Welcome to Optimum Physical Therapy
Where excellent patient care in a reassuring, relaxing and friendly environment is the primary focus.
COVID-19: New Arrangements
COVID-19 is a new illness that can affect your lungs and airways. It is caused by a virus called coronavirus. It can take up to 14 days for symptoms of coronavirus to appear. They can be similar to the symptoms of cold and flu. Common symptoms of coronavirus include:
- A fever (high temperature of 38°C or above)
- A cough – any kind of cough, not just dry
- Shortness of breath or breathing difficulties
- Loss or change to your sense of smell or taste – this means that you’ve noticed you cannot smell or taste anything, or things smell or taste different to normal
Coronavirus is spread from sneeze or cough droplets. You could get the virus if you come into close contact with someone who has the virus and is coughing or sneezing or if you touch surfaces that someone who has the virus has coughed or sneezed on and bring your unwashed hands to your face (eyes, nose, mouth)
In Ireland since March 13th there have been severe restrictions in place in order to manage the spread of coronavirus so that it does not overwhelm our health services. This has to a large extent been successful and therefore in line with HSE and government guidelines we are preparing to reopen our clinic on Monday 29th June.
Please be assured that the health and safety of our clients and ourselves are the top priority. This means that there will be some significant changes to how the clinic operates, which are outlined here:
To make an appointment:
- Call or text Dee (as usual) on 086-8774819
- Email Dee at dee@opt.ie
- Message on FB through the Optimum Physical Therapy page
- Use the message facility on this website
We will reply as soon as possible and will ask the following questions:
- Do you have symptoms of cough, fever, high temperature, sore throat, runny nose, breathlessness, changes in taste or smell, or flu like symptoms now or in the past 14 days?
- Have you been diagnosed with confirmed or suspected COVID-19 infection in the past 14 days?
- Are you in close contact with a person who is a confirmed or suspected case of COVID-19 in the past 14 days (i.e. less than 2 meters for more than 15 minutes cumulative in 1 day)?
- Have you been advised by a doctor to self-isolate at this time?
- Have you been advised by a doctor to cocoon at this time?
- Are there any other circumstances relating to COVID-19, not covered above, which may need to be considered to allow you to attend a face to face appointment safely?
Your responses to these questions will determine if you can safely attend a face to face appointment.
What to expect at your appointment:
- Please advise by phone or text when you arrive for your appointment, but remain in your car or outside the clinic to be let in.
- Please do not bring any unnecessary personal items into the clinic.
- We will be wearing a mask, face shield and apron – pleas don’t take offense, this is for everyone’s safety.
- We will take you temperature prior to allowing you enter the clinic using a non-contact thermometer. Once your temperature is 38°C or below you will be allowed into the clinic.
- Hand sanitizer will be available inside the clinic entrance.
- Please wear a mask and gloves for the duration of you appointment. These are only to be put on after sanitizing your hands on entering the clinic – do not wear them into the clinic. If you do not have these items, they can be provided for a small additional charge.
- Please maintain respiratory hygiene throughout the appointment.
During your appointment we will maintain social distancing as long as possible, but during the treatment phase this will not be possible. We will wear PPE and gloves or repeatedly sanitize our hands in line with guidelines as appropriate during the treatment phase.
After the appointment you will be asked to remove your mask and gloves and dispose of them and to sanitize your hands again before leaving the clinic.
Other Changes:
- Previously we used towels for draping during treatments for the comfort of our clients, however will now no longer be possible to do this. Please feel free to bring your own towels for this purpose if this will make you feel more comfortable during your treatment. We do apologise for any inconvenience that this may cause but again it is for health and safety reasons.
We apologise for the changes that we have had to make and sincerely hope that the new procedures do not offend. All of these changes are necessary to ensure the health, safety and wellbeing of all our clients and ourselves and to ensure that we maintain the highest standard or care for all. As HSE and government guidelines may be subject to change we my also have to amend these procedures. Please bear with us as we navigate these uncharted waters safely together! If you have any questions or concerns regarding the above please feel free to contact us at the above number.
What we do.
Assessment
Patient care and your individual needs are at the centre of all treatments at Optimum. After taking a detailed history, I will carry out a thorough assessment to establish the cause of your condition. I will then work with you to develop a treatment programme which is tailored specifically to you and your underlying condition.
