After Stroke or Head Injury, everything changes. Not just for the survivor, but for family, and friends too.


Exercise,balance and walking training are all key elements after stroke, so we'll show you how to get started.


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Red Flags in Pain relief treatment.

Andy MacKellar • January 23, 2020

This one way of treating long standing pain in people who've had a stroke.

When not to start pain relief treatment with Physiotherapy, Osteopathy, Chiropractic or other manual therapy. If you have these symptoms it's best to start with a trip to the GP.
These are usually known as red flags.
If you have:
Weakness or loss of movement of a body part... most common is the loss of ability to lift the toes and foot.
Loss of control of bladder or bowel. Either going too easily or if it's become more difficult.
Fever. High temperature that started around the time of the pain. Either can appear first.
Saddle anaesthesia. Pins and needles or numbness between the legs, where a bicycle saddle would be.
No change when you lie down or other main change of position. If movement or change of position doesn't alter your pain, up or down, then manual therapy probably isn't the place to start. Manual therapy can start after the trip to the Doctor.
Age. Back pain without a really obvious sudden cause, is really rare in under 20's and over 55's. When did yours start ?
Unexplained weight loss. If you're not trying to lose weight already and you have dropped a size or more in clothing. If the waist band steadily became loose ? See the GP first.
Major Trauma. If you have had a big fall.... off  a horse, bike, or a car accident, it's good to have some tests like X-ray or scan before manual therapy.
Night pain. If pain wakes you, and it's not obviously because you moved suddenly, then check with your Doctor.
Mid back pain. Most back pain is in the low back or in the neck area. In the middle, between and below the shoulder blades sometimes means start at the Doctors. Check.
Rheumatoid Arthritis. If you have this most manual therapy is likely to aggravate. Nerve stretch work can be helpful, but you would need to be guided through this, don't try following home programmes.
Morning Stiffness. If it takes more than half an hour or so to get rid of morning stiffness after sleeping, then you will need a blood test from your Doctor and the right kind of physiotherapy work, which will be more exercise based than about joint manipulations.

So why would I write about this when Ships Physio is all about stroke and head injury ? Well it's just that we do use all the same techniques and ideas as our colleagues over in Musculo- Skeletal physio departments. I think that 8 out of 10 of " Neuro " patients have a problem with pain. The next couple of posts are about reducing Sciatic type pain, so this part about Red Flags is meant to stop people using home treatment unwisely.

Physio for Stroke, Head Injury, Parkinson's Disease, Spinal Cord Injury

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By Andy MacKellar February 15, 2022
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By Andy MacKellar November 13, 2020
I have reviewed lots of other peoples CVs in the past, and always found it hard to get a real idea of the person behind it. Here is my own first attempt at an improvement.
By Andy MacKellar July 3, 2020
There are Seven main elements to any exercise programme. Whether you are a top flight sports person, or someone recovering from major illness or injury, your exercise plan needs to include exercises that do all of these things. It's going to vary according to the level that you are already at, and of course what the aim is. For some, your aim might be to walk ten metres, for others it might be to run a four minute mile. The advice works for everyone. The seven points to ponder are: 1. Stamina. 2. Strength 3. Speed 4. Suppleness ( stretch ) 5. Surge ( plyometrics ) 6. Skill 7. pSychology ( meditation, cognitive therapies etc.) 8. Sustenance ( nutrition ) 9. Sleep ! That's right Nine. And if anyone can suggest more I would be happy to listen. I still call it the Seven Secret S's though, as only 7 of them include exercise forms.
By Andy MacKellar June 10, 2020
A simple home treatment method for sore necks and shoulders. If you want to try this kind of self treatment you will need guidance with this, so drop us a line and we can meet by video link. Our video link is totally secure, but needs no knowledge of adding software to your computer, phone or tablet.
By Andy MacKellar June 10, 2020
If you learn a bit about how you are built, we think it will be easier to follow home exercises and self treatment procedures that we teach people to use at home. We'd love to improve these as always, so do share your criticisms and ideas. We won't take it personally. We'll just make it better.
By Andy MacKellar May 9, 2020
We've been working with video exercise "handouts" for the last 12 years, so it was a relatively straight forward adjustment to maximise this element when the Corona virus lockdown started. We still visit some of our patients, but many are benefitting from Skype, What's App and Zoom calls. We also have our own system built into our notes system that requires no knowledge of programmes to download or other hurdles with the famous systems mentioned. The software company that runs the system has even featured us in a case study about using this kind of working. It's helping us now, as we all live with the lockdown situation, but we think it will become part of the future anyway. That's because it's better in some ways. By that I mean that we can easily add in a 10 minute consultation by video link on a day when we wouldn't plan a full visit, which takes an hour in your home, and probably adds at least half an hour travel time to our day. It can just help to check that a home exercise is being done accurately, and encouraging enough to help people really get stuck in to their rehabilitation at home. And in a more independent way than if we are there with you. So we think that it will change our working practices for the better in future.
By Andy MacKellar April 3, 2020
Who knew there was so much to say about your big toe ? The joint that attaches your toe to the main part of the foot is key to walking. So it needs to be flexible enough to provide the propulsion stage of walking. This clip shows how you can have a go at improving the range of movement in the big toe joint, and the effects ought to be two fold. One is improvement in any pain that you experience and the other is to have better gait or style when walking. Do send your comments and share your experience if you try this at home.
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