Multiple Sclerosis (MS) is an autoimmune disease of the central nervous system in which the insulating covers of nerve cells become inflamed in the brain and spinal cord causing damage. This damage disrupts the ability of parts of the nervous system to communicate with the rest of the body resulting in a wide range of signs and symptoms, including:

• numbness or weakness in one or more limbs on one side off the body
• partial or complete loss of vision, usually in one eye at a time, often with pain during eye movement
• prolonged double vision
• tingling or pain in parts of your body
• electric-shock sensations, especially bending the neck forward 
• tremor, lack of coordination or unsteady walk (gait)
• slurred speech
• fatigue
• dizziness
• problems with bowel and bladder function

With MS, new symptoms either occur in isolated attacks or build up progressively over time. 
 
Between attacks, symptoms may go away completely, however, permanent damage often occurs, especially as the disease advances.
 
Multiple Sclerosis is more common in:
 

• those between 15 and 60 
• women (twice as likely as men)
• those with a family history 
• people who have had viral infections such as Epstein-Barr, the virus that causes infectious mononucleosis.
• those of Northern European descent.
• cooler climates
• those with an autoimmune diseases, such as thyroid disease, type 1 diabetes or inflammatory bowel disease.
• smokers

There's no cure for multiple sclerosis, however, treatments can help speed recovery from attacks, modify the course of the disease and help manage the symptoms.     Management may include:
 

• drug therapy

• rest 
• exercise
• reducing stress
• keeping cool
• a balanced diet
• physiotherapy to help with balance, movement and fatigue 
• occupational therapy to help with managing every day life 
• music therapy to help with emotional wellbeing 
• speech language therapy  for communication and swallowing

 
Therapy Professionals Physios, Speech Language, Music, Occupational Therapists and Dietitians can help just call us. 
 
 
Follow this link to hear Tracey Ellery’s song (composed with Kimberley Wade, Music Therapist) on her experience of MS:
 
 https://www.facebook.com/cantabrainerschoir/videos/1963130150584002/
 

For more information check out the MSNZ website.
 
MSNZ is a non-profit organisation formed to provide on-going support, education and advocacy for people with MS and their support networks.  It also aims to educate the general public, employers and health professionals about MS and actively funds key research into the condition.

Just contact us at Therapy Professionals our friendly therapists can help. 
 
 
            Phone                        (03) 3775280, 
            Email:                         admin@tpl.nz
            Website:                    http://www.therapyprofessionals.co.nz
 

Are Lazy Boy Chairs fit for purpose in residential care?

Keeping residents mobile for as long as possible is an advantage for residential providers.  Mobile residents are easier to look after and cause staff less physical strain. The question is are residential facilities purchasing the best chairs, to encourage mobility?
 
Many residents, particularly in aged care facilities, spend much of their time sitting in one position. To keep mobile residents need to be able to get out of their chairs with ease.  In order to do this, they must:

• have their feet flat on the floor
• be able to wriggle forward in the seat 
• push up with the hands on the armrests
• have the right height chair with a seat that doesn’t slope backwards

 
Lazy boy chairs seem to be the chair of choice for many aged care and other residential residents.  However are they fit for purpose?
 
The ‘La-Z-Boy’ chair originated in America and was based on the reclining patio chair that had a back which swung back on an angle pushing the seat forward.  Once they were upholstered, they were marketed as ‘comfortable recliner lounge chairs’.  When wheels were added to the chairs, they became a common feature in aged care and other residential facilities.  Often the wheeled lazy boy takes the place of a wheelchair reducing transfers and opportunities for walking. 
 
Little thought has been given to whether lazy boy chairs fit the needs of residents or the staff caring for them. The standard lazy boy has a number of issues for the residents, mobility, posture and lack of pressure relief. They are generally too low with a seat that slopes backward, making it difficult for the person to wriggle forward and get out of.  They are not supportive enough, encourage a fixed slumped posture, which can affect breathing, eating and drinking. For residents who are unable to move themselves they do not offer much pressure relief making them at risk of a pressure injury. 
 
A common practice is to place pressure cushions on the seat of lazy boys, this raises the person higher in the chair, reducing the support from the armrests and increasing the falls risk.
 
