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Category: article
Fitness after Total Hip Replacement
Joint Replacement
- Surgical procedure for chronic severe joint pain
- Replacement with prosthetic
- Loss of muscle strength and mass has usually occurred
- Most frequent procedures are THR and TKR
Total Hip Replacement (THR)
- Frequent procedure in elderly population
- May be done for OA or RA or hip fracture
- Aim is to decrease pain and improve mobility and function
- Partial – (hemi-arthroplasty) or full
Management
Risk of dislocation for approx 3 to 6 months post-operatively
- Anterior approach – avoid extension and abduction and external rotation
- Posterior approach avoid flexion above 90 and adduction / internal rotation
Functional movements: what to avoid
- Sitting in a low chair (use wedge cushion)
- Lying on side – pillow between knees
- Avoid crossing legs over midline
Hip surgery recovery steps
- Carefully following the specific rehabilitation program provided your surgeon and his team
- Avoiding repetitive heavy lifting
- Avoiding excessive stair climbing
- Maintaining appropriate weight
- Staying healthy and active
- Avoiding impact-loading sports such as jogging, downhill skiing and high impact aerobics
- Consulting your surgeon before beginning any new sport or activity
- Thinking before you move
- Avoiding any physical activities involving quick stop-start motion, twisting or impact stresses
- Avoiding excessive bending when weight bearing, like climbing steep stairs
- Not lifting or pushing heavy objects
- Not kneeling
- Avoiding low seating surfaces and chairs
Beyond Chronic Pain: a Personal Journey to Create Healthier Habits
Beyond Chronic Pain: a Personal Journey to Create Healthier Habits
Finding Vitality and Joy in your life
Physiotherapist Jodie Krantz shares her healing journey towards a more satisfying and comfortable way of living within with her own body. Retracing her steps, Jodie invites you to join her on a challenge to improve your own quality of life and perhaps that of your nearest and dearest.
I reached the age of 50 with my body in a condition better than many my age. Being a Physiotherapist I had always done some form of exercise. My weight was in the upper end of the healthy range for my height. I didn’t smoke or drink to excess – ever. I’d always watched what I ate and ‘listened to my stomach’, stopping when I felt full. I considered myself very fortunate to have completed my training as a Feldenkrais practitioner in 1999. This was a profound learning process which gave me access to the tools to keep my body moving like a much younger person, even into old age.
Yet the small aches and pains had accumulated over the years to the point where there was never a day without some sort of pain. Headaches were frequent and although not severe, made me nauseous, fatigued and thick-headed. This very unpleasant feeling would last 2 to 3 days or more. Foot pain made it hard to walk for more then 20 minutes. My lower back twinged frequently, especially after sitting and in bed at night. I often complained to my partner about being tired. Worst of all, severe episodes of lower back pain had seen me bed-bound and off work for up to 5 weeks.
I knew what I had to do, but it was hard to do it. I had to change some fundamental habits I had formed in over 50 years. The intentions I set for myself were:
- To allow myself the ‘luxury’ of getting treatment when needed
- Improve my diet and rid myself of ‘addictions’ – sugar, coffee and alcohol
- Shed a few kilos
- Reduce my stress levels
- Increase my cardio-vascular exercise
- Get enough sleep on a consistent basis
There was no point changing everything at once. The body doesn’t like radical change and it’s usually not sustainable. The biggest challenge I faced was finding the extra time required, a challenge I know that many of my friends, family, colleagues and clients share!
Next birthday I turn 57. In the past few years I’ve turned my life and my pain around. Fatigue as I once knew it, is but a distant memory. I simply feel the happiest I’ve ever been in my life.
Habits and Choice
Habits and Choice
In our classes we explore the way in which our habits influence our freedom of choice. We all have habits, some of them that are very useful. Consider the way we can drive a car or clean our teeth without making much conscious effort.
Other habits are not very useful or even harmful such as constantly hunching the shoulders or poor posture at the computer. Holding the breath is a habit we often consider to be bad, however even our ‘bad habits’ have uses. It’s useful to hold your breath for example when you are diving underwater. Â In Feldenkrais we are not trying to get rid of our habits, but simply to become aware of them, so that in any one moment we have freedom of choice.
