The Wellness Blog

June 28, 2022

By admin Our Blog, Wellness

What is Functional Capacity Assessment within my NDIS Plan?

Within your NDIS Plan you may see the term “functional capacity assessment” within the area of funding for Occupational Therapy.

A functional capacity assessment is an all-encompassing assessment that addresses all areas of your life to identify strengths and barriers, areas requiring assistive technology or additional support or funding from NDIS and areas where your needs are adequately met.

Sounds a little intimidating? Don’t Worry! That’s why we are here!!

A functional capacity assessment is designed to paint the most accurate picture of YOU and YOUR NEEDS to NDIS.

For example, you could state to NDIS that you have some difficulty showering but can complete it, however by completing the showering tasks independently you are then confined to the couch to rest for an hour or so to recover. This might take time away from spending time with your family, or engaging in an activity that satisfies you mentally, physically or socially. A functional capacity assessment can breakdown the task and offer some valuable insights and recommendations surrounding potential equipment or work simplification strategies (maybe a shower stool, a handheld shower hose and a long handled sponge) to make the world of difference to completing the task.

This is one example of many.

As an Occupational Therapist I am equipped with the functional knowledge and experience to assist you to get the most out of your time, energy and assistance. With you being the expert in YOU and me being the expert in OT – we make a great team!

You may find it comforting to know that a functional capacity assessment is typically completed in the comfort of your home. In my experience, it can take approximately 2 hours and during the assessment, I will complete a thorough assessment including:

what supports you currently have in place
activities of daily living such as cooking, cleaning, personal care, showering, toileting, work or parental responsibilities
how you access the areas in your home, the equipment you have in place and equipment you may also require
community access, driving, public transport
managing your medication, finances and well-being
Memory, thinking, communication
Upper and lower limb function, mobility and transfers including falls

If you feel as though your needs are not being met within your NDIS plan and need assistance from an Occupational Therapist, speak with your Local area coordinator or Support coordinator about accessing a Functional Capacity Assessment.

Beth Wiggins is one of our Occupational Therapists at The Wellness Place and as part of her role within our team, she conducts Functional Capacity Assessments for patients with an NDIS plan.

By admin May 27, 2022 Our Blog

What is an Occupational Therapist?

Occupational Therapy (OT) is the use of assessment and intervention to develop, recover or maintain the meaningful activities, roles, or occupations of individuals, groups or communities in every day life. This includes: taking care of oneself and others, working, volunteering, participating in hobbies and social or leisure activities.

When should you see an OT?
If you are feeling unsafe in the home, including getting in and out of the shower, negotiating steps or getting in and out of your house. If you are having trouble getting in and out of bed or on and off chairs.
If you are falling frequently
If you are having difficulties completing your daily routine including meal preparation or personal care tasks due to pain, fatigue, limited mobility or general weakness.
If you are having difficulty with mobility and require a wheelchair or a powered mobility device.
If you are an NDIS participant wishing to get the most support out of your plan

Our Occupational Therapist Beth Wiggins can assess your house and give recommendations surrounding your areas of concern

By admin May 24, 2022 Naturopathy, Our Blog, Wellness

Kickstart your Mindfulness Practice

Our Naturopath – Meagan Grossman has put together a 3 part series to kickstart your mindfulness practice and this is the first instalment in the series.

Have you heard of journaling before? Perhaps it’s something you did when you were younger and grew out of. Maybe you’ve heard of it before but don’t know where to start. Or maybe this is the first you’ve heard of it. Either way, if you are looking at improving your feelings of stress and increasing mindfulness in your life, it is the perfect place to start.

This is a three-part journey into the introduction of journaling techniques which aims to improve feelings of self-compassion, mindfulness, stress and even improve sleep quality and onset time.

In the next blogpost, we are going to dive into self-reflection activities but before we get into that, we first have to understand ourselves and what better way to start than with understanding our core values!

Values

To understand yourself, you first need to understand your values for right now. Emphasis on right now is important as our values can change daily, as we get older, and as circumstances change.

What are values?

Values are things in life that resonate with you. They summarise what makes up the person that you want to be. As we get caught up in life and stress, we sometimes lose sight of the person we are working towards embodying and can end up acting out of emotion and impulse more than we would like. When we have a clear summary of our values, we can actively make choices that align with them which puts us back on track to hitting our goals.