Initially small wheels were fitted to lazy boys making them hard to push especially on carpeted floors; many of these chairs are still around.  Larger wheels were introduced to make it easier for care staff to push the chairs; unfortunately this makes the chairs too high for the average resident to place their feet on the floor. This leaves their legs dangling, which is uncomfortable, and encourages them to slide forward in the chair.  Even with larger wheels lazy boys are heavy to move and put staff at risk of injury.
 
Electrically operated lifter lazy boys can be useful for people who have limited arm strength and are unable to push themselves up from a chair.  They may find the assistance to stand enables them to get up independently and maintain their mobility.
 
Lazy boy chairs are often not the best choice for older and disabled people or their carers.  There are many other options.  Therapy Professionals Ltd’s friendly Physiotherapists or Occupational Therapists can give unbiased advice on seating which can improve the comfort and mobility of residents in residential facilities. They may also be able to suggest less costly and versatile alternatives. 

Just contact us:
            
            Phone:            03 377 5280
            Email:              admin@tpl.nz
 
For more information on choosing chairs for your facility, seating people correctly
and pressure areas check out these links.
 
https://www.therapyprofessionals.co.nz/uploads/4/9/5/2/49523375/seating_people_comfortably.pdf
 
https://www.therapyprofessionals.co.nz/uploads/4/9/5/2/49523375/skin_injuries_caused_by_pressure.pdf
 
https://www.therapyprofessionals.co.nz/uploads/4/9/5/2/49523375/seating_advice_for_residential_care.pdf

Allergy Awareness Week  -20 April – 25 April 2021
 
Food Allergies

The number of people worldwide with food allergies appears to be increasing. Scientists aren’t sure exactly why.  Is it that allergies are being identified more or is there something in our food or environment that is causing the increase?
 
About 2- 4% of adults and 6-8% of children have food allergies, the most common are to cow’s milk and egg, followed by soy, peanuts, tree nuts and wheat. The majority of children will lose their allergies by age three to five years.  Allergies to peanuts, tree nuts, fish and shell fish are generally prolonged, which is why these four allergies are the most common amongst adolescents and adults. 
 
There is a difference between a food allergy and food intolerance.  Intolerances cause symptoms such as bloating, stomach cramps and aggravation of eczema or asthma and usually occur several hours or days after eating.  Allergic reactions to foods usually occur quickly and symptoms can include hives, itching, swelling and vomiting as well as potentially life threatening anaphylaxis.

Coeliac disease is not an allergy or intolerance but an abnormal immune based reaction to gluten, a protein found in wheat, barley, oats and rye.  It is life-long and treated by eliminating all gluten from the diet.
 
There are no proven treatments for food allergies so avoidance is the only way to protect against an allergic reaction. If you suspect that you have a food allergy or intolerance, talk to your GP who can refer you for further testing or to an allergy specialist.  Self-diagnosing a food allergy or intolerance can be risky as you may be cutting out important foods unnecessarily.
 
A Dietitian can help by giving advice to manage allergies and intolerances and to ensure that your diet is nutritionally complete.

If you would like help managing a food allergy or think you have a food intolerance, Therapy Professionals Ltd Dietitian is available to assist, just contact us on ​ 
   
            Phone:           (03) 377 5280 
            Email:            admin@tpl.nz

For more information see:                   http://www.allergy.org.nz   
                                                                 http://www.coeliac.org.nz
                                                                 Health Info Canterbury - allergies

Is ageing, disability, injury or illness affecting your ability to be heard?
 
The pitch, pace, pause, tone and volume of your voice comprises about 38% of all your communication.
 
We challenge you to reflect on the quality of your voice, to take action to improve it whether or not you have lost it.
 
World Voice Day on 16 April, is an annual event highlighting the significance of the voice in our daily life.
 
The quality of your voice affects your communication, so it matters.  There is a range of things you can do to improve it, such as

• joining a choir
• attending a drama group
• going to a speech and drama teacher

 
If your problem is significant then we recommend you see a Speech Language Therapist through the public health system or privately.
 
Some Christchurch people with neurological conditions such as Parkinson’s disease, and Stroke, are learning to use their voice effectively with an initiative, the Cantabrainers Choir.
 