Treatments are for individual clients of all ages with conditions resulting from injury, infirmity or medical conditions such as:
- Sports and work related injuries
- Injury screening and prevention
- Rehabilitation – from injury and surgery
- Chronic Pain relief
- Back Pain
- Neck Pain
- Sciatica
- Repetitive strain injuries
- Whiplash
- Postural issues
- Shoulder problems
- Knee problems
- Stress related conditions
- Tension headaches
- Joint strains
- Tennis elbow
- Golfer’s elbow
- Ankle sprain
Treatments
I use a variety of techniques, ensuring that you are comfortable with them. These include:
Movement
Massage
Myofascial Techniques
Positional Release
Joint Mobilisations
Dry Needling
Kinesiology Taping
Exercises
How Can Optimum Help You?
Ongoing Care
A treatment is not simply one session, or a series of visits. Physical Therapy adopts a ‘big-picture’ or holistic approach. At Optimum I provide you with the knowledge and any necessary rehab plan that will allow as fast a recovery as possible and also to mitigate recurrence of injury.
So what does that mean in practice?
What it means is that I take into account any work or activity related issues which may be contributing to your condition. I will also take into account social and psychological issues which may also be contributing to your physical condition. I can also work with you to change activity patterns which may have contributed to your condition.
Call or contact me to find out more about the Treatments I provide
Massage Therapy
The benefits of massage therapy are extensive. It is estimated that up to 90% of disease is stress related and massage is an effective tool for managing stress, in the following ways:
- Decreased anxiety
- Enhanced sleep quality
- Greater energy
- Improved concentration
- Increased circulation
- Reduced fatigue
Massage can also help manage or alleviate a number of other health issues, including:
- Ease depression and anxiety
- Alleviate low back pain and improve quality of movement
- Pump oxygen and nutrients into tissues and vital organs, improving circulation
- Enhance immunity by stimulating lymph flow – the body’s natural defence system
- Release endorphins (amino acids that work as the body’s natural painkillers)
- Relieve migraine pain
- Increase joint flexibility
- Exercise and stretch weak, tight or atrophied muscles
- Promote tissue regeneration and reduce scar tissue
- Reduce post-surgery adhesions and swelling
- Reduce spasms and cramping
- Relax and soften injured, tired and overused muscles
Falls Prevention in Older Adults
Postural Stability Instructor with Later Life Training
The Postural Stability Instructor (PSI) qualification is based on a programme of exercises and support developed by Skelton & Dinan for a research intervention called FaME (Falls Management Exercise) in 1996-97.
The PSI course is evidence based and designed to equip health and exercise professionals with the knowledge and practical skills to deliver this proscriptive, progressive, individually tailored, postural stability programme to reduce falls risk factors in older people.
Qualified PSIs can teach all chair based FaME exercise (individual and group session) and the Otago (home based) exercise programme, both of which can reduce the risk of falls significantly.
The PSI qualification is the first and only evidence based accredited and endorsed falls prevention qualification. PSI is underpinned by current evidence (Cochrane Reviews, Sherrington Falls Exercise Review, NICE falls guidance, FaME programme, ProAct65+ study) and recommended by the Department of Health Prevention Package (2009), the RCP Audit of Falls Services (2012)and the Age UK Expert Series (2013) and ProFouND
Benefits of FaME – Physical
- Reduced risk of falls
- Improved strength & power
- Improved balance & mobility
- Improved asymmetry in limb function
- Possible improvement in bone mineral density
- Re-training floor skills to reduce the risk of a long lie following a fall
- Improved confidence in balance
- Reduced anxiety and fear
- Increased activity and social interaction
Other benefits of FaME
- Following a fall there is an increased fear of falling which leads to reduced activity.
- This in turn leads to decreased muscle strength, flexibility, balance and therefore an increased risk of falling again.
- In order to stop this cycle, we aim to reduce the fear of falling by gradually and progressively reintroducing activity – beginning with chair based exercise.
- The final stages of the exercise plans are to provide the participants with the strength and confidence to be actively able to get down to and up from the floor. I also introduce floor based activity so that if they do have a fall they have the techniques and strength available to either get up from the floor or to move on the floor to be able to reach a phone to call for help, thereby avoiding long lies.