Your activities:

Write down a list of up to 10 values that apply to you. See the image below for a list of examples.
Once you’ve got your 10, list them in order of importance.

Keep them handy in a notebook or in your phone. We will be building on this in the next blogpost.

Table

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By admin April 28, 2022 Uncategorized

What does a Podiatrist do?

It is a common question and often a point of confusion as to what a podiatrist does, as far as treatment and scope of practice.

Most of our time is spent assessing, diagnosing, and treating lower limb conditions. In terms of our training most undergraduate programs are 4 years of full-time university with a focus on biochemistry, human biomechanics, anatomy and physiology, in addition to podiatry specific clinical practice and associated study.

We treat people of all ages, and a myriad of conditions. Basically anyone with feet! And this is what makes a day in the life of a podiatrist so diverse. In a single day, you could treat a person for heel pain, whilst later addressing ingrown toenails, providing intervention for an in-toeing child and screening for neuropathy and circulation in a diabetic patient.

No issue is too big or too small .

Below is a broad list of categories that a podiatrist treats.

Skin and nail care: When it comes to making sure your nails are healthy or free of fungus, corns/hard skin and callus are removed safely and painless, and addressing ingrown toenails, we are the people to see.

Orthotic therapy: Biomechanical and postural complaints such as flat or very high arched feet, in addition to optimising foot function can be addressed with orthotic therapy in the form of custom or pre-made dependant on the circumstances. They can be a very useful tool to unload injured tissues during an acute or chronic injury, or a way to reduce muscular and joint strain in active individuals with jobs or activities that place high demands on the lower limb.

Diabetes screening and management: Podiatrists play a vital role in screening for the effects of diabetes such as neuropathy and impaired circulation. Due to the increasing epidemic of diabetes and the burden it places of the health system, it is crucial to prevent complications related to diabetes. We ensure diabetic’s feet are in good condition to ensure long lasting mobility and prevent hospitalisations.

Footwear: A podiatrist is well positioned to provide advice on appropriate footwear for an individual based on their unique biomechanics, activities and occupation. Aside from the dynamic function of the foot, the size and shape of feet mean considerations for length and width and the shape of the outsole are important considerations. We have regular contact with leading footwear companies on the latest innovations and ranges that can suit a person’s foot, get the right fit and help with the particular issue, rather than worsen it.

Running and Gait Analysis: From simple gait retraining and analysis, it can help paint the overall picture of why someone might develop lower limb pain. It can also be useful to have a trained eye to assess running technique to optimise efficiency, reduce injury and facilitate improved performance.

Paediatric issues: We commonly see young children for postural concerns, ingrown nails, warts/verruca and in-toeing. Often a parent wants to be advised if their child is progressing and developing with a normal range and we can provide assessment to decide whether intervention is necessary.

Aches and pains: If that niggling knee, hip or back pain is keeping you from staying active, we can assess if their is a contributing factor by evaluating your movement patterns, limb-length and gait cycle. We can help with a combination of assessment, and effective treatments. Life is too short to be in pain!

By admin March 30, 2022 Advice, Our Blog, Wellness

Reformer Pilates and Mat Pilates at The Wellness Place

Main Benefits of Pilates

The primary benefits of Pilates are core muscle strengthening and posture correction. Here are some specific benefits you may experience:

Increased strength, muscular control, flexibility, and mobility
Improved posture and balanced muscles
Improved joint health and bone density
improved balance
Rehabilitation for back pain and extremity pain
Improved pelvic health
Decreased pregnancy-related pain and strengthened core postpartum

Postnatal Classes Offered

One of the best ways to help your body return to its pre-pregnancy state is through Pilates. Some of the benefits include strengthening the pelvic floor, abdominal. low back muscles and leg and arm strength. Helping new mums regain their fitness and energy levels and help build the strength to carry bub!

Issues that Pilates can help with:

post and pre-natal conditions, lower back pain, poor posture, neck, shoulder and Upper back pain, extremity injuries, balance issues.

Pilates strengthens the body to prevent recurring issues from coming back.

How to Prepare

Please dress in comfortable workout clothes and bring a drink bottle. The Wellness Place provides mats, however you are more than welcome to bring your own mat if you prefer. For your first class, you will need to arrive 15 minutes early to fill out additional paperwork. This will also allow time for you to chat with your instructor if you have any additional questions.

