• Back pain doesn’t get worse with age.
• Back pain can be one of the biggest causes of disability
• In most cases back pain is NOT due to any significant structural damage or disease.
• Back pain is usually caused by a combination of things such as:
  • deconditioning, changes in activity levels, poor sleep, stress and tension, feeling run down, low mood, inactivity and poor conditioning. Any of these factors may combine to make your back feel very sensitive to movement and load
• Backs love movement and activity, and carrying more load makes backs stronger.

• Give you a clear diagnosis about what are the main factors affecting your back pain.
• Give you a plan to help you control your pain. This might involve hands on work, but always an active management plan.
• We have expertise in the science of back pain, the science of exercise and how to set up an effective management plan
• Take you on a journey to get living again – we will help you achieve your goals!

• There are a number of myths around back pain which we believe are not helpful (Australian Physiotherapy Association 2020)
  • Back pain is inevitable with age
  • Backs wear out with everyday bending and lifting
  • A weak core causes back pain
  • A scan will show me the cause of my back pain
  • Pain when exercising means it’s getting worse
  • Flareups or pain for a long time means there’s serious damage
  • Poor posture causes back pain
  • Injections, surgery or strong painkillers will cure my back pain

The good news is that you can take control back of your back pain. If you need help to get moving and Get back to normal, we can help you here at pro health.

• recent changes to your bladder or bowel habits associated with progressive back and leg pain and loss of power and sensation in the leg
• a history of significant trauma such as a fall from a height such as a ladder or a roof
• a previous history of cancer, feel generally unwell, have significant night pain, a recent history of weight loss

• Shoulder pain is common without any significant structural damage to the joint.
• Lots of people WITHOUT shoulder pain have rotator cuff tears.
• Rotator cuff tears do not predict shoulder pain.
• Noisy shoulders are common and not a sign of damage.
• Scans are usually only needed if you have had a traumatic injury.
• Using your arm and getting it stronger reduces your shoulder pain.
• Lifestyle factors such as diet, sleep and general health are all important for relief of shoulder pain.
• Cortisone may offer short term relief, but you need a long term rehab program to get your shoulder back on track.

• Shoulder pain is a sign that I’ve seriously damaged or torn something.
• A noisy or clicking shoulder is a sign that there must be something seriously wrong.
• An MRI is needed to see what is wrong with my shoulder
• I should rest my shoulder.
• All I need to fix my shoulder is a Cortisone injection
• If I’ve torn my rotator cuff tear I must need surgery

• Diagnose the cause of your shoulder pain and determine whether further investigation is needed.
• For people who have had shoulder pain for a long time we have a lot of experience in assessing and identifying the important factors affecting your pain and making a plan to get you back to your valued activities.

• Exercises such as squatting, step-ups and walking help strengthen to the knee
• Lifestyle factors such as diet, sleep and general health can improve knee pain
• Increase physical activity from a distance and pace which is comfortable for you and increase your activity as your pain allows.

• Stop exercising if the knee is painful
• Rest until knee pain goes away
• Avoiding weight bearing exercises such as step ups, running, jumping or squatting
• Getting a scan to find source of knee pain
• Look for surgical intervention or injections as first line of treatment

• We can diagnose the cause of your pain and develop a plan to manage your symptoms
• If you have developed pain over a long period of time, we will help you identify the key factors related to it
• We have close working relationships with a network of Orthopaedic Surgeons, Sports Medicine Specialists, as well as GPs, should the need arise for further investigation or treatment.

• An X-Ray is not a good indication of how sore your joints are
• The amount of arthritic change on a scan is a poor predictor of pain and disability
• Abdominal fat, muscle weakness, protective muscle guarding, and lack of confidence of using the joint is a predictor of pain and disability
• Building up the strength of the of muscles around the arthritic joint can help to reduce pain
• Getting fit, strong and normalising the way you move, can help to reduce pain and disability
• A 10% reduction of body weight can lead to a 50% reduction in pain

• Arthritic joints always need surgery.
• Arthritic joints always cause pain and disability.
• Exercise for arthritic joints makes them worse.
• People with arthritic joints need to rest.

