Why am I hurting?

“Sometimes things happen to our bodies that are puzzling and even worrying, but we don’t know where to turn to find out what it means and whether we need to be concerned,” says Rogier van Bever Donker, President of the South African Society of Physiotherapy. “A physiotherapist – a first-line practitioner whom you can consult without a referral – has extensive knowledge of anatomy and physiology, and will be able to assess your symptoms, diagnose and treat or refer you to the right specialist for treatment, so that’s a good place to start.”

Some strange symptoms which physios can help you understand and, in some cases, also treat:
• Pounding headaches
If you have headaches that cause a sensation of tightness across your forehead, around the sides of your head or at the back, chances are this is caused by the muscles of the scalp and neck contracting. This is very often a response to stress, depression and anxiety. Your physiotherapist can help by working on the physical symptoms; she or he can also help you with advice and tools to help manage the stress.
• Vertigo
You moved your head, and now you feel as if the world is spinning; you may feel nauseous and find it difficult to maintain your balance. A few episodes like this, and you’ll definitely want medical help! “Benign Paroxysmal Positional Vertigo (or BPPV) is the most common cause of
vertigo,” write the experts on It’s a condition of the ear which affects balance – some little crystals important to balance get dislodged and move into a part of the ear where they shouldn’t be. “It causes episodes of vertigo, triggered by movement and changes in position. BPPV can be effectively treated with the appropriate mechanical manoeuvres performed by a qualified healthcare professional.” Your physiotherapist knows just what to do – it’s an effective technique involving simply moving the head and body in specific ways that encourage those little crystals to go back to where they belong.
Balance impairment and dizziness – another version
Another cause of balance problems might be a whiplash injury. Sometimes the whiplash itself was fairly mild, so you may not connect the dots between the injury and your balance problem. Physiotherapy treatment has been shown to very effective in treating balance impairment following whiplash, so do consult a physiotherapist.
Numbness and tingling in the hand
Do you feel tingling, numbness and even pain in the thumb, index finger and maybe the middle fingers of your hand? If you give your hand a quick shake, it might go away, so you’re not really worried. But with these symptoms, you might be in the early stages of Carpal Tunnel Syndrome, a debilitating and painful condition where inflammation squeezes an important nerve. It can cause severe distress and sleepless nights as it progresses, but is certainly treatable, so consult your physiotherapist before it goes any further.
• Uncontrolled urination
Do you know how many people experience what is called ‘urinary incontinence’? It’s huge: “Population studies from numerous countries have reported that the prevalence of UI ranged from approximately 5% to 70%, with most studies reporting a prevalence of any UI in the range of 25–45%.” (I. Milsom & M. Gyhagen (2019) The prevalence of urinary incontinence, Climacteric) Although it mostly affects women, it does occur in men, too.
It can range from a little spurt as you hit the ball while playing tennis, to such uncertainty about flow that you avoid going out lest you be caught short. Few people realise that a physiotherapist can really make a profound difference to your life, with treatment and exercises that improve your control of your urine. A physiotherapist with an interest in the pelvic floor muscles can help you if you are in the very early stages – and if your incontinence is really bad. So consult your physiotherapist now!

Article courtesy of the Physiotherapy Society of South Africa. (

Tips for home-care with Covid

“If you fall ill with Covid, you will likely need to look after yourself at home,” says Rogier van Bever Donker, President of the South African Society of Physiotherapy. “Most people do not need to be hospitalised; and with hospital facilities under pressure in some parts of the country, people who are not severely ill are encouraged to care for themselves at home.”

What do you need to know about self-care?

