RE Harper Health & Training in City Beach, Western Australia | Medical and health

RE Harper Health & Training

Locality: City Beach, Western Australia

Phone: +61 411 881 959

Address: Challenger Parade, 6015 City Beach, WA, Australia

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• Physical therapist

23.01.2022 Watch this spoken word poet brilliantly slam Congress for its inaction on gun reform (via IN-Q)

22.01.2022 COMPLEX REGIONAL PAIN SYNDROME (CRPS); A VERY DIFFICULT CONDITION TO TREAT! CRPS is chronic pain after some form of traumatic phenomenon to a joint such as ankle or knee, It typically presents as pain out of all proportion to the injury/insult/trauma There are two types of CRPS: Type 1, without nerve injury and, Type 2 where there is nerve injury... CRPS may be a dysfunction between the central nervous system and the peripheral nervous system that causes pain that is localised and out of proportion to the trauma such as a knee replacement of broken bone(s) For example, one wouldn’t expect to have ongoing knee pain post-surgery, although even arthroscopy can contribute to the syndrome. It would be fair to think there would be some pain but that it would dissipate altogether after a reasonable time post-op Blood vessels can be dilated resulting in redness and warmth or constricted when the opposite results. Both these conditions contribute to pain Abnormal signal from MRI or isotopic bone scan with early or decreased uptake may be helpful to determine CRPS CRPS can also be a manifestation of diabetes as well as other predisposing conditions such as hyperthyroidism, hyperparathyroidism and type IV hyperlipidemia WHEN CRPS IS DIAGNOSED, REST IS CONTRAINDICATED. THE PATIENT SHOULD BE AS ACTIVE AS CAN BE TOLERATED! With exercise in mind, physio can be helpful with ultrasound and hydrotherapy facilitating range of movement exercise Patients should take pain control before exercise Early mobilisation, motor imagery and avoidance or surgery are important keys to management. Graded motor imagery can be effective in reducing pain in CRPS. It involves encouraging the person to differentiate between left and right limbs to re-establish right and left concepts in the brain Progressively, a mirror box can be introduced. The person is asked to watch the mirrored image of the unaffected limb moving in the mirror. Then the affected limb is placed in the mirror box while watching the mirrored image of the unaffected limb. This tricks the brain into thinking it is seeing the limb with CRPS moving without pain Patients should consider discussing the use of Gabapentin with their doctor because it has been shown to be mildly effective with some neuropathic pain Another option to consider with the doctor is the use of a bisphosphonate medication such as alendronate where there is possibly excessive bone turnover Rheumatologists, pain practitioners and other specialist clinicians should also be considered

20.01.2022 Albany surf craft challenge A great time with Quinn Mindarie boat crew.

17.01.2022 Knee Pain Knee pain can have several causes One of those is a meniscus tear. It is a common injury that affects the knee joint. Meniscal tears can occur in isolation or in combination with other structures in and around the knee including ligaments and tendons. The method of injury is usually a forceful twisting or hyperflexion of the knee joint. Clicking, popping or locking of the knee are common complaints associated with the injury.... Sometimes the injury can go unnoticed for several hours until swelling begins and causes pressure on nerves leading to pain, other times, people will report immediate pain! The meniscus is a piece of cartilage in the knee that cushions and stabilizes the joint. It protects the bones from wear and tear. The actual location of the injured portion of the meniscus will have a bearing on its repair because some sections of the meniscus have better blood supply than others. By asking the right questions and determining how the injury occurred, followed by a complete and comprehensive physical examination of the knee, physiotherapists can diagnose if the meniscus is torn and if other structures in the knee are also implicated. If necessary, an MRI can be obtained to confirm the diagnosis, and perhaps also confirm the severity of the tear. It should be noted MRI findings are not always associated with pain. Whether it is knee, back, shoulder or other parts of the body, MRI findings will often report things such as degeneration that are not necessarily causing pain! For example, 90% of disc degeneration reported in MRI findings are not associated with pain! Hence the need for a thorough subjective examination. Repair and Healing In a critically appraised paper in the Journal of Physiotherapy, Grotle and Hagen (2016) from the Oslo and Akershus University of Applied Sciences in Norway asked the question, In patients with degenerative meniscal tears, does supervised exercise therapy lead to greater improvements in knee function than arthroscopic partial meniscectomy? They concluded exercise gave better thigh muscle strength after three months but knee function was no better than arthroscopy. They wrote; ‘exercise should be considered as a treatment option’. It must be noted the patients in their study were between 35 and 60 years of age and had unilateral knee pain with more than two months without a major trauma. Take Home Message So, for me, the take home message is give physio a go before going to the expense of MRI and surgery. The physical outcome will very likely be the same without all the cost to you and to the health budget. Importantly, what must be remembered, is because of relatively poor blood supply to the meniscus, and relative to the amount of damage, healing and recovery will be slow and may take several months or longer to regain normal walk, jog, run activity.

15.01.2022 Well, it's getting lighter in the morning now and that means longer times enjoying the ocean and body surf after a good gym workout or nice long run about the burbs or through Bold Park. Touch footy on the beach to start up soon. Keep an eye out!

15.01.2022 Strapping ankles---is it worth it? Recent research regarding optimising ankle performance when strapped was published in the Journal of Science and Medicine in Sport, 20(29017)236-240. The researchers looked at the effects of both Rocktape (kinesiology (elastic) tape) and normal rigid strapping tape. The research was done on 24 healthy university students, 12 men and 12 women aged between 19 and 24. They all reported no musculoskeletal injury in the preceding 6 months. Three ...conditions were tested: no tape, rigid tape and elastic tape. The results were interesting! When comparing scores between those who had the best score with those of the worst proprioceptive score when not taped, they found that the best scorers were worse off with tape whereas the below average scorers were better off when taped. The type of tape used did not make a significant difference. Interestingly, all participants felt significantly more supported and confident about their proprioceptive performance when wearing Rocktape compared to rigid tape. There was no difference in perception of comfort between groups or participants. The suggestion here is those who have reduced proprioception may be better off having their ankles strapped while those with good proprioception are probably better off not being strapped. But that means having proprioception assessed to start with, something that is not readily available to most athletes. One finding was that regardless of type of tape, comfort is essential. So, if you get your ankle strapped, make sure it does feel comfortable. Another finding was that Rocktape was more comfortable and with proprioception in mind it may be preferred over rigid tape. But care here! This study was about proprioception, not support, as may be required for an injured ankle. Rocktape Rigid tape .

02.01.2022 The Ankle: Best practice for recognition and assessment of ankle instability The following points are taken from various contributors, Issue Number 2, 2017, Sports Physio, an Australian Physiotherapy Association publication. Ankle injuries not only make up 15% of reported sports injuries, but are common amongst the general population....Continue reading