Moshe Feldenkrais often said that unless you have at least 3 options you have no real choice. Is having 2 options real choice? Imagine if someone told you that for the rest of your life you have 2 choices – you can wear any colour of clothing you like as long as it’s black or white. Would you have real freedom of choice? What about all the shades of grey in between? and all the colours of the rainbow?
In every Feldenkrais lesson, group or individual, we present you with a variety of different and often novel movement options. These unique and different movement combinations awaken our sense of curiosity, facilitating learning. This begins the process of freeing ourselves from habitual ways of moving, thinking and feeling that may be limiting us. It’s as if each Feldenkrais lesson adds new colours to your movement palette, giving you true freedom of choice.
Spinal Mobility – Alison’s Classes in Fourth Term 2016
Neck and back pain are one of the most common health problems affecting people in our community today. They often cause us to restrict our movement to protect ourselves. While this may help in the short term, long-term it may result in chronic, persistent or recurrent pain. According to award winning author Norman Doidge, the patterns of self-protection may themselves become the primary source of pain and disability.
In our classes we learn how to free ourselves from these restrictive patterns. There are pain-free ways of softening, turning and bending our spines. We will also be investigating how our breath, the use of your eyes and tension held at our jaws and hands can influence the mobility of the spine. Improving the efficiency of our movement patterns helps us to find a more fluid, comfortable and even graceful style of movement. Our aim is to improve our ability to bend and twist the neck and back, so we can relieve our own pain and tension.
Carpal Tunnel Syndrome
Do you experience numbness of your thumb, index finger and part of your middle finger? Then you may have Carpal Tunnel Syndrome. Symptoms are often worse at night
The Carpal Tunnel is found on the palm side of the wrist. Several wrist tendons, blood vessels and the median nerve pass between the wrist bones and an overlying band of connective tissue through this area.
The causes of Carpal Tunnel Syndrome are still being researched and debated. The condition may be related to posture and biomechanics, for example sleeping with the wrists flexed and repetitive overuse activities have been cited as possible risk factors. Obesity, aging and genetics appear to be other possible factors in the development of this condition. It is more common in women, during pregnancy and in people with diabetes.
Like to know how you can help yourself heal? We can assist you with posture and ergonomic advice and gentle exercises and stretches. Some people will eventually require resting a splint, cortisone injections and / or surgery, because if left untreated permanent nerve damage and weakness of the hand may occur.
Private Health Insurance Claims FAQs
Private Health Insurance Claims FAQs
Australian private health insurance companies are bound by new legislation introduced by the Federal Government and taking effect from 1st April 2019. This has left many people asking whether our Physiotherapy, Feldenkrais and Clinical Pilates services are still covered.
DISCLAIMER: There are hundreds of different health funds in Australia. Each fund offers different levels of cover for Physiotherapy services and different rebates. As a result the following FAQs are a general guide only. For accurate advice please call your insurance company. It may be helpful to quote the item codes listed in the Frequently Asked Questions below.Can I claim Individual Physiotherapy appointments at Free2Move?
Individual appointments may be claimable under item code 500 (initial assessment consultation) or item code 505 (subsequent consultation). If you have two or more problems requiring treatment you may be able to claim for a long consultation (item code 506). Please check with your insurance company to find out whether you are covered and how much you would get back for each of these items.
Can I claim for Individual Pilates Appointments at Free2Move?
Under the new legislation, exercises which are drawn from our knowledge of Clinical Pilates may be included as part of your Physiotherapy treatment. We only provide treatment that we consider to be within the accepted scope of clinical practice for our profession. As a result you may be able to claim for your treatment under item code 500 (initial assessment consultation), item 505 (subsequent consultation) or item 506 (long consultation – 2 or more problem areas). Only your health fund can advise whether you are covered and how much you would get back.In this case the following codes will appear on your receipt: item code 500 (initial assessment consultation), item 505 (subsequent consultation) or item 506 (long consultation – 2 or more problem areas). Please check with your health insurance provider to find out if you are covered and what rebate you would receive.
Can I claim for Individual Feldenkrais Appointments at Free2Move?
