or have any queries in relation to this policy, please do not hesitate to contact us on 01283 716559 or info@bridge38physiotherapy.co.uk

 

Can I run with pain?

If we sustain an injury most of us know or have heard of the acronym RICE (Rest Ice Compression Elevation).  We are led to believe that rest is an important component in order to help the injury heal.   However,  recent evidence and research now challenges the RICE phenomenon and in particular the rest element.

The question many runners or sports which involve running have is; can we run whilst we have pain?  For most of the runners I see in the clinic I aim to keep them running to some degree, but there are a number of factors to consider before I can make the best decision.

Continue reading “Can I run with pain?”

Motivation Motivation Motivation – Where have you gone?

As a Physiotherapist, I know general adherence to physiotherapy treatment can be poor with only about 30% continuing after 12 weeks.  This is a problem because it has also been proven that treatment adherence has significant effects on outcomes.  This is also the case for adherence to exercise, to dietary changes, to taking medication.  Those who do it, who comply, DO BETTER

There are lots of different reasons, we lose our mojo.  Here are 3 tips to help you plan and stay motivated to your exericse programme.

Tip 1:  Think about your current situation


 Have a think about your current situation in relation to what your original goals were or what you really want to achieve.
For example, it might be to get back to running 5k 3 times a week pain-free.  It might be to get strong enough to be able to go skiing again after an injury.  Have a think or write down what you need to be able to do to achieve your goal.

Tip 2:  Next explore why you think you stopped doing what you were doing?    These are your barriers to adherence.

Some of the common reasons are:

  •         I forget to do my exercises.
  •         There were too many exercises.
  •         I didn’t have the time.
  •         I couldn’t see how it would help.
  •         I’ve had conflicting advice.
  •         I did it for a week or two but nothing changed.
  •         I didn’t know exactly what I was meant to do.

Tip 3:  Solutions to the Barriers

Use a table format with 2 columns or simply make 2 headings.

Heading 1: Will be the barriers  to exercise

Heading 2: Will be your solutions to these barriers.

Below  I have written out some of the common barriers that I hear on a regular basis in the clinic.  I have come up with some helpful solutions to overcome them. Of course you may come up with your own solutions that work for you.

Barrier 1:

Why am I doing these  exercises?  How do they relate to my injury?

Solutions:

 People who understand “the why” are more likely to adhere to their programme.  If you are unsure then speak to your physiotherapist.

Barrier 2:

Expecations:  “I’m no better and I’ve been doing my exercises for 2 weeks”

Solutions:

People who are really clear on the expecations of how long they will need to do their rehabilitation to make a difference adhere better.  This is something your physiotherapist should make clear to you.  If not ask.  If you think you are going to get better in 1 week but it actually takes 3 months you are likely to give up.  However, if you understand that in order to make a difference you will have to work at it for a longer period you are more likely to continue.

Barrier 3:

Time:  “I haven’t got time to do my exercises”

Solutions:

Think about what exercises can be incorporated into your daily routine.  For example: every time you boil the kettle repeat 10 squats. 

Sometimes one key exercise can be just as effective as three.

Think about creating a habit – doing your exercises at the same time and same place.  A bit like brushing your teeth.

Barrier 4:

Tiredness and Fatigue: ” I’m too tired”

Solutions:

The 5 minute rule:  Do something for just 5 minutesOften that 5 minutes will turn into a bit more but even if it doesn’t you will still have had a positive outcome.

Barrier 5:

Forgetfulness:  “I keep forgetting to do my exercises”.

Solutions:

Old fashioned I know, but sometimes writing out a plan with tick boxes stuck onto the fridge is a great incentive – there is something so satisfying seeing a row of ticks when completed.

Use Technology:  Set up reminders on your phone at a time you know
you will be able to do them.  There are also Apps out there now to help you. I put all my client’s exercises on an app called PT Momentum.  You just click on the app and all your exercises are there, just tick them off when completed.

Barrier 6:

Too many exercises:  Depending on your injury, you may need to work on a few exercises for a successful outcome. This can sometimes feel daunting.

Solutions:

Focus on one area:  Pick just one area or one or two exercises to do at each session then vary the exercises you choose in your next session. 

Barrier 7:

My Programme is boring.

Solutions:

Ensure you have plenty of variation in your programme. Many exercises can be varied easily to make them harder or easier.  Examples may include trying your exercises with your eyes shut or standing on one leg doing your exercises. Perhaps you could add weight or increase or decrease the speed of the exercise.  Add a timed challenge – how many can you do in a minute and test yourself every 4-6 weeks.

Patience and Time:  Remember to give yourself time to get better.  Many injuries take on average over 50 days to get better but adhereing to your rehabilitation is going to achieve you a better and quicker outcome in the long term.  

If you would like any more information on progressing or developing your rehabilitation please contact me below.

To Stretch or Not to Stretch?

Many Clients I see, particularly those involved in sport, are often tight and complain no matter what they do their calf just doesn’t seem to release or that hamstring muscle has “always been tight”.  Many report they stretch or may use the torturous foam roller to help. Both forms can help but only for a short time but as soon as they resume activity the tightness returns.  So this begs the question is there any benefit to stretching and should we still do it?

Continue reading “To Stretch or Not to Stretch?”