Your instructor will provide detailed instruction for all movements as well as individualised modifications if required. The most important element is that you are having fun. The next day you might feel muscles that you have never felt before.

How Are Yoga and Pilates Different?

While yoga and Pilates are both fantastic forms of exercise, there are some primary differences. Pilates focuses on increasing core strength and endurance and improving posture. Yoga focuses on stress reduction, meditation, and flexibility.

One-on-One Clinical Pilates

We are pleased to offer one-on-one clinical Pilates which is a form of physical exercise that focuses on posture, core stability, balance, control, strength, flexibility, and breathing. This type of Pilates is more custom-tailored to treat your symptoms than regular Pilates. With the one-on-one classes, you get the individual attention that’s more based on your specific needs and goals.

Whether you’re seeking to increase muscle strength, improve flexibility or just boost your overall wellbeing, you should consider Pilates at our practice. Pilates connects the mind and body through precise movements and physical control. Each movement is designed to lengthen, strengthen, and stretch muscle groups through non-impact movements.

Pilates is suitable for almost all demographics including teenagers, athletes, pregnant women, and the elderly. If you’re new to Pilates there’s nothing to feel nervous about. The most important thing is to have fun!

By admin February 16, 2022 Advice

When Should I See a Physio for Knee Pain?

Should I see a physio for pain in my knee?

Whether it’s a recent knee injury or a nagging pain that just won’t go away, you’ve decided to seek help. You’re probably wondering, ‘Should I see a doctor or a physio for my knee pain?’

The answer depends on your symptoms. While physiotherapists can treat a variety of knee injuries and reduce pain successfully, there are situations in which you should contact a doctor.

When should I see a doctor instead?

Some symptoms require immediate medical attention since they could be signs of a serious underlying condition, such as infection, a blood clot, a broken bone, or an injury that requires surgery. You should seek out a doctor’s care at the emergency department if:

Your pain is unbearable
Your knee looks misshapen or extremely swollen
Your knee or its surrounding tissue is hot or red
You have a fever

Also, you should consider making an appointment with an orthopaedic doctor if your knee will not bear weight, if it feels locked or incapable of movement, or if it shifts or gives way when you put weight on it – in this case, you may require knee surgery. Some conditions such as knee osteoarthritis that can’t be managed with regular exercise, a healthy diet, or equipment may require surgery.

Otherwise, a good physio can usually handle most types of pain of the knee joint and surrounding muscles and prescribe exercises and other interventions that can help you heal – and even prevent future knee trouble.

What can a physio do for my knee pain?

A Physiotherapist can assess and diagnose the cause of your knee pain and then provide you with a custom treatment plan that will relieve your pain and help you recover more quickly. Many of the exercises your physio prescribes for you will eventually help to strengthen the muscles surrounding your knee, giving your knee joint added support.

Dry needling and manual therapy may also be recommended.

Activity modification to help reduce pain e.g. if your diagnosis is runner’s knee, swapping it out for low impact exercise like cycling or swimming will help your knees and muscles recover faster.

Injuries such as patellar tendinopathy (patellar tendonitis or tendinitis) otherwise known as Jumper’s knee may benefit from cryotherapy and rest, but may also require specific biomechanics or strength training intervention.

If you’re dealing with knee pain that has given rise to chronic inflammation, your physio might recommend that you work with a nutritionist, massage therapist, or chiropractor to reduce the inflammation through a holistic approach.

In addition, physiotherapy is often an essential ingredient in your recovery from serious knee injuries. So, if you’re seeing an orthopaedic physician for a serious injury, your doctor will likely refer you to a physiotherapist at some point in the treatment process.

However, you don’t need to obtain a referral from a doctor to make an appointment with a physio. Physiotherapists have the qualifications to diagnose and treat most conditions that cause knee problems so long as the condition is treatable by physical means.

Physio treating a paitent for knee pain

Can I do physiotherapy for knee pain at home?

While treatments themselves occur inside the physio’s own facilities, your therapist will likely assign you some exercises that you can do at home to speed your recovery.

First, you’ll perform each exercise under your physio’s supervision to make sure you’re doing them correctly. Then, when you’ve mastered these exercises, you can perform them at home as your physiotherapist directs.

