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Turning down the Stress Volume

3/30/2017

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Emma’s top tips for turning down the Stress volume

We all find ourselves saying “I’m stressed” or hear our family, friends or work colleagues saying the same. Stress is incredibly common, which is why it is hard to define or realise when it is happening to us. Generally speaking, stress is related to two main components:
 
  1. One or more demanding situations or events that put us under pressure, such as:
       a) external demands - having lots of things to do and think about or not having much control over what happens  (e.g. work, money issues, family)
       b) internal demands – the pressure we put on ourselves
           (e.g. looking immaculate, getting the highest mark in a test)
  2. Our reaction to being put under pressure – feeling that we don’t have enough personal, social or financial                   resources to deal with the demands that have been put on us and anticipating failure or a worst case scenario

Being under pressure is a normal part of life. In small manageable amounts, stress can be a useful driving force helping us to take action and get a job done. However, if someone experiences chronic stress especially if it is from different parts of their life they can become overwhelmed, experience a negative effect on their emotional well-being and begin to find it harder to tackle everyday tasks. When stress overwhelms someone it has the potential to lead to anxiety and/or depression.

So, how can you help stop Stress from taking over?
Given that stress is a normal part of everyday life, we have to accept it will always be in our lives. However, we do need to keep our levels of stress low, where possible, to maintain emotional well-being. Here are some ideas you can try:-

  • Reduce the demands you are under – there are many stressors we can’t reduce, but there are certainly some we can. Try to assess what does and doesn’t matter – be ruthless with your to-do list. You can also prioritise your to-do list and work out what can wait until another day rather than feeling you have to do everything all at once
  • Increase your coping abilities – more efficient management of the demands you can’t get rid of will help you to feel more in control and less overwhelmed. Try getting more organised (tidy up and file things away), make lists, break down big jobs into smaller ones and don’t avoid those jobs that fill you with dread, instead tackle them head on. If you can still detect that stress is around, then look towards your support network and ask for help or delegate some of your to-do list to other people
  • Don’t put yourself under too much pressure – be aware of your own internal demands and the expectations you put on yourself. Don’t feel you have to live up to other people’s expectations of you either. For example, if you don’t have the time or interest in attending a party but feel you have to go because your friends are, try giving yourself permission to say “no” and wait to accept an invitation that brings you pleasure rather than adds to your demanding life
  • Take a deep breath – when people experience stress, it is both the mind AND the body that are affected. Stress turns on the physiological stress response called “fight or flight” and relaxation turns this stress response off. Most people think they know how to relax but often they don’t. Relaxation is a skill and it takes time to learn and find the right methods for you. Take some time to invest in self-care for your body and mind, and practice ...
  • Exercise - exercise is a natural stress buster and anxiety reliever. Research shows that as little as 30 minutes of exercise three to five times a week can provide significant stress and anxiety relief
 
Become a stress spotter
People are different, and so stress affects different people at different times and in different ways. I have listed some of the most common symptoms of stress so that you might begin to think about your own personal response to stress. I am sure that some of these symptoms you will recognise while others might come as a surprise. Developing self-awareness and becoming a stress spotter is a good starting point if you want to tackle this unwelcome visitor in your life!

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Why would you come and see a clinical psychologist for help?
 
I am a firm believer that everybody has the ability to manage stress with their own personal and social resources. I also recognise that sometimes, people are so overwhelmed with stress and demands that are out of their control that it makes it hard for them to see or believe in their own resources. This is where someone like me, a clinical psychologist, can support the process of developing ways to manage the impact of stress – now and in the future.
 
The impact of stress, and especially chronic long term stress, is that it can be pervasive – overwhelming and negatively influence our thoughts about ourselves and our lives, cause problems in our relationships and convince us that our bodies and minds are weak and unable to cope. Stress can have us taking short cuts to relieve the pressure, like drinking more alcohol, eating quick and unhealthy meals or avoiding the jobs that need to get done. These short cuts can lead to longer term problems, and we might find ourselves tangled up in both stress and our response to it. Chronic stress is particularly tricky because it is there every day and so we adapt to it and forget that it’s even there – being chronically stressed feels normal but it’s not the new you!
 
In my work as a trained therapist, I want to help people do a number of things, which include:-
 
  • Understand the impact that stress is having on their own personal life
  • Develop a deeper understanding of why stress has been able to make such an impact
  • Explore how someone dealt effectively with stress before it overwhelmed them
  • Facilitate the development of a compassionate stance – help people be kind to themselves
  • Collaboratively reduce the impact of stress on someone’s life now and in the future
 
Ultimately, I aim to enable people who work with me to leave therapy feeling empowered and re-united with their personal resources to manage stress effectively so that they are freed up to enjoy life. I want people to leave therapy with the knowledge that their current situation doesn’t have to be their final destination.
 
For more information about Emma Offord, please click here

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Common causes of chronic knee pain

3/30/2017

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Common knee problems
Pain in and around the knee joint is a very common symptom. Here are three most commonly seen in practice.

1. Patellofemoral Pain Syndrome (PFS)
This is common in young adults, athletes and the elderly. The kneecap (patella) lies in a groove at the front of the lower end of the thigh bone (femur) and moves effortlessly up and down in the groove as you bend or straighten your knee. PFS is caused by ‘mis-tracking’ of the kneecap. It creates irritation on the cartilage in the grove which manifests as pain and a grinding or clicking sensation (known as crepitus) in the front of the knee, around and behind the kneecap. The pain can occur with everyday movements such as walking up and down stairs, often making kneeling or squatting difficult and is made worse by running or sports.