  • Eat and drink: It’s so simple, but crucial: your body needs food and water for the immune system to work. Physiotherapists on home calls have found many people who haven’t eaten or aren’t drinking enough, which affects their immune system’s ability to do its job. If you have limited energy, save it for cooking an egg or even two-minute noodles; don’t waste it on having a shower, changing the sheets or wiping the kitchen surfaces. Keep something to drink on your bedside table and make sure you’re well hydrated!
  • Be prepared: If you’ve just had a positive test, chances are you will have a few days of feeling really bad in the coming week (for most people, it will be just a few days; but bear in mind that for some, it will last longer). Prepare with that in mind: make sure your bedroom is ventilated, that you have things handy that you might need (including books, e-readers or tablets). Do you have animals? Get a feeder that will dispense food and fill it; put out several bowls of water (physios on home visits say one thing that causes anxiety is when patients don’t have enough energy to feed their pets for a few days).
  • Invest in an oximeter: The little devices that measure your oxygen levels are essential. You can order one from your local pharmacy. The oximeter shows the oxygen saturation (‘sats’) in your blood, as well as your pulse rate. Check what your sats should be with your doctor (if you have certain conditions like Chronic Obstructive Pulmonary Disease or COPD, your normal sats might be a bit lower). For most people, dropping below 95 is a concern. Monitor your oxygen for 14 days.
  • Symptoms of concern: Call your healthcare provider if you have difficulty breathing, chest pain, if you cannot move or are extremely fatigued, or if your symptoms worsen or do not improve.
  • Keep in touch: Keep your phone charged and close at hand. Stay in touch with a friend, a relative, a colleague; make an agreement that you will call or WhatsApp every day, so that someone is aware if things get bad or you need help.
  • Do breathing exercises: “The more you can strengthen your diaphragm and improve your breathing, the better you will fare,” says van Bever Donker. Ask your physiotherapist for information about simple breathing exercises that will help you breathe better.

Article courtesy of the South African Physiotherapy Society!

All in the head

Mid-winter 2021 has not been the most fun, has it? Coping with loadshedding on top of a Covid-19 third wave is enough to give anyone a headache.

Headaches are among the most common causes of pain in the world, as an article in PhysioPedia tells us: “Headache disorders are ranked as the third most disabling condition in people aged under 50 years old in the Global Burden of Disease Study.” Two out of every three people experience headaches – some pretty severe, like migraines and cluster headaches, which can be very debilitating. Many people experience cervicogenic headaches.

A cervicogenic headache is a ‘secondary headache’ which arises from problems in the cervical spine (the neck), usually due to stiff joints and muscles, or problems with the nerves in this area. The pain is referred from the neck to the head and face. The causes may be sustained posture (like sitting at your desk in one position for hours without a break) and repetitive movements. In times of stress and tension, we often hold a lot of tension in our neck muscles which can refer, metamorphosing into a headache which we may not even realise is coming from our neck. These headaches may also be associated with some sort of trauma (whiplash following an accident is one example), or problems with the temporo-mandibular joint, familiarly known to your physiotherapist as the TMJ. This is the joint that links your lower jaw to your skull, just below the level of your ear. And pain in this joint is commonly associated with stress and anxiety – we may not even be aware of doing things like grinding or clenching our teeth when we’re anxious, but the result can be a pain which translates into headache. Cervicogenic headaches may occur occasionally, or they may plague you for days, weeks or even months, till you find yourself popping pain pills frequently to cope with the pain. “Painkillers help as a temporary fix,” says Dr Ina Diener, past-President of the South African Society of Physiotherapy (SASP). ”But the ideal solution is to do something about the cause – those tight muscles and joints. Physiotherapists can do a great deal to relieve cervicogenic headaches.” As first-line practitioners (you don’t need a referral to see a physiotherapist) physios can diagnose and treat cervicogenic headaches with techniques that include:

  • – Mobilisation of stiff joints
  • – Release of trigger points
  • – Prescription of exercises aimed at strengthening, stretching and relaxing different muscles in the neck and shoulders
  • – Movements that help you become aware of how your head is positioned on your neck
  • – Assessment of your daily working posture (or other sustained position) and assistance with varying it
  • – Advice on stress management techniques

“Physiotherapists are also able to help with other headache conditions, like tension-type headaches, or even the spasm and muscle stiffness that often comes with migraines,” says Dr Diener. “It’s really worth consulting your physiotherapist for help with headaches!”

Article brought to you by the South African Physiotherapy Society!