Exercise and other treatment options to treat pain affecting the knee cap, cartilage, muscles and ligaments will vary based on the condition causing the pain. Some of the best physio exercises for knee problems include:

Hamstring stretches
Calf stretches
Isometric quadriceps contractions
Straight leg raises
Calf raises
Low-impact aerobics
Postural correction exercises
Bridges
Knee extensions with resistance bands
Leg side raises with resistance bands

When you combine physiotherapy with home exercises, a healing diet (excess weight is a leading contributor), stress reduction, and other natural treatments, you’ll have a better chance of knocking your knee pain and muscle soreness out for good.

At The Wellness Place, we have a broad range of holistic therapies that treat the whole body. For professional medical advice, get in touch with our Perth-based team in Bassendean today.

By admin December 30, 2021 Naturopathy, Our Blog, Wellness

Supporting the body pre and post COVID-19 vaccine and booster

Covid-19 and its many vaccines has probably been one of the most discussed topics over the last year. With the current mandates in place for WA regarding the covid 19 vaccine and boosters, you may be curious as to how to support your body naturally before and after the vaccine. While research is generally limited regarding the benefits of natural immune support alongside the covid vaccine, there are a few things you can try to prevent the incidence of unwanted side effects and boost recovery after. We asked our Naturopath, Meagan Grossman, what measures we need to take before we have our Covid-19 vaccine (or any vaccine for that matter).

Zinc

Zinc plays an important role in the immune system. It also promotes wound healing, improves digestive function, and is involved in taste and smell. Consuming foods that are high in zinc such as oysters, red meat and cashews may be helpful in supporting your immune function following vaccination. If you are vegan, vegetarian or not consuming enough of the foods that are high in zinc; supplementation may be beneficial. It is always best to consult with a naturopath regarding any supplementation to ensure you are taking a supplement that is most suitable to your needs.

High dose vitamin C

Vitamin C is a potent antioxidant that is essential for immune system function. Consuming foods that are high in vitamin C may be beneficial for immune support and recovery post covid vaccine. Some foods high in vitamin C include:

Blackcurrants
Capsicum
Kiwi fruit

Supplementation of vitamin C can also be helpful but again, it is always best to consult with a Naturopath to get the right product for you.

Vitamin D

Vitamin D is otherwise known as the sunshine vitamin as the sun’s UV rays are converted by the body into vitamin D. With a lot of the population working indoors, low vitamin D levels are generally common among Australians – particularly during the colder months. Vitamin D is important for optimal immune function and bone health. While most of our vitamin D comes from the sun, some foods contain high amounts of vitamin D.

Ways to increase intake of vitamin D:

Get outdoors more, try exercising outdoors instead of in the gym or eating your lunch out in the sun.
Increase intake of foods that are high in vitamin D such as mackerel or sardines.
Consider supplementation during winter or as part of your preparation for your covid 19 vaccine.

Cardiovascular support

Support cardiovascular health by increasing your intake of omega 3 rich foods such as fatty fish or start supplementation of a good quality fish oil. Herbs such as Ginkgo biloba and Astragalus membranaceus may also be helpful in supporting cardiovascular health post vaccination.

Herbal medicine

Herbal medicine is rich in antioxidants and plant constituents that may assist in supporting the whole body following vaccination.

When considering a diet plan or supplementation, it is always best to consult with a Naturopath to ensure the product is right for you and your needs. Do not start supplementation without consulting with a health practitioner first as it may interfere with the current medication you are taking.

Take away

Diets high in fatty fish, a wide variety of fruits, vegetables, and nuts are important to maintain optimal health during times of increased stress (ie. following a covid 19 vaccine). Getting outdoors often is important to ensure optimal vitamin D levels are maintained. If you feel your diet is not meeting its nutrient requirements, discuss a diet plan with a nutritionist and consult with a Naturopath if you feel supplementation is necessary.

By admin November 16, 2021 Our Blog

Plantar Fasciitis – What is it? How do I treat it?

Plantar Fasciitis also known as Plantar heel pain (PHP) or Plantar fasciopathy is a common condition that affects the heel in over 2 million people each year. It is estimated that almost 10% of the general population is affect by PHP at some point in their lives.

