Bill: This is a question that I get asked a lot, Steve. Whether old back injuries come back to haunt you. The answer, well, sometimes they do. If you haven’t done the work after the injury to restore your body back to what it should be. However, if you’ve got some structural damage there, that might be something that you are stuck with. But nine times out of ten, I find that people are just weak where they’ve been injured twenty years ago.
Example, the people who have had a fall whilst they have been skiing at the snow. Or they slipped down the stairs 14 years ago and say that’s when my leg or my hip pain began. What do you think? Should they be sore 14 years later if they just bruised an area?
Steve: Not if they just bruised an area. But it also depends on how old they were at that time, how severe the injury which is kind of what you’re saying. And I think the biggest thing is have they done the work to restore their full health. And if they haven’t, then there’s a good chance that it will come back. And if they’ve done a little bit of work, but then their lifestyles leads to a particular position or loading — you know, someone who sits on a desk all day.
Whilst they may have restored their back ten years ago, by sitting all day and neglecting their health, there’s a good chance that their back’s more predisposed to re-injury of that spot or a spot around that area. Bottom line is we should all be looking at our bodies, day in day out, week in week out, year on year on. So, twenty years later the only injury you have is a new one.
Bill: Can physiotherapists crack backs like chiropractors? A lot have questioned it, but the short answer is yes. So, physiotherapists are generally known as manipulative physiotherapists.
But the term manipulation, adjustment, cracking, cavitation, grade five mobilisation – they all describe the same thing. So, physiotherapists can adjust backs just like chiropractors if they have received the appropriate instruction then they can do that.
Steve: Does Myotherapy work? Short answer is — YES.
Steve: But, there’s a longer answer.
Bill: If you’re issue is related to soft tissue or muscle problems, that’s the myotherapy field of expertise. And so, myotherapists are tertiary-qualified clinicians who are very good at actually seeking out what the cause is. If it’s soft tissue and their techniques will certainly assist with that. What would a good myotherapist do if it’s not soft tissue that’s driving the pain, Steve?
Steve: If it wasn’t something that was soft tissue, I would refer them to an appropriate health care professional.
Bill: A doctor?
Bill: Surgeon, physio…
Bill: How strong should an older person be? Well, they need to be strong enough to move their own body through gravity. To take the extreme example, if you can’t lift your own body weight out of a bed or out of a chair, well, essentially, you’ll be stuck in a nursing home having people assist you to do that.
To come forward a little bit, if you can’t walk 5 kilometers in 60 minutes, then you’re beginning to struggle. And then pretty soon, you’ll find you can’t actually cross the lights in time before they change from green to red because you’re walking so slow. So, all the people need to work more diligently to maintain their fitness. What do you think, Steve?
Steve: Yeah, absolutely. From the age of thirty, thirty, our balance starts to decrease. That’s a fact. So really, you could argue we’re all getting old but from thirty we’re in an“old space” or starting the “old journey.” So if you’re not looking after yourself, balance-wise, you’re likely to fall. If you’re not looking after your body, your lower limb strength, like Bill said, can’t get out of a chair, can’t walk upstairs, can’t control yourself down a hill, you can’t get anywhere at a particular pace.
You don’t want to be that guy at the lights that you’re beeping — hopefully you’re not beeping cause you’re quite relaxed at the lights — but the person coming across the road, you’re beeping to the other cars, “Wait! That person hasn’t finished crossing the road yet.” You don’t want to be that person because it’ll affect everything else that you do. That’s why I think that it’s really important that old or older people can be as strong as they can be. And certainly Bill and I work with people where the person might be seventy but have a body of a forty-year-old. They might be eighty but they move like a sixty-year-old. That’s ‘cause they put the work in.
Know more about Clinical Pilates – a total body-conditioning program that helps to “re-program” the body.
Bill: So, the difference between remedial massage and myotherapist essentially is in Australia is a degree. A tertiary degree. So a remedial massage therapists and myotherapists stand all over the same treatment turf. They will work with soft tissue to help make someone well.
A good remedial massage therapist can be just as effective as a good myotherapist. Myotherapists will then go to bat and say that they have better clinical diagnostic skills. And certainly from the education that they have, I would agree with that in principle. But a good remedial massage therapist will pick that, those skills up on the job, over the years.