Should I carry on running with pain?

I see many runners in the clinic with a variety of running injuries from achilles tendinopathies, to knee pain and groin pain.  One of the big issues I discuss with every runner is whether or not they can continue to run with pain and if so are they damaging themselves?

Well in todays 5 minute video I share with you my expertise on this very subject.  You will find out

1. whether you are ok to run with pain.

2. If you are able to continue to run, how will you know you are not causing further harm?

3. What are some of the common warning signs that mean you should not be running and when to get it checked out.

 

 

 

Why “Rest” May Take you Longer to Recover From Injury

If you’ve ever googled recovery from an injury you may have come across the R.I.C.E principe.  This stands for Rest, Ice, Compression and Elevation.  “Rest” implies that following an injury you should rest it and it will get better.  This advice is still given by many GP’s and accidenct and emergency clinics.   The trouble is, this advice does not tell us how long to rest for and what exactly does rest mean?

Continue reading “Why “Rest” May Take you Longer to Recover From Injury”

Posture – Is there such a thing as good or bad posture?

Posture – is there such a thing as good or bad posture?

Is this such a BAD posture? Read on to find out more!.

 

 

 

Many people I see in the clinic want to improve their posture.  If I ask them to demonstrate what they think they want their posture to be like, invariably they will sit up straight pinning their shoulders back and pulling the their stomach.

Is this posture any better than me sitting above in the opposite position of slumped at a desk?  The simple answer is No.

Posture if fundamental for efficient movement.  It is not the case that we have two choices either good or bad posture. We all move through a range of body positions depending on our activities.  Even when standing still and breathing the body is active and moving in subtle ways to maintain balance and control with minimal effort.

If we actively try and fix our posture in the traditionial shoulders back stomach in approach we will create rigidity which prevents freedom of movement and will reduce physical performance. It will restrict our ability to breath effectively and create tension in neck, shoulders and lower back, similar to sitting in a slumped position.

This upright posture is tiring and hard to sustain. After 5 minutes you resort back to sitting in a slumped position, and so the cycle of upright vs slumped begins.

What can I do to help?

One of the simplest things I tell people to do is move.  Sometimes we view our posture as the reason we get back pain or neck pain but actually the reason may be as simple as not moving or changing position.  So simply getting up moving around and then going back to what you were doing may be all that is required.

However,  if you know you are going to be spending time sitting for longer periods here are some really brillian tips.

Even Better is that they are easy to do and involve minimal effort and can be done in any position anywhere.

 

Ballooning:

  • First stand or sit in a relaxed position almost slumped.
  • Now imagine a large helium balloon with a string attached to the back of the top of your head.
  • Then visualise this large balloon gently lifting the weight of your head off your body. Imagine it lengthening the back of your neck so that your chin drops down slightly.
  • Allow yourself to lengthen without straining.
  • If sitting notice how the balloon takes you from the back of your sitting bones to feeling like your body is now sitting on top of the sitting bones.

This should feel effortless. If you feel any tension anywhere stop let go, give yourself a little shake and switch on your balloon again.

Jo Elphinston founder of JEMS explains more about ballooning in this great little  video.

What should it feel like?

No Tension: Ballooning involves minimal effort and, therefore, there should be no tension anywhere in the body.

Breathing should feel easier . Try sitting bolt up right and take in a large breath and see what it feels like and do this again sitting slumped.  Now switch on your balloon and take in a deep breath.  You should notice quite a difference in how deeply you can breath.

Automatic Support from the muscular system:  Place one hand on your stomach when sitting slumped then notice as you  switch on your balloon your stomach naturally lengthens and draw inwards.  You have activated your trunk muscles by cleverly stimulating a reflex which was triggered by your head position.  This is involved much less effort than actively pulling in your stomach.

Relaxed Shoulders: Take a note of the difference in your shoulder position when you have your balloon on and off . Again you will feel that the  shoulders and chest have opened up slightly as your balloon goes on.  No fixing shoulders backwards or pulling shoulder blades back and down. Just light effortless opening.

For more information feel free to contact Fiona at Bridge 38 physiotherapy .

Why Everyone Should Practice Improving Their Balance.

Introduction

Balance refers to an individuals ability to maintain their line of gravity within their base of support.  You might also hear people talking about postural control and postural stability. Poor balance is surprisingly common and I see it in the clinic on a daily basis. Infact almost everyone I see when I test their balance say “oh my balance is rubbish”.  Poor balance has been linked to injury risk. Even in sports which involve sitting such as dressage riding and kayaking, significant differences in left and right standing balance have been noted to correlate with technical problems and injury even when seated.

Poor balance is also linked with falls in the older population.Improving your balance will reduce the liklihood of injury or reinjury and allow the body to make fine adjustments without inappropriate muscle tension.

Continue reading “Why Everyone Should Practice Improving Their Balance.”

10 Tips To Motivate You To Stay On Track

 

As Physiotherapists we know that the most successful outcomes to recovering from injury and staying injury free are from those that buy into their self management and continue with it on a regular basis.  Studies suggest that as much as 65% of patients don’t do their exercises as instructed. Don’t feel guilty read on to help you stay on track.

Continue reading “10 Tips To Motivate You To Stay On Track”