The terminology is also a point of contention with the suffix “-itis” often incorrectly indicating that there is an inflammatory process underlying which histological studies of the plantar fascia reveal is not the case. There can be inflammation of surrounding soft tissues etc but not of the plantar fascia itself.

Anatomy and Function

The plantar fascia or plantar aponeurosis is a fan shaped connective tissue attaching onto the calcanea tubercle and fanning to attach onto the more distal aspect of the plantar metatarsal heads. There is a medial, central and lateral band. It is composed of Type 1 collagen fibres which is also what tissues like the Achilles and patella tendons are made of. The plantar fascia serves as an elastic storage of energy during the gait cycle storing energy during the transition from heel strike to toe off during walking/running, in particular the extension of the big toe and lesser toes leads to the “Windlass effect” which can be likened to a series of pulleys which engage the medial band of the plantar fascia and central/lateral bands respectively.

Symptoms

There are several hallmark symptoms that feature in most cases such as a throbbing medial plantar heel or pain after the first steps after a period of inactivity or rest. Palpating the medial aspect of the plantar calcaneus generally produces a sharp stabbing pain. It is imperative that an accurate diagnosis is obtained, as the management for other pathologies can be quite different.

Differential diagnosis

Generally a thorough clinical history and examination will elicit a satisfactory clinical diagnosis, however, imaging modalities such as ultrasound and MRI will rule out other causes of heel pain. Some other pathologies that can present quite similarly include:

-Fat pad bruising

-Bursitis

-Baxter’s Neuritis or Neuroma

-Calcaneal Stress fracture

-Muscle strain

-Insertional Achilles tendinopathy (more posterior located pain)

A sonographic image of PHP will typically show thickening of the plantar fascia at the insertion (>3mm thickness is clinically significant) or minor or partial tearing. Although the presence of significant tears will often be accompanied by a traumatic event or memory of a particularly sharp, painful sensation during movement.

Risk Factors

We know this condition to be particularly prevalent in those with high BMI, taller or in occupations with long periods of standing. It can often be brought about where there is a high spike in training loads or “too much too soon” as far as exercise or physical activity. This can precipitate due to lack of time allowing for adaptation of the connective tissues. Inactivity can also be a factor, with occupations where there are lengthy periods of sitting, which leads to shortening and tightening of hamstrings and calves which can affect the plantar fascia function.

Calf tightness and poor ankle mobility are often factors in PHP, due to the Achilles tendon and plantar fascia sharing fascial attachments and a common anchor point in the calcaneus.

Footwear can be an important consideration, where tight toe boxes, high heels and poor cushioning can negatively impact the function of the feet and lead to development of foot pathologies.

Management

In the initial term use of rigid taping to perform a low dye strapping is highly useful to unload the painful plantar fascia and provide support for the medial arch during ambulation. This can be continued up to 2-3 weeks on initial management. This also forms a good test to evaluate whether the use of orthoses will provide pain relief and improvement of biomechanics.

Often, we have to address the proximal factors such as excessive calf tension that is restricting the ankle and puling tension through the plantar fascia. A dedicated calf stretching and strengthening regime should effectively lengthen the calf muscle whilst improving strength in the plantarflexors at the ankle and muscles of the foot.

Careful examination of the patient’s gait cycle and biomechanics may reveal some clues that may contribute to the pathology. We may look to optimise this in the form of orthotic therapy and footwear prescription. It may be the case that certain footwear is exacerbating the issue or is providing poor off-loading or cushioning of the painful insertion point of the plantar fascia. This is where we could look to improve cushioning with appropriate footwear options or orthotic accommodations.

Manual Therapies and Other Interventions

In the case of recalcitrant cases of PHP, we may look at further interventions such as Extracorporeal Shockwave Therapy, Plasma Rich Platelet injection or Corticosteroid injection.

There is poor evidence for good long term outcomes with CSIs and PRP, however some promising results have emerged looking at ESWT in treatment of PHP. Often times, combinatorial therapies such as Stretching/Strengthening of calf muscles and ESWT have had great synergistic effects. The bottomline being to address the factors that are contributing, as PHP is often of a multifactorial cause.

Dry needling and soft tissue therapy, despite poor evidence in the literature, can have benefit as far as pain relief and improvement of symptoms or excessive muscle tension, and can be a useful adjunctive therapy.