Under the new legislation, exercises which are drawn from our knowledge of Feldenkrais may be included as part of your Physiotherapy treatment. We only provide treatment that we consider to be within the accepted scope of clinical practice for our profession. As a result you may be able to claim for your treatment under item code 500 (initial assessment consultation), item 505 (subsequent consultation) or item 506 (long consultation – 2 or more problem areas). Only your health fund can advise whether you are covered and how much you would get back.
Can I claim for Group Pilates Sessions at Free2Move?
Free2Move no longer offer Group Pilates Sessions. However we do offer Exercise Rehab Group Sessions, which may incorporate some exercises which are drawn from our knowledge of Clinical Pilates. In these sessions a maximum of 4 people attend our exercise studio at the same time. Each person has an individual exercise programme specifically created by their Physio to address their health goals and medical conditions. As this service is within the accepted scope of clinical practice for our profession, the sessions may be claimable under item code 560. Please confirm whether your health insurance policy covers you for this service.
Can I claim for Pilates Floor Classes or Feldenkrais Floor Classes at Free2Move?
Unfortunately our Pilates and Feldenkrais Floor Classes are no longer claimable under private health insurance. The Federal Government’s legislation being introduced on 1st April 2019 means that no health insurance company anywhere in Australia is allowed to offer refunds on these classes.
COVID 19 Update
Our floor classes will all be held online for Term 2 and 3 in 2020. We are using the Zoom app to bring all our classes to you in your own home. This is a great way to take a break from your computer and get some exercise. More than ever we need to learn new ways to take care of both the body and the mind. Because of our training in the Feldenkrais Method we are able to provide support for you during this difficult time. At the end of each class their will be a time for chatting together to help reduce social isolation. Online classes are not claimable under private health insurance.
Important note about our Floor Classes
Please be assured that as Physiotherapists with over 20 years experience each, we still offer the same high standard of movement and posture education in Pilates and Feldenkrais floor classes. It is unfortunate the Federal Government does not recognise the value of these services to our clients.
Training in the Feldenkrais Method is highly sought after by Australian Physiotherapists. We believe that this is because it is often effective where traditional approaches have not worked. Principal Physiotherapist of Free2Move Jodie Krantz has been invited on numerous occasions by the Australian Physiotherapy Association to present Feldenkrais workshops to her Physio colleagues. Jodie also taught Feldenkrais for 7 years as part of the Bunbury Pain Management Programme run by St John of God Hospital in Bunbury.Â
In 2018 Jodie was assisted world renowned Physiotherapist and researcher, Dr Marie-Louise Bird in presenting a Pilates for Older Adults training workshop to Physiotherapists in Perth. This workshop was also organised by the Australian Physiotherapy Association. Clinical Pilates is different from fitness Pilates. The exercises originally developed by Joseph Pilates are often not appropriate for our clients. Clinical Pilates refers to exercises that are specifically adapted to fit the medical diagnosis and functional goals of our clients.ÂWhere can I find more information?
Please follow the links below for more information about the changes.
Federal Government Legislation changes
Hicaps codes for Physiotherapy
Information about Hicaps codes from the Australian Physiotherapy AssociationPlease be assured that as Physiotherapists with over 20 years experience each, we still offer the same high standard of movement and posture education in Pilates and Feldenkrais floor classes. It is unfortunate the Federal Government does not recognise the value of these services to our clients.
Training in the Feldenkrais Method is highly sought after by Australian Physiotherapists. We believe that this is because it is often effective where traditional approaches have not worked. Principal Physiotherapist of Free2Move Jodie Krantz has been invited on numerous occasions by the Australian Physiotherapy Association to present Feldenkrais workshops to her Physio colleagues. Jodie also taught Feldenkrais for 7 years as part of the Bunbury Pain Management Programme run by St John of God Hospital in Bunbury.
In 2018 Jodie was assisted world renowned Physiotherapist and researcher, Dr Marie-Louise Bird in presenting a Pilates for Older Adults training workshop to Physiotherapists in Perth. This workshop was also organised by the Australian Physiotherapy Association. Clinical Pilates is different from fitness Pilates. The exercises originally developed by Joseph Pilates are often not appropriate for our clients. Clinical Pilates refers to exercises that are specifically adapted to fit the medical diagnosis and functional goals of our clients.
