frais kilométriques et indemnisations possibles

frais kilométriques et indemnisations possibles | Thierry Payet

En tant qu’infirmier(e) libéral(e), vous vous déplacez quotidiennement au domicile de vos patients. De visites en visites, les kilomètres s’accumulent et les frais liés à ces nombreux déplacements deviennent conséquents.

Indemnisations possibles ? Cotations applicables ? Conditions d’application ? Modalités de facturation ?  

Medicalib vous en dit plus à ce sujet.

Développez votre patientèle grâce à Medicalib. Recevez directement sur votre téléphone des demandes de soins, de patients situés dans votre zone de tournée.


I – Indemnités forfaitaires de déplacement (IFD/IFI) et indemnités kilométriques (IK)

Dès lors que le médecin a prescrit une intervention à domicile et que cette mention figure sur l’ordonnance, la facturation de frais de déplacement (indemnité forfaitaire de déplacement, indemnités kilométriques) est possible. Cette facturation vient s’ajouter aux honoraires des actes de soins réalisés et des majorations éventuelles (nuit, dimanche et jours fériés)

Bon à savoir Si le déplacement n’est pas mentionné sur l’ordonnance, vous pouvez le facturer « avec tact et mesure ». Il ne sera alors pas pris en charge par l’Assurance Maladie et, il reviendra au patient de vous verser le montant de cette indemnité.
Pensez à bien l’avertir!

A – Indemnités forfaitaires de déplacement

IFD pour les IDEL

Le montant des IFD est fixe. Défini par la nomenclature générale des actes professionnels (NGAP), il est pris en charge par l’Assurance Maladie

IFI pour les IPA

“Les frais de déplacement se cotent en association à chaque forfait [(éligibilité, initial ou suivi)], via le code prestation IFI”[1].

Cette “cotation [est] possible à chaque déplacement réalisé pour des soins liés à la dépendance dès lors qu’un forfait BSA, BSB ou BSC ou DI dans le cadre de l’article 12 du chapitre I, est facturé le même jour au patient.” [2].


B – Indemnités kilométriques (IK)

Les frais engendrés par les fréquents déplacements représentent un coût non négligeable pour les professionnels de santé. L’administration fiscale a donc prévu une indemnisation basée sur un barème détaillé.

“Au début de chaque année civile [(1er janvier)], l’administration fiscale propose à chaque professionnel de santé de choisir entre deux options de prise en charge des frais” [3] : frais réels de déplacement ou forfait kilométrique.

Frais réels de déplacement

Cette option nécessite de comptabiliser tous les frais réellement engagés dans le cadre de l’exercice libéral : déplacement, frais de stationnement, garage, péages, carburant, entretien du véhicule. Tous les justificatifs de ces dépenses devront être soigneusement conservés.

Bon à savoir  “Il est important de procéder à l’évaluation exacte de la quote-part en rapport avec l’activité libérale » [4]

Forfait kilométrique

Cette option nécessite de tenir un cahier de bord quotidien reprenant l’ensemble des kilomètres parcourus dans le cadre de l’activité libérale. Ce forfait prend en compte les charges liées à l’entretien du véhicule, aux frais d’essence… “Il est calculé suivant un tableau annuel mis en place par l’administration fiscale”[5].

Il est nécessaire de répondre à certaines conditions pour pouvoir prétendre à cette option, à savoir : 

  • le domicile du patient doit être situé dans une agglomération différente de celle du lieu d’exercice du professionnel.
  • la distance entre le cabinet infirmier et le domicile du patient doit être supérieure à 2 km en plaine et à 1 km en montagne.

Le montant des indemnités kilométriques varie en fonction du « terrain » au sein duquel l’infirmier évolue (plaine, montagne…).

Ces dernières se calculent sur la base d’un aller-retour entre le domicile du patient et le cabinet de l’infirmier. Un seuil est soustrait de la distance évaluée : 4 km en plaine et 2 km en montagne.

Par ailleurs, depuis janvier 2020, un plafonnement des indemnités kilométriques a été instauré. 

KILOMÈTRES TERRAIN FACTURATION
0 à 299 km plaine 0.35 €/km
0 à 299 km zone montagneuse 0.50 €/km
300 à 399 km tout type de terrain A partir du 300ème km  l’indemnité journalière est diminuée de 50 %
400 km et + tout type de terrain Au-delà du 400ème kilomètre, l’infirmière libérale ne peut plus prétendre au remboursement de ses indemnités kilométriques.

II – Cotations applicables

Désignation Cotation Prix
Indemnités forfaitaires de déplacement IFD 2.50 €
Indemnité forfaitaire de déplacement dans le cadre d’un forfait dépendance  ou d’une prise en charge IPA
4 IFI /jour maximum pour un même patient.
IFI 1 2.50 €
Indemnités kilométriques
(pour chaque kilomètre parcouru jusqu’au domicile du patient).
IK plaine :
0.35 €/km
montagne :
0.50 €/km
pieds ou ski : 3.40 €/km

Complétez votre activité grâce à Medicalib. Recevez directement sur votre téléphone des demandes de soins concernant de nouveaux patients, situés dans votre secteur d’intervention.