This is a choir with a difference.  Its purpose is not so much to create sweet music but to provide a safe environment in which members can rediscover their voice.
 
Difficulties with vocal expression are common in neurological conditions.  For example, in Parkinson’s disease, the voice can become very quiet, rapid, flat and monotone.  Following a stroke, people may experience a complete or partial inability to form spoken words.  Even with the ability to plan words and sentences people may lack the muscle coordination, making words sound slurred and incomprehensible.

Singing can be a route to overcome some speaking difficulties.  For example, it is well known that people who stutter can often sing quite well; the underlying rhythm provided by music can overcome the difficulties in planning the sequencing of regular speech.  For others, problems with speech may be due to memory impairment or word finding difficulty.  The use of familiar songs, rhyming and repetition can be a very effective way of helping them become more fluent.

Research shows, after trauma the brain may recover some abilities given effort and the right stimulation.  Like getting fit, rewiring the brain (neural plasticity) requires intensive exercise to be done accurately and regularly.  Choral singing makes practice enjoyable while the group encourages rehearsing for longer and experimentation.  As a result people may, for example, speak louder, for longer and use more words.
 
The Cantabrainers Choir was started in 2012 by Therapy Professionals Ltd with a small grant from Music Therapy NZ.  The Choir is run by a Music Therapist and Speech Language Therapist because music and speech share many characteristics:  pitch, rhythm, tone, pace and the volume. 
 
After an initial 10-week pilot programme Therapy Professionals Ltd decided to continue the choir as the voice improvements and social benefits were so significant a – to quote a choir member, “The music has been a real uplift and meeting new people has been wonderful and so much fun.  I have a lot more confidence than I had.  It’s got me out of my cage”.  
 
In early 2019 the choir was taken over by The Canterbrainers Therapeutic Choir Trust. 
See their website: https://www.cantabrainerschoir.nz
 
If you have a neurological condition the Cantabrainers Choir is a choir for people with neurological conditions.  It’s easy, just email cantabrainerschoir@gmail.com or phone: 022 593 5411.

World Parkinsons Awareness Day - 11 April 2021

James Parkinson, English Surgeon, first described the effects of what we now know as Parkinson’s Disease. 
 
Parkinson’s New Zealand Website describes Parkinson’s as a progressive neurodegenerative condition. It is caused by insufficient quantities of dopamine – a chemical in the brain. Dopamine enables quick, well-co-ordinated movement. When dopamine levels fall, movements become slow and awkward. Parkinson’s has both motor and non-motor symptoms, and while it cannot be cured it can be treated.
 
As Parkinson’s is a progressive condition it can often take many years to develop and has little effect on life expectancy. Different people will experience a different number and combination of symptoms. 
 
Parkinson’s is relatively common. Approximately 1 in 500 people have the condition. It becomes more common with older age groups, and it is believed 1% of people above the age of 60 have Parkinson’s. The average age of diagnosis is 59.
 
Although there is a slight increase in risk of development of Parkinson’s in people who have family members with Parkinson’s, the risk is very low.

Although there is a slight increase in risk of development of Parkinson’s in people who have family members with Parkinson’s, the risk is very low.
 
Visit https://www.parkinsons.org.nz for more information
 
The following are some interesting talks relating to Parkinson’s:
 
“Deep brain stimulation is becoming very precise. This technique allows surgeons to place electrodes in almost any area of the brain and turn them up or down – like a radio dial or thermostat – to correct dysfunction. Andrea Lozano offers a dramatic look at emerging techniques in which a woman with Parkinson’s instantly stops shaking and brain areas eroded by Alzheimer’s are brought back to life”
https://www.ted.com/talks/andres_lozano_parkinson_s_depression_and_the_switch_that_might_turn_them_off
 
Listen to 'The chemistry of disease' on Radio New Zealand.
Guy Jameson has been awarded the Beatrice Hill Tinsley Medal for his work understanding the chemical structure of proteins that are important in diseases such as Parkinson's.
 
http://www.radionz.co.nz/national/programmes/ourchangingworld/audio/201815053/the-chemistry-of-disease

If you or someone you know is struggling with Parkinson’s Disease our friendly
therapists can help, just contact us on:
Phone: 03 377 5280 or email: admin@tpl.nz
​

World Autism Awareness Day - 2 April 2021
​Raising understanding and awareness of Autism Spectrum Disorders

Friday 2 April is World Autism Awareness Day and it falls during World Autism Awareness week (29 March – 4 April 2021).