Flexible Chest and Spine
A Flexible Chest and Spine – The Hidden Key to Freeing the Neck and Back
The Hidden Key to Freeing the Neck, Back and Shoulders
Most people don’t consider their chest and spine as playing a large role in feeling comfortable and at ease through the neck, shoulders and back. The first instinct when dealing with neck and shoulder pain is to spend time working on localised ‘knots’ and muscle tension. However this could be addressing the symptoms, whilst ignoring the underlying cause.
The thoracic spine, and the rib cage serve as the support structure for the entire upper body. Finding comfortable alignment and releasing through the chest and spine allows the rest of the body to relax. In turn, when there is stiffness through the chest and spine, the neck, back and shoulders work overtime to try and correct this, leading to muscle tension, ‘knots’ and pain.
The ‘knots’ are not actually a ball of tangled fibres as you might imagine, they are trigger points. Trigger points are highly sensitive points in the muscles and connective tissue, which can refer pain to other places. In Feldenkrais we don’t massage or manipulate the ‘knots’. Instead we address underlying causes – stress, poor posture and inefficient use of the muscles.
How Feldenkrais Can Help
Feldenkrais uses a process known as ‘sensory-motor learning.’ Students are guided to closely attend to how they are moving, reducing unnecessary and wasted effort. The Feldenkrais Method accesses our brain’s own neuroplasticity, allowing us to revise and replace movement habits which may no longer be serving us.
READ MORE about how Feldenkrais actually works.
BOOK A CLASS or REQUEST AN INDIVIDUAL APPOINTMENT
Our Mental Map of the Thorax
We begin the process of re-educating our posture and muscle use by improving our self-image.
When Moshe Feldenkrais talked about the self-image he was not referring to self-worth or self-concept. What he meant was the sensory map of the entire body that each of us carry in our brain. Our self-image is not totally accurate and is constantly open to change. Neuroplasticity allows us to continually refine and update our mental maps
Our mental map of the thoracic spine and ribs is often particularly vague. For one thing the back of our ribs are out of sight and therefore often out of mind. Secondly, it’s usually the hardest part of the body to reach with the hands. (Think about trying to apply sunscreen in between the shoulder blades!) Thirdly, the sensory nerve endings are spaced far apart in this area compared with say the hands and lips. As a result our ability to feel the difference between 2 different points is poorer in this area.
Improving Awareness of the Chest and Thoracic Spine
The thoracic spine is not only the longest section of the spine, it is also normally the stiffest. The reason for this is the attachment of the ribs cage. The ribs serve the function of protecting the vital organs within the thoracic cavity, including the heart and lungs. Although the ribs are made of bone, they are more flexible than we might imagine. They have moveable joints at the back, where they articulate with the spine. They also have bendable cartilage attachment to the sternum (breast bone) at the front. The lowest 2 ribs are even more flexible, because they don’t attach at the front but ‘float’ freely at one end. For this reason they are called ‘floating ribs’.
If the thorax is used like an immobile block more strain is shifted onto the relatively mobile neck and lower back vertebrae. Without the protection of the ribs, these sections of the spine are prone to injuries such as cervical or lumbar disc herniations. Learning to better mobilise the chest also helps with the co-ordination of the arms and legs for walking, running and sports and a huge variety of other activities.
The Chest, Ribs and Diaphragm in Breathing
Holding on to unnecessary tension in the chest and abdomen increases the effort required to breath. At times tension is so great that the breath is held completely. At other times breath is not held but it is restricted. This can occur at the end of the breath in or the breath out or somewhere in between. Sacrificing breath markedly impairs our ability to function efficiently and drains energy.
Breath holding and tension around the chest and diaphragm are a common response to physical, mental or emotional stress. Under stress the sympathetic nervous system takes over, resulting in the ‘Fight, Flight or Freeze’ reaction. In our current world we are constantly called upon to achieve, produce results and keep up with a myriad of small and large tasks. This includes keeping up communications through social media and the internet.
Many people use television or social media platforms to relax when they finish work, however the content often keeps the mind revving in high gear. We are losing the art of unwinding and allowing our parasympathetic nervous system take over. The parasympathetic nervous system allows us to ‘rest, digest and repair’. For better sleep and more daytime energy, we need to know how to wind down before we go to bed.