Medicalib travaille jour après jour afin de vous offrir un service de qualité

Notre mission : faciliter votre quotidien d’infirmier ou d’infirmière libéral(e) en vous proposant des solutions adaptées et des articles utiles à l’exercice de votre pratique professionnelle.

Notre site internet permet aux patients de prendre facilement rendez-vous avec un(e) IDEL disponible près de son domicile. 

Notre plateforme nous permet de vous accompagner dans le développement de votre patientèle et dans l’optimisation de votre tournée. 

Pour plus d’informations sur Medicalib, rendez-vous sur notre site!


Sources :

  • [1] L’exercice des infirmiers en pratique avancée – Ameli – MAJ 30 septembre 2021
  • [2] La nomenclature des actes – L’infirmière libérale française – MAJ janvier 2021
  • [3] Frais de déplacement et indemnités kilométriques en libéral – Officéo
  • [4] Frais de déplacement et indemnités kilométriques en libéral – Officéo
  • [5] Frais de déplacement et indemnités kilométriques en libéral – Officéo
  • Les tarifs applicables en métropole, dans les départements d’outre-mer et à Mayotte – Ameli – MAJ 29 décembre 2020
Shoulder impingement — Full Circle Osteopathy

Shoulder impingement — Full Circle Osteopathy | Thierry Payet

A common shoulder complaint that we see is shoulder impingement, otherwise known as subacromial impingement. Say ‘shoulder’ and most people think of a ball and socket joint. This joint does indeed make up a large part of the shoulder, but there is much more to it than that. Over the top of the ball and socket joint sits a bony ‘bridge’ which is made up of the collar bone (aka the clavicle), shoulder blade (specifically the ‘acromion’ part of the shoulder blade) and a joint which connects the two (aptly named the ‘acromio-clavicular’ joint). Beneath the bridge and above the ball and socket joint is a small gap called the sub-acromial space (sub = underneath).

It is within this space that the abovementioned impingement occurs and if present, may cause pain when moving the arm.

 

Why does impingement occur?

 

Well, there are quite a few soft tissues which run through this space that help keep the shoulder functioning. These parts include the tendons of the biceps and one of the rotator cuff muscles, a ligament and a fluid-filled sac called a ‘bursa’. Bursi allow smooth, frictionless movement around joints and can be found all over the body. Any of these body parts can be involved in shoulder impingement if they become inflamed. Repeated, overhead arm use in throwing sports, or chronic poor positioning of the shoulder and posture in desk workers can lead to these soft tissues becoming irritated and inflamed. For example, a cricketer who spends a large part of their career throwing a ball could lead to increased stress placed on the rotator cuff tendon that passes through the space, leading to inflammation, wear and tear, and poor movement. This then has a direct effect on other surrounding structures, so a person may end up with an inflamed bursa too.

 

Signs and symptoms

 

When someone has shoulder impingement, they may experience any or all of the following:

 

•           Pain when moving the arm (e.g. our cricketer above may feel pain when throwing)

•           Decreased range of motion in the shoulder

•           Weakness when using the arm on the affected side

•           Reduced ability to perform everyday tasks such as reaching up high in a cupboard, doing up a bra, putting on a coat or holding/lifting a child

 

Get to the osteo quick sharp!

 

If you want to get on top of your shoulder pain quickly, then we recommend a trip to see us here at Full Circle Osteopathy. After some thorough questioning and assessment, we will work out what lifestyle or movement factors are responsible for your pain. We’ll get to work with our hands straight away. Using a combination of soft tissue massage, joint mobilising, and many other techniques, we will aim to reduce your pain and get you moving better. Someone with a shoulder problem nearly always has an issue related to neck or back movement, so don’t be surprised if we go looking further afield on the body for answers to your problem.

 

If you are a thrower, we may ask you to demonstrate a throw so we can see how you are moving (don’t worry, we won’t ask you to do this if you are in acute pain). Likewise, if you are a desk worker, we may ask to look at your desk set up and sitting posture. Getting you to take a photo of yourself at your desk is often helpful for us to see if you need to make some changes that may be affecting your posture day-to-day. When it comes to any lifestyle advice, whether it’s the hobbies you have or the way you sleep, we’ve also got you covered!

 

 

We pride ourselves on awesome treatment, but shoulders are often tricky to treat, and some cases may take longer than others. To ensure you get back on the right path as quick as possible, always follow our advice between treatments, and please do your exercises! If you have weakness somewhere which is leading to your pain, a few treatments are not going to resolve this. Weakness and instability need strengthening, and strength takes time to build. Consistency is key with exercise. We will educate you on what you need to do, but you need to be the one to do it at the end of the day. It’s a team effort. We know it’s hard to keep motivated, but rest assured we will always be there on those days when you need a hand!