Autism Awareness Week’s goal is to shine a bright light on autism, increasing knowledge of autism and the importance of early diagnosis and early intervention.

It celebrates the unique talents and skills of people with autism and is a week where individuals with autism are warmly welcomed and embraced in community events.

Autism New Zealand has a knowlegeable, professional staff who work daily with children and adults with autism and their support networks. Their main role is ‘essentially empowering people living with autism’.

What is Autism and Aspergers Syndrome?

Autism New Zealand’s definition is:

“Children and adults who have an autism spectrum disorder look the same as other people, and due to the invisible nature of their disability it can be much harder to create awareness and understanding.

Autism and Asperger syndrome still remain relatively unknown disabilities among the general population.

Yet it is estimated that autism spectrum disorders (ASD) are approximately four times as common as cerebral palsy and 17 times as common as Down's syndrome. ASD affects 1 in 66 people, approximately 65,000 New Zealanders, which is equivalent to the entire region of Otago.”

The following are some wonderful audio links around Autism which are well worth a listen:
 
“Autism Research - Dr Javier Javier Virues-Ortega” on Radio New Zealand.
 
https://www.ted.com/talks/ami_klin_a_new_way_to_diagnose_autism

There's no known cause ... and no cure. Autism remains one of the most complex disorders for researchers to tackle. But what if we could see inside the brains of sufferers to see if therapies are actually reshaping them? That's what a New Zealand team plans to do. It's a world-first study combining the latest behavioural science with cutting-edge functional magnetic resonance imaging (fMRI) technology. 

“Karen Pierce and Eric Courchesne - Early Detection of Autism” on Radio New Zealand.
 
https://www.rnz.co.nz/national/programmes/sunday/audio/201811139/karen-pierce-and-eric-courchesne-early-detection-of-autism
 
Karen Pierce and Eric Courchesne are directors at the University of California's Autism Centre of Excellence. Dr Pierce specialises in the early detection and treatment of Autism Spectrum Disorder (ASD) in toddlers, and Dr Courchesne's research has proved that the abnormal brain development causing autism begins in the womb. Karen Pierce and Eric Courchesne are the keynote speakers at Autism New Zealand's national conference later this month.
 
What's going on in the minds of children with neurological disorders?
 
https://www.radionz.co.nz/national/programmes/ninetonoon/audio/201817128/what's-going-on-in-the-minds-of-children-with-neurological-disorders
 
Susan Haldane is the head of Mind Over Manner - an organisation which uses the power of theatre to help people understand what's going on in the minds of children with neurological disorders like ADHD and autism.
 
 
‘'Professor Russell Snell - the hunt for autism genes” on Radio New Zealand
 
https://www.radionz.co.nz/national/programmes/saturday/audio/201837972/professor-russell-snell-the-hunt-for-autism-genes
 
Kim Hill (RNZ) talks to Professor Russell Snell, a world-renowned geneticist based at the University of Auckland who has long studied human disease genes and variations in genes in general with a focus on the molecular genetics of disease, in particular neurodegenerative diseases like Parkinson's and Alzheimers.  

Omega 3 Oils
 
There is limited evidence that fish oils (omega 3) reduce inflammation in some people with arthritis.  Omega 3 oil is also thought to reduce risk of heart disease.
 
It is recommended to have 1-2 servings of fish or other seafood a week for good health.  Omega oil is also found in flaxseed oil, walnuts and a small amount in red meats.

Vitamin Supplements 

If you are unable to achieve a healthy food intake, vitamin supplements may be necessary.  Talk with your Doctor about this.
 
Alternative Arthritis treatments 
​
Alternative treatments are available for many chronic diseases.  Discuss these with your Doctor before you try them as they may interact with your treatment.

Need more help? 
​
Therapy Professionals Ltd has experienced Dietitians who can provide group or individual nutrition education.  For Enquiries:  phone 377 5280.

