It’s a Wednesday afternoon of a quite usual working day. From my desk here at Restart Carseldine headquarters, I observe the coming and going of gym members who have committed time and energy towards their health and wellness goals, some a bit sweatier than others. Alas, my contemplations are interrupted; we have received an email from eFax, our digital fax provider.
Pleasingly, the fax is a Chronic Disease Management (CDM) referral from a local GP, detailing the treatment care plan and health history of one of his patients for Exercise Physiology treatment. Before attempting contact with said patient (whom we’ll name Karen), I scroll to the ‘Referred Conditions’ section to learn more on the nature of the referral: Generalised Osteoarthritis.
When it comes to being diagnosed with this condition, Karen is by no means alone. She is one of 3.85 million Australians who suffer with Arthritis in 2016, a condition that is the leading cause of disability and chronic pain in Australia. But what is Arthritis? Arthritis is often referred to as a single disease, but is in fact a title that encompasses more than 100 different medical conditions that affect the musculoskeletal system, specifically where two or more bones articulate to create a joint.
Fast forward to the following Monday morning, and I have just completed Karen’s 45 minute initial appointment. With such a broad and generalised referred condition, it was important to quickly identify where and how her osteoarthritis affects her in her day to day life. Karen suffers with bilateral (left and right) shoulder, Cx spine (neck) and bilateral hand (pain > R hand) osteoarthritis, the pain from which has caused her to give up playing social tennis. As a nurse of 20+ years, her occupation is also negatively affected by this joint discomfort, causing her to regularly take NSAIDs (non-steroidal anti-inflammatory drugs) such as Ibuprofen to get through the working day. Karen also reports that across an average month, she will have 2-3 sick days due to joint pain and associated headaches. As a working 48 year old female, Karen is one of the 2.4 million Australians who put up with arthritis-related joint pain on a daily basis at work.
Aside from joint pain, Karen also reports joint stiffness and inflammation, a fear of exercise in case it makes her symptoms worse, and a loss of strength and muscle tone throughout her upper body. Our first appointment together consisted of initially assessing her upper body joint range of motion, which identified distinct limitations throughout her thoracic spine (mid-portion of spine) resulting in decreased trunk and upper limb mobility. My first treatment objective is to therefore improve her mobility through these areas, with the goal to ease pain and joint stiffness, improve joint mobility, and in turn facilitate improved joint nourishment via improved blood, oxygen and nutrient supply. Subsequent appointments will be used to assess the success of the prescribed stretch and mobilisation techniques, and providing improvements are achieved, begin to introduce weight bearing and resistance exercises. These exercises will be important to not only support Karen in her occupation, but to reduce the risk of further joint deterioration, maintain optimal posture, restore muscle tone and strength, and reduce the risk of bone mineral loss and osteoporosis onset.
Karen is in fact our ideal client, someone we see very much of in our day to day life as exercise physiologists. Empowering people to commence specific, individualised and evidence-based exercise is what we specialise in here at Restart. Additionally, our role as exercise physiologists puts us at the coal face of reducing the burden on the health care system. Unbelievably, Arthritis costs the economy $23.9 billion per year in medical care, including indirect costs such as loss of earnings and lost production. Encouragingly however, research suggests that early intervention can delay the onset of Arthritis and is projected to reduce the number of Arthritis cases in the medium-term future.
In the meantime, I am highly confident that a happier Karen will return in 7 days time with a renewed vigour for movement and exercise, and a reduced dependance on pain-killing medication. I would love to help facilitate her to a return to sport, as life is all about doing what we enjoy.
For us here at Restart, that includes helping people like Karen; for Karen, that means a return to social tennis!