A Mobile Mind and a Comfortable Body
By improving the accuracy of our mental maps as well as the mobility of the chest and ribs we can enhance all of the above functions. We reduce strain on the neck, shoulders and lower back by sharing the work load more evenly. We enhance our ability to easily and comfortably bend and twist the spine in all directions by listening to which sections of the spine are overworking and which could participate more fully. We can connect our limbs to our central axis so that we may use large muscles to provide the power, while smaller ones are reserved for accuracy
Breathing can become simpler, lighter and more spacious, as we learn to use more of ourselves. The mind naturally becomes calmer and our sleep deeper and more refreshing. As we re-discover the pleasure of letting go of excessive effort, our parasympathetic nervous system naturally takes over. Some people even fall asleep during Feldenkrais class – and this is perfectly ok (but we’ll wake you up if you start to snore loudly!)
First Term 2018 – Feldenkrais Theme
First Term 2018 – Feldenkrais Theme
Each term in our Feldenkrais Classes Jodie and Ali each have a particular focus or theme. The theme carries through a whole term so that participants can explore movement in a more structured and informative way.
Feldenkrais Awareness Through Movement lessons involve sensing and moving the whole body. Every part of the body is connected to every other part in numerous ways. The arms, legs and feet are connected to each other through the skeleton, through the connective tissue and through the nervous system. All Feldenkrais classes help the whole body to function more efficiently and comfortably, regardless of the specific theme.
Mobility of the Chest and Ribs – Jodie’s Theme
- Improve breathing – the most fundamental movement of all
- Discover a more supple chest and spine
- Reduce strain on the shoulders, neck and lower back
- Experience a light yet powerful connections of both the arms and the legs to the central axis and ‘core’.
- Relax deeply
In Jodie’s classes this term we will explore how the chest connects with every other part of the body. Through movement and focused attention we will come to understand why the chest and ribs are so vital to overall functioning. Participants will discover how and why it’s so common to stiffen this area and what to do to prevent or reverse this.
Of course a stiff chest has a huge impact on breathing and the ability to get oxygen to the tissues. This is especially so while exercising or exerting ourselves. Bracing and stiffening of the chest and ribs often relates to fully or partially holding the breath. The adversely affects health and vitality.
We will begin this term’s classes with a series of undulating movements, which start at the feet and flow all the way along the length of the body to the head. We will use a blanket roller to restore mobility and comfort to the chest and spine. We will then gradually progress through some gentle yet powerful lessons which improve awareness of the chest in all it’s dimensions. Finally we will explore to some more challenging whole body movements lying on the side and the back, all the while taking care to stay in the range that is absolutely safe and comfortable. Movements will be in every plane, including twisting, side bending, flexing and extending.
Softness and Connection in the Hands, Arms and Shoulders-Ali’s Theme
For the first term of 2018 Ali’s focus will be on creating softness and mobility in the body by exploring the connection between the hands, shoulders and chest. The aim for the classes will be on reducing tension through the fingers and hands, finding the connection between the hands and the rib cage, and increasing mobility through the chest and shoulders.
It can be hard to imagine that tense fingers and hands have anything to do with our shoulders, let alone effect mobility through our sternum and chest. Yet so often the stiffness we feel in our shoulders, has everything to do with how we hold and move our hands and arms. And in turn, finding release and mobility in our hands and arms can release tension through our shoulders, collarbone and rib cage.
Ali’s classes will also use awareness through movement to explore how alignment and connection through the lower limbs and pelvis can influence your capacity to find freedom in your upper body
My Feldenkrais Story: Helen Pendlebury
Now an open road My Feldenkrais Story: Helen Pendlebury
Helen Pendlebury shares her Feldenkrais story
Helen Pendlebury, lives in a lovely home in Marangaroo. She is a painter, she loves spending time with her family, especially her five grandchildren and enjoys being involved with her local community. Things weren’t always quite as cosy as they are now. This is her true Feldenkrais story.For ten years Helen didn’t have a fixed address. She house-sat, stayed with family and friends, and lived in group homes. She also struggled on and off with chronic pain and mobility issues. She had tried Feldenkrais in the past and had left it behind due to shoulder pain. More than two decades later, she found her way back to Feldenkrais and the effect on her physical and mental well-being has been transformational.