• We can identify the key factors linked to your pain
• We can set you up with a specific rehab plan to get you strong, relaxed and confident
• We work with other health professionals to assist with weight loss

• There are three main types of headache:
  • migraine
  • tension headache
  • headache from the upper neck
• Inactivity, ergonomic factors, poor sleep patterns, stress, worry and low mood can all be associated with headache
• Working with a qualified physiotherapist can help with tension and neck related headaches

• neck being ‘out’
• by poor posture
• by weak muscles

• Diagnose the type of headache you have.
• Provide exercises, relaxation, ergonomic advice and stress management strategies for tension headaches
• Use exercise, advice and some hands-on techniques, we can help reduce the pain caused by neck-related headaches

• A noisy or clicking hip DOES NOT mean your hip is damaged.
• Pain coming from the hip joint is hard to locate and is usually felt into you groin and top of the thigh
• Exercise has been shown to help reduce hip related pain
• A big part of long-term hip pain can be because of muscle changes and protective movements causing irritation by increasing compression of the joint
• The stronger your hip muscles are the more they can help with absorbing shock when you are loading your hip.
• The pain in your hip and what is on an MRI scan DO NOT always match.
• People can make a full recovery back to everyday function and elite level sport after hip injuries.

• A hip injury could end my career
• Pain at my hip means I have seriously damaged something.
• My hip pain has been there for years so it must be arthritis.
• If exercise hurts my hip, I need stop it.
• I’m too young to have hip pain.
• Noises around my hip must be causing problems
• If I just ignore my pain it will probably go away.

• Use the most up to date assessment techniques and strategies to correctly diagnose the cause of your hip pain
• We can provide a return to running or gym-based exercise programme.
• Give you evidence-based advice about whether you need a scan or not.
• In most cases we will take you through 3 stages of rehab
  • Settling the pain with advice and gentle exercise and hands on treatment if needed
  • Getting strong with progressive specific exercise rehabilitation
  • A return to play program for sports
• We can link with a surgeon/ sports consultant regarding assessment and rehabilitation.

• Neck pain is rarely caused by significant damage to bones or discs
• Neck pain may be linked to factors such as stress, muscle tension, a strain, poor sleep and activity levels.
• Getting fit, strong and normalising the way you move helps neck pain.
• So-called abnormal findings on scans like disc bulges and degeneration are common in most necks without experiencing pain.

• Turning or twisting your neck is dangerous when your neck is sore
• If your neck is sore there must be something out of place
• Bad posture is causing your neck pain

• We can identify the keys factors linked to your neck pain.
• We can help relieve your pain, reduce muscle tension and get you moving again.
• We can set you up with a specific rehab plan to get you strong, relaxed and confident.

• Tendons don’t like sudden increases in load.
• Tendons adapt to graduated loading.
• Strengthening the muscles around the tendon helps.
• Loading a painful tendon is not dangerous – it won’t snap.
• Painful tendons get better with the right treatment.

• Tendons need to be rested, massaged and stretching.
• Tendon injuries always need surgery.
• The amount to pain always reflects the amount of damage done.

• We can set you up with a specific rehab plan to gradually get you loading your tendon and strengthen your muscles to get you back to normal sports and recreation activities.

• Whiplash can be scary and painful – but it rarely results in long term damage to the neck structures.
• Whiplash is associated with a strain to the soft tissues (ie muscles and ligaments) that get better with the right treatment.
• Resting, worrying, protecting the neck, and avoiding movement are the worst things to do following whiplash.
• Too much treatment can make things worse.

• Whiplash means your neck is seriously damaged.
• You need to rest and avoid moving to let your neck heal.
• Whiplash needs a lot of treatment.

• We can provide you with strategies to relax your neck, be confident, get strong, and moving normally again.
• We can help get you back to enjoying life as quickly as possible.
• We don’t over treat whiplash – we know it doesn’t help.

• Wear comfortable supportive footwear
• Gently move your feet up and down first thing in the morning for 2-3mins before putting your feet on the ground
• Do stretches as prescribed by your physiotherapist at least 2-3 times per day

• Walking on bare feet even at night to go to the bathroom
• Wearing slippers or sandals
• Avoiding exercise
• Rolling a golf ball or something hard under your foot

• At ProHealth Physiotherapy, we will assess you to determine the reason for your foot pain.
• We will then make a treatment plan designed for your needs so that you can return to your previous activity level as soon as possible
• Orthotics may be required to reduce strain on your foot however, if required this will be discussed with you during your consultation

• In Ireland, 1 million women have some degree of incontinence (1 in 3 women suffer)
• Incontinence can be very embarrassing
• Incontinence doubles risk of post-natal depression (Journal of Obstetrics & Gynaecology in 2011)
• Weak Pelvic floor increases risk of falls (rushing to the loo, distressed)
• Lack of Awareness among Health Care Professionals or women themselves that Specialised Chartered Physios exist to address these issues

We know from research that a thorough assessment & diagnosis with a Pelvic Health physiotherapist and a follow on individualised, evidence-based treatment plan can help to alleviate any symptoms you may be experiencing.