FaME in Practice
So what does a FaME exercise programme entail? Well, in order to achieve the four main outcomes…
- Improve balance and co-ordination
- Increase Functional Capacity
- Increase Bone and Muscle Mass
- Increase Confidence (reduced fear of falling)
…there are 7 evidenced based activities:
- Dynamic endurance training for balance
- Dynamic balance training
- Targeted resistance training (weights, bands and body weight) including targeted bone loading for leg and ankle strength, for arm and back strength
- Backward chaining
- Functional floor activities
- Flexibility training for leg and ankle, chest and spine
- Sustained, three dimensional adapted Tai Chi training
But remember…
- Both individual and group sessions are tailored to each individuals ability and progressed according to their individual needs
- There is a comprehensive referral and pre-participation screening process including measurable functional assessments which allow for ongoing monitoring of progress
- I work with the individuals current medical and physiotherapy team to ensure the total well-being of every individual
How PSI works in practice
- Initial consultation, screening and assessment including health questionnaire, functional assessment and goal setting.
- Supervised exercise session (ideally once a week for minimum 12 weeks). See attached sample exercise class outline.
- Home exercise plan to be completed once or twice a week between supervised sessions.
- Reassessment and exercise plan progression.
Dry Needling
Dry needling is a safe, effective treatment whereby a solid filament needle is applied directly to a trigger point – a tight band of tissue – in a muscle. This direct stimulation results in a mechanical and physiological resolution of the trigger point. Dry needling can produce the same effect as the injecting of a local anaesthetic to the area of the trigger point.
Technique
I identify a taut band or trigger point first by palpating the muscle.
I will then insert a needle directly into the taut band or trigger point that I have just located. This may elicit a local twitch response in the muscle.
Results
There are generally three patterns of pain relief that can occur following a dry needling treatment:
- Pain relief immediately upon removal of the needle
- Pain relief the next morning
- Pain relief over a course of treatments
- Local effect – needling stimulates never fibres in the skin and muscle which promotes healing
- Segmental effect – nerve relief at spinal cord level
- Analgesic effect – stimulates the body’s internal pain suppressing mechanisms from the brainstem
- Central effect – other areas of the brain are influences – including the cerebral cortex and limbic system
- Trigger points – trigger points are deactivated
Possible side effects of dry needling
Dry needling is very safe. Serious side effects are very rare – less than one in 10,000 treatments. However, you should be aware of the following possible side effects:
- Drowsiness after treatment in a small number of people, and, if affected you are advised not to drive
- Minor bruising or bleeding occurs after needling in about 30% of treatments
- Pain during treatment occurs during approximately 1% of treatment
- Symptoms can get worse after treatment (approximately 3% of patients).
- Fainting can occur in certain patients, particularly at the first session, but again this is very rare
Optimum Physical Therapy use only single use, sterile, disposable needles.
Sports Physical Therapy
GAA Teams
Working with GAA teams involves both attendance at matches and individual treatments between games as needed.
At matches I see players for injury assessment, taping and strapping and warm up rubs before the game. During the match I assess any injuries that occur on the pitch and make a call with the management as to whether the player is fit to continue or not. Post match I give players advice on how to manage any bumps, bruises or injures that the sustained during the game. I also provide the players with advice and rehabilitation plans and exercises to aid their recovery.
Playing Camogie for my GAA club, Na Fianna
Croke Park dressing room for the Dublin Premier Junior Camogie Team for their All Ireland Championship Final, September 2017
Working with Na Fianna Senior Camogie Team
Cycling
My role in cycling is formally called ‘soigneur’ but we are generally called ‘swannys’. I am responsible for the riders wellbeing, both nutritional and physical. I prepare all the riders race food and beverages. I give the riders warm up rubs pre-race and I do recovery work with the riders each evening to ensure they are ready for the next days racing which includes their immediate post race food and additional food each evening to aid their post race recovery and ensure their nutritional need are being met.
Working with Nicolas Roche at the Road World Cycling Championships in Austria 2018
Team Ireland staff and riders at the Road World Cycling Championships in Austria 2018
With the riders and staff of the Irish team in Tour de L'Avenir 2017
A girl and a van - working with UCD Cycling Club in the Tour of Ulster 2018
UCD Team Ras Tailteann 2018
Waiting for the UCD riders to cross the finish line at Ras Tailteann 2018
If you are a team manager and require a physical therapist to support your team contact me on 086 8774819 or email dee@opt.ie, or fill out the contact form. Rates are available upon request.