Ways to Maintain Healthy Weight 

To lose weight
 
Even a small reduction in body weight will relieve stress on joints

• Replace sugar in drinks with artificial sweetener.
• Use trim milk ‘calcitrim’ milk.  This has less fat and more calcium than regular milk.
• If you enjoy a biscuit with a cuppa, have a plain, un-iced one, and have only one!
• Use tinned fruit that has no added sugar
• Use diet soft drinks or cordials
• Have small servings of meat, medium serve of potato and fill up on vegetables for the main meal
• Treats are for sharing.  Share a cake, dessert or sweet gifts.
• If you eat for comfort or company, write a list of other things you enjoy.  For example phone a friend, have a relaxing bath, listen to music, do an easy puzzle, go for a walk, pick flowers
• Exercise regularly for general good health

 
Ways to gain weight 
​
For some people, keeping weight on can be a struggle

• Have small regular meals with nourishing snacks inbetween
• Make sure everything you eat and drink is packed with good high calorie foods eg milky coffee, grated cheese on vegetables, butter on biscuits
• Consider having your main meal at midday if you get tired towards evening. Have dessert for afternoon tea or supper.
• Drink high protein milkshakes made with Complan or Sustagen powders.
• If cooking makes you tired, use convenience foods, for example, frozen meals, ready-made custard, cheese slices.  

If you would like advice from our Dietitians, call us, we come to you
 
                                    Therapy Professionals Ltd
                                    Phone No:     (03) 377 5280
                                    Email:             admin@tpl.nz
                                    Website:         www.therapyprofessionals.co.nz 

​
​
​Ageing and Down Syndrome
International Down Syndrome Day 21 March



​Adults with Down syndrome are living longer than ever before, now commonly reaching their 50’s 60’s and 70’s.  For this reason it makes sense to learn all we can about the unexpected challenges that may accompany growing older.
 
Many documents refer to adults with Down syndrome as ‘experiencing accelerated ageing'. What this means is, conditions usually seen in elderly adults (over 65) within the general population are being experienced by individuals with Down syndrome in their late 40's or 50's.  The reason for this is not fully understood, but is believed to be largely related to the genes on chromosome 21 responsible for Down syndrome which are also associated with the ageing process.
 
As we do not yet fully understand the ‘ageing’ process in adults with Down syndrome, predicting and preparing for this is challenging. Being aware of possible changes, and monitoring for early signs of these, will help with a proactive response.  Below are a few common signs of ageing in adults with Down syndrome:

Eyesight changes:

• Cataracts - causing clouding of the lens of the eye, which can make vision blurry and impaired.
• Keratoconus - where the cornea becomes cone shaped, distorting vision.

 
Diagnosis: Regular check ups with an Opthalmologist can help with early diagnosis.
 
 
 Hearing changes:

• Conductive Hearing Loss -  increased risk.
• Ear wax - Smaller ear canals can lead to build up of ear wax, impairing hearing. 

 
Diagnosis: 
Routine ear examinations for wax and periodic screening with an audiologist is recommended.
 
Undiagnosed vision and hearing problems are common and are frequently mistaken as stubbornness, confusion or disorientation. These can be greatly improved with glasses, hearing aids, removal of ear wax and environmental adaptions.
 
Hypothyroidism:
 
Common in adults with Down syndrome but frequently undetected. The thyroid gland is involved in various metabolic processes controlling how quickly the body uses energy, makes proteins and regulates hormones.
 
Signs and symptoms can include:

• fatigue 
• 'mental sluggishness' and/or confusion
• weight fluctuations
• mood changes especially irritability

 
Diagnosis and treatment:
It can be easily detected by a blood test and controlled with medication.

Obstructive Sleep Apnoea:
 
Leading to poor quality sleep which is not restorative. It can also put a strain on the heart and lungs and cause high blood pressure. 
 