PFS can be caused by factors such as:
  • Imbalance between the weaker inner quadriceps (thigh) than the outer quadriceps muscle.
  • Poor pelvic musculature which stabilizes the pelvis
  • Poor foot mechanics and over pronation
Treatment can be simple painkillers and anti-inflammatory medication. Manual therapy such as an osteopath or a physiotherapist and home exercises to restore the balance. This may also involve assessing the whole of your leg, or in some cases it may require a podiatrist to correct faulty foot mechanics using orthoses / supports in your shoes.

2. Osteoarthritis or ‘wear and tear arthritis’
Osteoarthritis is the most common type of knee arthritis causing the cartilage at the end of the bones to be worn away, reducing the ability of the bones to glide over each other and to absorb shocks. This causes a chronically painful knee that is often more painful with activity. It can become stiff with prolonged sitting and may become enlarged due to new bone formation at the edge of the worn cartilage.
 
Arthritis typically affects patients over 50 years of age, is more common in patients who are overweight and tends to run in families. Other factors that can contribute might include trauma to the knee, meniscus tears or ligament damage. 

Management of osteo-arthritis can be helped by simple over the counter analgesia or anti-inflammatory medication. Injections of hyaluronic acid can be helpful in relieving pain.
Therapies – such as Osteopathy or physiotherapy may also help to alleviate pain and improve the function and mobility to the area in early to moderate stages along with an exercise programme and advice about the importance of being active to Acupuncture helps reduce muscle tension and helps to reduce pain. Severe arthritis though may need a prosthetic knee (knee replacement).

3. Iliotibial Band Syndrome (ITBS)
The Iliotibial band is a band of fibrous tissue that runs down the outside of the leg, beginning at the hip and extends to the outer side of the lower bone (tibia) just below the knee joint. It helps to provide stability to the outside of the knee joint and helps the knee to flex.
When tight the band rubs on the bottom end of the femur it causes friction and becomes inflamed causing pain, ranging from a dull ache to sharp pain.  This is particularly common in runners who increase their mileage, or walkers who have poor foot mechanics.
 
It can be treated by stopping or reducing training load and intensity, and avoiding downhill running. Stretching exercises and anti-inflammatory medication such as Ibuprofen can be prescribed by your GP. Manual therapy such as such as physiotherapy or osteopathy is helpful. A podiatrist may need to assess your foot mechanics. Self-massage, can help but avoid direct massage onto the side of the knee where you feel the pain, as this may aggravate the friction syndrome.
 
For further information on any of these conditions please contact us today



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Verrucae and Verruca Needling

3/30/2017

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Verrucaes
Verrucae are caused by a viral infection of the foot. Curiously, the specific virus that causes them is the Human Papilloma Virus (HPV), the same virus that causes cervical cancer in women. There are many strains of the Papilloma Virus and the ones that usually affect the foot are HPV-1, HPV-2 and HPV-4.

The HPV-1 strain usually causes rather large verrucae; these can be quite painful if they are on a weight bearing area. HPV-2 strain verrucae, on the other hand, are referred to as "mosaic verrucae", as they appear scaly and overlapping and cover a large area.

Finally, there is the HPV-4 strain, which causes multiple, small circular lesions. Clearly, none of the strains are anything you would want to be suffering from.

Verruca sufferers find the condition not only annoying and unpleasant, however, but also frequently hard to get rid of. There are three main reasons for this: firstly, the virus infects the most external part of the skin where little bloodstream reaches and so few white blood cells (which could potentially fight the virus) ever get to it; secondly, it alters some white blood cells’ function so that they cannot fight the virus properly and, thirdly, it prevents infected cells from being noticed by the immune system. 

Although verrucae can be annoying or unsightly, they actually don't usually cause noticeable problems. So, in many cases, no treatment is required, as they can self-resolve within a couple of years. In some instances, however, this does not happen, or the verrucae simply cause too much discomfort, and so patients require treatment in order to finally be rid of them. 

Fortunately, there are today many verruca treatments available. Here, I am going to talk more about “verruca needling”, also known as “dry needling,” which has become very popular in recent years. Unlike most other treatments which require several courses of treatment, verruca needling usually needs only one (although, very occasionally, a follow up treatment can be required). It is therefore highly suitable for busy people or individuals who find it difficult to make repeat treatment visits to a clinic. It is also considered to be one of the most effective methods for getting rid of long lasting verrucae because it works by putting the immune system's white blood cells in contact with the virus (various research had suggested a 60 – 90% success rate).

The procedure is painless under local anaesthetic, with the podiatrist injecting the local anaesthetic at ankle level so that the foot will go numb before the needling. Once the foot is numb, the podiatrist will then use a needle to puncture as many as several hundred holes into the verruca. By doing this, the virus is pushed into deeper tissue through which blood vessels pass, therefore allowing your immune system to recognise the virus and initiate your natural immune response.  If there is more than one verruca, only one lesion (either the primary one or largest one) needs to be treated as the initial immune response to the primary verruca will also destroy the others.

Following the procedure, you will only need a simple dressing and to minimise weight bearing for a day. No further dressings are usually needed after that; you can simply go home, shower and return to normal life. You will also be offered two follow-up appointments to check the healing process, the first of which would usually take place one week after the procedure and the second eight weeks after the procedure. 

So, if you have been suffering with verrucae and you haven't tried needling, this could be just the treatment you need! 
 
If you think you might be interested, or would like further information or to find out if you are suitable for the procedure, simply contact us at the Centre for Complementary Health. 

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