By admin November 4, 2021 Naturopathy, Our Blog

What is the Importance of Microbiome – We ask Meagan Grossman, our Associate Naturopath

The importance of microbiome

Bacteria is all around us – including inside and outside our bodies. In years gone by, beneficial bacteria were only considered in relation to our gut, however, as it turns out, we are completely covered in a balance of good and bad bacteria. In your gut alone, you will find about 100 trillion balanced good and bad bacteria. Collectively, these bacteria make up what is called the gut microbiome. There is a bidirectional relationship between the gut and the brain which is termed the gut-brain axis. There is also a balance of bacteria on our skin which maintains skin health and prevents infections and bacterial overgrowth.

In regard to healthcare, the microbiome should be considered as a starting point for all chronic health conditions and health optimisation. The reason for this is that the diversity of the microbiome is essential for mental health, immune function, nutrient absorption, metabolic health and much more. The function of the microbiome is so significant that it has now been termed the ‘forgotten organ’.

At birth, the human gut is completely sterile (unlike that of a chicken who is born with a diverse range of bacteria in their gut) and relies on the mother and environment around them to introduce the foundations of their microbiome. Some research suggests the importance of nature time for children and their microbiome and mental health development. A recent study in 2020 researched the effect of nature time on gut microbiome quality, fecal serotonin, and psychosocial behaviour in children. The study found that the children who were allocated nature play had a more stable level of fecal serotonin; while the other children displayed a decrease in fecal serotonin. Serotonin is involved in mood stability and feelings of happiness. Because of its involvement in mood, you would assume most of your serotonin is found in the brain. However, most of your serotonin is actually found in the digestive system. That said, it makes sense that the children who were allocated nature time during the study also showed a decrease in anger frequency and improvements in prosocial behaviour. These improvements in behaviour may result from the improvements in microbiome quality and diversity which were observed in the children with nature-play time.

The quality of the microbiome impacts mood and mental health. This relationship is termed the gut-brain axis. The gut-brain axis is a newly researched bidirectional relationship between the digestive system (and associated microbes that live in there) and the brain. While the quality and diversity of the microbiome impact mental health; stress and lifestyle changes associated with excessive stress (eating less or eating more calorie dense foods, poor sleep, alcohol consumption etc.) can cause bacteria to die off which has a detrimental effect on mental health.

Foods high in good bacteria:

Yoghurt – try and avoid yoghurts high in sugar, Vaalia and Siggi’s are some good brands to try.
Kombucha – avoid kombucha flavoured treats, they often don’t contain any beneficial bacteria and are typically just used as a marketing tool
Kefir
Pickled vegetables – these are super easy to make at home and are a great addition to eggs, salads, and avocado toast.

Good health begins in the gut. Ensuring you are eating a nice diverse range of bacteria can improve overall digestive function, mental health, immunity, and a wide range of other health outcomes.

By admin October 15, 2021 Wellness

Inflammation: Friend or Foe? | We ask Dr. Soroush Ebtash!

Almost everyday we talk to our patients about the role of your immune system in pain and inflammation.

It’s easy to forget that the immune system that is responsible for fighting germs and illness is the same immune system that produces the inflammation that heals sprained joints or causes arthritic joint pain.

It’s also easy to forget that inflammation in itself is not good or bad. It’s a response from specific cells and systems in the body in response to a perceived threat.

While chronic inflammation can have negative effects on your heart, arteries, and brains, we need acute inflammation to help heal from injuries and to fight off infectious diseases.

A key lynchpin to an appropriate immune and inflammatory responses goes back to the brain and nervous system.

Acute inflammation acts like a reflex not much different than when a doctor taps on your knee to see if it kicks. If you have a cut or scrape, your immune system will kick into gear to wall that area off from germs and create heat and swelling and there’s nothing you can do about it. It’s embedded into our physiology.

However, chronic inflammation is something in which our brains have a say. Exercise, nutrients, fasting, meditation, and a wide variety of interventions have the ability to use our brain to modify how our immune systems produces inflammation.

It’s through this understanding that we have the ability to help address some of the chronic inflammation that leaves us susceptible to the chronic diseases of aging.

If you have concerns about inflammation and how it is affecting your body, feel free to reply to this email with your questions, and we’ll get back to you if we have good answers.

Find out the latest news at The Wellness Place, and check out our articles on your health-related needs.