Early signs include:                         

• snoring
• gasping noises
• daytime sleepiness
• morning fatigue
• excessive napping 
• fragmented sleep 

Later signs:

• irritability 
• poor concentration
• behaviour changes
• impaired attention

 
Diagnosis: Via a sleep study

Osteoarthritis:
 
Many individuals with Down syndrome have hyper flexible joints. Over time these can lead to increased wear and tear on the large joints (hips, knees etc.) causing osteoarthritis. Those who are or have been overweight are at a greater risk. Arthritis is painful and it can lead to:

• decreased mobility 
• poor fitness
• negative behavioural changes
• decreased willingness to participate in activities
• mood changes especially irritability

 
Treatment:     
Pain levels are often under reported so needs to be discussed with a GP or specialist if suspected.  Suitable pain relief is essential. 

Osteoporosis:
 
A thinning of bone mass leading to the risk of fracture. Adults with Down syndrome are at a higher risk for disease especially if there is:

• immobility 
• low body mass
• family history of osteoporosis
• early menopause
• long time exposure to certain anti-seizure medications

 
Diagnosis:  A bone density scan and can be treated with medication, exercise and diet.

Atlantoaxial or Cervical spine (neck) instability:
 
Instability between the first and second spinal bones directly below the base of the head, If instability is present and arthritis changes occur in the spine, there is increasing risk of damage to the spinal cord in that region. The bones of the neck are more vulnerable as adults with Down syndrome grow older.
 
Symptoms include:

• weakness in the arms or hands
• walking abnormalities
• incontinence

 
Diagnosis: 
A screening cervical spine x-ray is generally recommended at least once during adulthood.

Coeliac disease:
 
Where one’s body cannot digest gluten present in wheat products, causing damage to the lining of the intestine and preventing absorption of certain nutrients causing:

• gastrointestinal distress
• nutritional deficiencies
• general irritability
• behavioural changes

 
Diagnosis:
Screening can be done via a blood test, but formal diagnosis requires a biopsy of the small intestine. 
 
Treatment:
Dietary modification
 
Alzheimer’s:
 
A type of dementia that gradually destroys brain cells affecting:

• memory
• ability to learn
• make judgment 
• communicate 
• carry out basic daily activities 

 
Early onset Alzheimer’s disease is more common in adults with Down syndrome as they both share a genetic connection on chromosome 21. The risk of developing Alzheimer’s disease increases with age, although it is not inevitable that people with Down syndrome will get Alzheimer’s. It is helpful to have a good baseline of basic self-care skills, personal achievements, academic and employment milestones and other skills for comparison as changes are observed.
 
Diagnosis: clinical judgment based on an accurate history. 

Reference:        
National Down Syndrome Society NDSS Aging and Down Syndrome Health and Well-being Guide. 

About Osteoporosis - Moving Safely

Good posture and proper body mechanics are important throughout your life, especially if you have osteoporosis. “Body mechanics” refers to how you move throughout the day.
 
 
Safe Movement
 
Knowing how to move, sit and stand properly can help you stay active and prevent broken bones and disability. Proper posture can also help to limit the amount of kyphosis, or forward curve of the upper back, that can result from broken bones in the spine.
 
One of the most important things about body mechanics and posture is alignment. Alignment refers to how the head, shoulders, spine, hips, knees and ankles relate and line up with each other. Proper alignment of the body puts less stress on the spine and helps you have good posture.

Unsafe Movement
 
To keep proper alignment, avoid the following positions or movements:

• Having a slumped, head-forward posture
• Bending forward from the waist
• Having a slumped, head-forward posture
• Bending forward from the waist
• Twisting of the spine to a point of strain
• Twisting the trunk and bending forward when doing activities such as coughing, sneezing, vacuuming or lifting
• Anything that requires you to reach far.  An example is reaching up for an item on a high shelf, which also could cause you to lose your balance and fall.

Some exercises can do more harm than good. If you have osteoporosis or have had broken bones in the spine, you should avoid exercises that involve bending over from the waist. Some examples include:

• Sit-ups
• Abdominal crunches (also referred to as stomach crunches)
• Toe-touches

 
Many exercises and activities such as yoga, Pilates, tennis and golf may need to be avoided or modified because they often involve twisting and bending motions. Bending forward during routine activities also puts stress on the spine and can increase the chance of breaking a bone in the spine. While bending forward puts strain on the spine, it is usually safer if you’re able to keep your back flat.

