Aftercare & Homework
To get the most out of your treatment, it is important to allow the body to adjust over the next 48 hours. These guidelines are to help you get the most out of your treatment:
I almost always give my patients homework. This is because in the majority of cases the reason they are in the clinic room is because of a lifestyle pattern. Thus, I am a firm believer that making small realistic changes to adjust this pattern can lead to long term health improvements. Homework will be specific to the individual but recommendations will usually involve exercise advice, stretches and postural recommendations.
Some form of regular exercise most days for at least 10-15 minutes. Even better is rekindling or finding a joy in exercise. This means finding a sport for you as well as something that will fit into your everyday lifestyle. Probably the two types that suit most people are walking and swimming. Variety is important so keep it interesting by maybe taking in some hills/practise walking or swimming fast for a short distance and then slowly to recover and repeat (called interval training). Others find it more fun to exercise with others and have a commitment so in this case regular gym class can work. For those adverse to gyms, there are lots of great sports available for all ages and for men and women in our local (and wider) area – here are some ideas. Many have trial sessions:
Netball / Zumba / Rowing / Football / Swimming / Cycling / Korfball / Kickboxing / Climbing / Golf / Martial arts / Tennis / Bowls / Squash / Waterpolo / Running / Hockey / Boxing / Triathlon / Archery / Volleyball / Cricket / Rambling /
Always listen to your body when exercising. Warm up for 5 minutes and cool down for 5-10 after each session and stop if you feel any pain.
On top of cardiovascular exercise, its worth remembering that there are benefits engaging in weight bearing exercise especially as we get older to prevent reduction in bone density associated with osteoporosis. Its also great as it keeps us strong to carry on our everyday activities and prevent injury. This includes walking and running (which may not suit everyone). We can also get these benefits from performing exercises using weights or resisting our own body weight. Examples include press-ups and squats.
The third strand to fitness is flexibility and suppleness. This can be achieved by doing some gentle stretches at home to relieve tension and stretch out the tissues. Yoga and Pilates are also excellent. There are lots of different classes out there, thus its important to find the right one for you and for the teacher to understand your body and take into account any health conditions you have.
The final key area is core strength. We use our core muscles all the time without realising it as they are key postural muscles. Many just think of the abdominals, but the core includes the external and internal obliques (side muscles) as well as the muscles of our lower back and buttocks as well. All key in keeping what I call a muscular belt around our lower spine and pelvis providing stability and protection against injury. Aging, old injuries and poor posture can lead to very common imbalances and weakness in these muscles as we over use others. For example in a common sitting office position it can be easy to overuse certain muscles and weaken others through inactivation.
You may find the following links useful (please note links will open a pdf in a new window):
I will often demonstrate some suitable stretches in clinic and am always happy to write these down so you can read more online. There are also detailed diagrams on the wall in the clinic to look at. Common muscles that need stretching include the large muscles of the thigh (hamstrings and quadriceps), deep gluteal muscles (especially the piriformis), neck (particularly the upper trapezius), mid and the low back.
Posture is about how we hold our body as we carry out our activities of everyday living. To maintain a healthy musculoskeletal system, where possible try and maintain a balanced posture. Putting too much weight through one side (e.g. carrying a heavy handbag on one shoulder, always carrying your toddler on the same hip, tending to stand on the same leg) can cause imbalances which eventually lead to problems. We all tend to favour one side and this way habits can form - some of these can be simply broken. For example, carrying a backpack rather than a bag, sitting evenly on both 'sitting bones' while avoiding crossing the legs, adjusting our driving position or office set up.
The following page on the NHS web site clearly outlines the most common postural errors and gives useful advice on how to correct them: http://www.nhs.uk/LiveWell/backpain/Pages/back-pain-and-common-posture-mistakes.aspx