• Afraid to go out in case you leak or are tired of wearing incontinence pads;
• Afraid to jump on the trampoline or go running or dancing
• Afraid to move or go for a walk
• Afraid to have sex because you might leak or its too sore
• Tired because your child is wetting the bed
• Anxious about a dragging sensation in your vagina
• Embarrassed about staining your underwear

You are not alone.  Whilst these conditions are common, continuing to “put up” with the symptoms is not normal and they are treatable.

• Children (bed wetting and constipation)
• Active teenagers usually involved at a high level in Sport
• Athletes (again performing at a high level)
• During pregnancy
• After child birth
• During the menopausal years
• After surgery (abdominal, pelvic, spinal, prostatectomy)
• Prolonged bed rest
• Aging

• Obesity
• Multiple Births
• Weight of baby at birth >8lbs
• Forceps delivery
• Episiotomy during delivery
• Repeated, heavy lifting eg at the gym
• Incorrect toileting habits (particularly learned from childhood)
• Inappropriate exercise: overtraining, incorrect use of weights, incorrect techniques particularly sit ups
• Chronic lung conditions that can bring on prolonged coughing eg asthma, COPD, Cystic Fibrosis
• Any condition that can weaken your pelvic floor muscles such as Multiple Sclerosis

With your consent, I will complete a full physical assessment of your problem and this usually involves an internal examination

I will then design an individualised programme to suit your needs

At all times your right to confidentiality and dignity will be respected

• Incontinence occurs in people of all ages and affects men (1 in 10), women (1 in 3) and children. it can be a great source of embarrassment to those affected
• Wearing pads is not the best solution
• Drinking less fluid does not improve incontinence
• Incontinence doubles the risk of post- natal depression (Journal of obstetrics and gyanecology 2011 )
• Weak pelvic floor increases risk of falls in the elderly (rushing to the toilet)
• Incontinence is one of the major reasons why the elderly are forced to go into a nursing home
• Mild occasional incontinence is often a warning sign to seek help but if left untreated leakage can happen everyday
• You are never too old to seek help
• Lack of awareness among healthcare professionals or women /men themselves that specialized chartered physiotherapists in pelvic health exist to help with these issues
• 1 in 3 of women performed their pelvic floor muscle exercises incorrectly

Pelvic floor dysfunction is any urinary or faecal incontinence or obstruction, Constipation, vagina or uterine prolapse, vagina or rectal pain, sexual dysfunction or pelvic pain (Mary O’Dwyer 2001)

Pelvic floor dysfunction can affect:

• Children (bed wetting and Constipation)
• Active teenagers usually involved at a high level in sport
• Athletes (again performing at a high level)
• Pregnancy
• After childbirth
• During the menopause
• After surgery (abdominal, pelvic, spinal and prostate)
• Prolonged bed rest
• Aging

• Obesity
• Multiple births
• Weight of baby at birth > 8 pounds
• Forceps delivery
• Episiotomy during delivery
• Repeated heavy lifting
• Incorrect toileting habits (particularly learned from childhood )
• Inappropriate exercise: over training, incorrect use of weights, incorrect techniques particularly with abdominal setups
• Chronic lung conditions that can bring on prolonged coughing such as asthma
• Stress and anxiety with other general health conditions such as irritable bowel syndrome can cause your public floor muscles to become overactive and can lead to difficulty with emptying your bowel and or bladder

Pelvic floor exercises are some of the best treatment tools recommended by the international continence society and is the first line treatment before surgery. 83% of women improve!

• I will begin by listening to your story and taking a detailed history
• With your consent, I will complete a full physical assessment of your problem and this usually involves an internal examination
• I will then design an individualised programme to suit your needs
• At all times your right to confidentiality and dignity will be respected

• Rehab doesn’t make a difference with ACL recovery
• Rehab shouldn’t start until one month after surgery
• All ACL injuries require surgery.
• Recovery from ACL surgery and return to sport takes a minimum of 12 months.

• If you have an ACL tear, your confidence in your knee is one of the best predictor of outcome.
• Some people with an ACL rupture don’t require surgery if they are rehabilitated well.
• Returning to sport is based on your strength, agility, function, and type of graft (if you’ve had surgery).
• Resting your knee for too long will reduce your muscle strength and delay your recovery.

• We can help with a quick diagnosis of your knee injury.
• We can develop an exercise program that is specific to YOU.
• We will give you the most up to date advice and best rehabilitation evidence to help your recovery
• We have close relationships with many orthopaedic surgeons and we will communicate with your surgeon to work out the best time frame for your return to sport
• We will perform specific return to sport tests, designed around your sport and your needs. We will make sure you are safe and confident before getting back to competition.