Kind of like working as a tradie, you tend to grow your skills after your apprenticeship has been done. So, remedial massage therapist, myotherapist… take your pick. Find a good clinician.
Bill: Myotherapy, what is it good for? Well, myotherapy — the “myo” part of the name refers to muscle and the therapy part refers to therapy. They work with soft tissue and basically assist with soft tissue back to normal function for persons. Well, anyone with a problem or injury could see a myotherapist for treatment. If the problem is bigger than soft tissue, good myotherapists usually have a great network of people around them like physiotherapists or osteopaths or chiropractors or general practitioners or even surgeons. So, good myotherapists should have the clinical skills and clinical knowledge to know if their skill set isn’t going to deal with the problem and refer on. But generally, it’s about soft tissue mobilization to help someone back to full function.
Steve: I was going to add is that if someone trains hard, elite athletes in particular, and really good in preventing muscles becoming injuries. Working on them, keeping them nice and loose and floppy for want of a better description, can help prevent injury in those muscles. And make sure they perform, optimally, so you don’t get tears and those sort of things…
Bill: Floppy muscles, technical term?
Bill: Floppy grade two.
Steve: Grade two floppy?
Steve: Going to Grade three.
Bill: Steve, you’re good with Greek and Latin, what does myotherapy mean?
Steve: Myotherapy — what does it mean? The world itself, “myo” comes from the latin word myo which means muscle. Therapy comes from the english word therapy. So, muscle, therapy. Rather than muscle therapy, it’s myotherapy.
Bill: Rolls off the tongue a bit better, doesn’t it?
Steve: It does.
Bill: So rather than being a muscle therapist, I’m a myotherapist?
Bill. Much better introduction on party day, I reckon.
Steve: I reckon. It would be creepy if you said you’re a muscle therapist.
Bill: Pretty much.
Bill: In Australia, we have a public health system called Medicare. In the public hospital system, there are clinics that will cover podiatry. However, there’s usually a mini-week waiting period to get into those clinics. You can also then seek treatment in a private practice.
In a private practice there is a chronic disease management program or CDM program that general practitioners or medical doctors can refer to. Which will entitle you to five sessions of treatment within a calendar year. If you require more than that, then there is also private health care cover and you’ll be covered in the clinic for that.
If that’s an issue for you, I would suggest you ring your local podiatrist and ask exactly what they do cover and how that works for you.
Steve: And to complicate it a little bit further, CDM or Chronic Disease Management Program used to be called the Extended Primary Care program. So, if you’ve heard of EPC, that’s the same that Bill’s talking about — the CDM. That’s interchangeable. It’s not a separate or another program. We still get asked about that.
Bill: So get on the phone and see what applies to you.
Bill: How often should you do Pilates?
Steve: Well, how often should you eat well?
Bill: Well, pretty much everyday.
Steve: So you should do Pilates often. I think the big misconception is you can do it once a week and get amazing results. Whilst you can get amazing results once a week, if you want truly amazing results, I’d be thinking two or three times a week. If you want to lose weight, you can eat a salad once a week and maybe lose a little bit of weight but if you want to lose a lot of weight, you have to eat healthy throughout the whole week. Pilates is like that. Get the body to move well, move strong and move efficiently day in day out.
Bill: So you’re saying it’s like a lifestyle thing?
Bill: You actually have to live it, breathe it.
Steve: Yes. Absolutely.
Bill: So, regular class work through the week would be about topping up my daily self practice.
Steve: That’s right.
Bill: It can be complex. Question is, is Pilates covered by Medicare — no. However, Steve will elucidate.
Steve: Well, if your GP thinks that you need to have cover under the CDM or the Chronic Disease Management Program, if your GP refers you for physiotherapy, a physiotherapist may decide to use clinical pilates exercises as your physiotherapy treatment. So it’s not direct referral for pilates under the generic term. However, clinical pilates is a tool that a physiotherapist may or may not use. So, the roundabout way, it could be covered for up to five sessions, but I wouldn’t be referring people just for pilates as such. You would need to be discussing that with your GP and with your physiotherapist.
Bill: So would Medicare cover me for pilates at my local gym?
Bill. Thank you.