‘It’s like yoga in that it’s a progression. I physically cannot do yoga. But this is an excellent form of movement to help unlock the knots, the tension and the memory.’
In 2014 Helen was given an opportunity to gain access to fitness and physical therapy training through a government program. ‘I’d been wanting to get my health back up.’ Helen went to the gym, and got a personal trainer. ‘The woman I had as a coordinator suggested yoga. Because I couldn’t get down on the floor, I remembered the term I had 30 years ago, of Feldenkrais. That had such an impact.’
Her Feldenkrais Practitioner asked Helen what she wanted to get out of Feldenkrais. Helen responded that she wanted the spring in her step back. ‘Halfway through the term, the spring in my step came back. I felt the best I had for a long time.’ Not only has Feldenkrais greatly increased Helen’s mobility, but it had a huge impact on other areas of her life. ‘It allowed me the confidence to go to Homes West and get accommodation. I found myself thinking, I can’t do this anymore. I have got start taking care of myself.’
Helen’s Homes West home, is perfect for her needs. She has also gained access to a mobility scooter and has appropriate seating in her house. ‘Feldenkrais gave me more clarity in my decision making, so I could move forward with my life.’
‘Feldenkrais gave me more clarity in my decision making, so I could move forward with my life.’
In the last two and a half years Helen has attended hands on one on one Feldenkrais sessions and group floor classes. ‘It’s like yoga in that it’s a progression. I physically cannot do yoga. But this is an excellent form of movement to help unlock the knots, the tension and the memory.’
Helen believes the mind and the body are connected. ‘It’s not just moving your body it’s moving your brain. Doing Feldenkrais allows the brain to work the way it’s meant to work. And if the brain’s working well then that’s a ripple effect through the body.’
‘I want to share what’s happened to me to help others to maybe try and see if it works for them. Open them up to the idea of experiencing the journey of Feldenkrais and finding the person deep within you.’ She warns that it isn’t an over-night miracle, and can take time to see real benefits. ‘I don’t want people trying it the one time and thinking that didn’t work. It’s a journey of self-discovery.’ For Helen, the change may have not been instant, but it has been dramatic. ‘It’s as though I’ve got a super woman strength compared to what I had before.’
‘Logically what it has done is given me more flexibility, clarity and a sense of being pleased to be here,’
‘Logically what it has done is given me more flexibility, clarity and a sense of being pleased to be here,’ says Helen of her journey with Feldenkrais. ‘I feel more connected to the earth, to myself and I am able to see much more clearly what’s happening around me. I have a much more open heart to life.’
Interview completed by Jessica Messenger in 2017
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Feldenkrais Awareness Through Movement Lessons
Awareness Through Movement Feldenkrais Lesson Feldenkrais Awareness Through Movement Lessons – Tips and Pointers
By Jodie Krantz
Before beginning Feldenkrais Awareness Through Movement for the first time, it can really help to have few tips. This will help you get the maximum benefit from the lessons.
Feldenkrais lessons are not intended as a work out. You are neither trying to stretch nor to strengthen your muscles.
Instead you are awakening your natural intelligence and body awareness. The process happens easily when you pay attention to what you are sensing without thinking about it too much.
The purpose of Feldenkrais is learning and the outcome is having a flexible brain. Developing a wide repertoire of movement and behavioural options means you are becoming more resourceful and resilient. In ever changing life, tfhis is true freedom.
Do Less and Feel More
- Reduce effort and unnecessary tension
- Stay aware of your breathing – it will quickly tell you if you are working too hard.
- If it hurts don’t do it. You can still benefit by imagining the movements.
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Follow the 3 S’s – Optimize The Learning Process
- Slow down – moving slowly allows your brain to take in more sensory information per second
- Smooth out your movements – this helps with coordinated muscle action
- Small is best – smaller movements ensure your comfort and safety and increase your sensory awareness
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Curiosity and enjoyment facilitate learning
Above all, enjoy your lesson. An open and curious attitude is the best approach.
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- READ MORE about Feldenkrais Classes with Jodie
- Visit the Feldenkrais Guild of North America