• Sit-ups
• Abdominal crunches (also referred to as stomach crunches)
• Toe-touches

 
Many exercises and activities such as yoga, Pilates, tennis and golf may need to be avoided or modified because they often involve twisting and bending motions. Bending forward during routine activities also puts stress on the spine and can increase the chance of breaking a bone in the spine. While bending forward puts strain on the spine, it is usually safer if you’re able to keep your back flat.

Sitting

• When sitting in a chair, try to keep your hips and knees at the same level. Place your feet flat on the floor. Keep a comfortable posture. You should have a natural inward curve to your lower back and a tall, upright upper back.
• When sitting in bucket seats or soft couches or chairs, use a rolled up towel or pillow to support your lower back.
• When standing up from a chair, move your hips forward to the front of the chair, and use your leg muscles to lift yourself up.
• When driving, use the head rest.
• When tying your shoes or drying your feet, sit in a chair. Place one foot on a footstool, box or on your other leg. Lean forward at the hips to tie or dry. Do not bend over or slouch through your upper back. Keep the natural curve of your lower back and a straight upper back.
• When reading, do not lean or slump over. Set your reading material on a desk, table or on pillows on your lap.
• When sitting at a desk, prop up a clipboard so it slants toward you, like a drafting table.
• Use a footstool or footrest when seated for long periods of time.

Standing

• Keep your head high, chin in and shoulder blades slightly pinched together.
• Maintain the natural arch of your lower back as you flatten your abdomen by gently pulling it in.
• Point your feet straight ahead with your knees facing forward.
• While standing in one place for more than a few minutes, put one foot up on a stool or in an open cabinet (if you are in the kitchen). Switch to the other foot every so often. You’ll find this much less tiring for your back and legs.

Lying Down and Getting Out of Bed

• When lying on your side in bed, use one pillow between your knees and one under your head to keep your spine aligned and increases your comfort.
• When lying on your back in bed, use one or two pillows under your knees and one under your head. Try to avoid using extra pillows to prop your head and upper back since this will put you into a rounded upper back position. But, if you have a rounded upper back posture with a forward head, you may need two pillows to support your neck comfortably.

 
When getting out of bed, reverse the steps you used to get into bed (above):
​

1. Keep both arms in front of you.
2. Pull your abdomen in and breathe as you roll onto your side.
3. Keep your abdomen pulled in and use your hand to raise your upper body as you carefully place your legs over the side of the bed in one motion.
4. Sit on the edge of the bed for a moment or two before you stand up. 

​When on your back, never lift your head and upper back to sit up in bed or get out of bed.

​ 
Ref:  National Osteoporosis Foundation USA

About your abdominal muscles

Our abdominal (stomach) muscles are critical in supporting our backs. It is very important to keep them strong.
 
We have four layers of abdominal (stomach) muscles, the rectus abdominis, external oblIques, internal obliques and transversus abdominis.  The first three of these muscles are vital for support of your lower back. They act as an inbuilt corset and are the majority of muscles that make up your core muscles.
 
To protect your back from injury keeping your core muscles strong is very important along with ensuring when you’re handling loads you lift without twisting and losing the curve of your spine.   If you want to protect your back from injury here is a simple way to strengthen your abdominal muscles.

Here is an exercise you can try to improve your abdominal strength. 
 
Sitting on a dining chair try lifting both feet just off the floor while your hands push down on the chair seat just beside your legs.   (See diagram).  
 
Hold for a few seconds and increase the time, as your muscles get stronger.
 
Practice four times before each meal perhaps!
 
NB       Remember to breathe normally – do not hold your breath

Notice how your stomach (abdominal) muscles feel while doing this exercise so you will know when trying the following.
 
Now you can practice bracing your abdominal muscles in any position – sitting, lying, standing, or walking.
 
Try doing it while doing everyday activities like vacuuming, standing doing the dishes, sitting watching the TV, lifting anything and while you do exercises and stretches. 
 
It’s particularly useful to brace these muscles while lifting, or carrying anything with a little weight especially children.

Strong abdominals help your back and as well as your figure!
 
If you are having trouble doing this exercise or have back pain, you don’t have to struggle alone.  Our friendly physiotherapists can help.
 
Just contact us 
 
            Ph:                             03 377 5280
            Email:                         admin@tpl.nz
            Website:                    www.therapyprofessionals.co.nz