 

If you have shoulder pain, then don’t stand on ceremony, book an appointment today by contacting our clinic on 0452 249 379 or by visiting our website here. We’ll have you back throwing balls from the boundary quicker than you can say howzat! And if you have no idea what howzat means, then we suggest you ask the audience or phone a friend! 😉

References:

1.     Brukner, P. and Khan, K. 2017. Clinical Sports Medicine. 5th ed. McGraw Hill Education : Australia

2.     Umer, M. et al. 2012. Subacromial impingement syndrome. Orthopedic Reviews. 4 (2). e18. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3395987/

3.    Bennett, S. et al. 2017. The use of osteopathic manual therapy and rehabilitation for subacromial impingement syndrome: A case report. Explore. 13 (5). 339-343. https://www.sciencedirect.com/science/article/abs/pii/S1550830717300149

mère et enfant en train de dormir

Le sommeil de l’enfant | Thierry Payet

Le sommeil de la mère et de l’enfant n’est pas toujours simple et ses désordres peuvent avoir de multiples répercussions sur la vie quotidienne et le bien-être familial. A l’occasion de la prochaine journée nationale du sommeil, qui aura lieu le 18 mars 2022, Santé Sur le Net s’est penché sur les résultats d’une récente étude menée sur le sommeil maternel et infantile.

mère et enfant en train de dormir

Le sommeil de l’enfant est souvent compliqué

Les troubles du sommeil sont fréquents chez le nourrisson et le jeune enfant, avec des effets négatifs à la fois sur l’enfant et sa mère. Chez l’enfant, les problèmes de sommeil peuvent affecter négativement :

  • Le comportement, en particulier une hyperactivité;
  • Le développement de l’enfant, notamment sur le plan cognitif ;
  • Le risque d’obésité au cours de l’enfance et l’âge adulte.

Ces troubles du sommeil sont notamment caractérisés par des réveils nocturnes fréquents, qui surviennent chez 75 % des enfants de moins de quatre ans, avec des conséquences parfois durables sur le sommeil de l’enfant. Et les mères, souvent celles qui se lèvent la nuit en cas de réveil nocturne, subissent aussi les conséquences de ces troubles du sommeil, avec un impact sur leur santé physique et mentale (diminution de la durée du sommeil, fatigue, stress, dépression…).

Les mères touchées par les troubles du sommeil de leur enfant

La préservation du sommeil de la mère et de l’enfant constitue donc un enjeu de santé publique pour la santé maternelle et infantile. Parmi les thérapies qui peuvent être proposées aux familles, figurent notamment les interventions comportementales du sommeil. Par exemple, la thérapie cognitivo-comportementale a démontré son intérêt dans la prise en charge de certains troubles du sommeil, comme l’insomnie. Elle est également efficace pour réduire le risque de dépression du post-partum et de l’anxiété chez la femme enceinte.

Dans le cas du sommeil de la mère et de l’enfant, ces interventions ont pour objectif d’établir un rythme circadien stable au cours de la première année de vie de l’enfant, grâce à une modification ou une adaptation des comportements au sein de la famille. Récemment, des chercheurs ont réalisé une revue systématique de littérature et une méta-analyse sur l’ensemble des études menées sur le sommeil de la mère et de l’enfant jusqu’en avril 2021, afin de déterminer l’efficacité des interventions comportementales du sommeil sur plusieurs paramètres :

  • Le nombre de réveils nocturnes de l’enfant ;
  • La qualité du sommeil maternel ;
  • La dépression chez la mère.

Le sommeil, un enjeu capital dès la naissance

Au total, les chercheurs ont retenu dans leurs critères dix études, parmi les 1 628 études recensées. A partir de l’analyse de l’ensemble des données, ils ont mis en évidence que les interventions comportementales du sommeil réduisaient significativement les troubles du sommeil chez l’enfant et amélioraient significativement la qualité du sommeil maternel. En revanche, aucune différence significative n’a été observée concernant :

Le nombre de réveils nocturnes de l’enfant ;

Le niveau de dépression maternelle.

Les chercheurs concluent sur la nécessité d’études complémentaires sur l’efficacité des interventions comportementales du sommeil. Elles devront prendre en compte certains paramètres, comme l’âge des enfants, la durée des interventions et les critères d’efficacité retenus. Pour la 22ème journée du sommeil, les experts du sommeil souhaitent retenir l’attention des professionnels comme du grand public sur l’importance de la durée et de la qualité du sommeil dès la naissance. Car le sommeil de l’enfant peut impacter durablement sa santé et celle de ses parents. A cette occasion, retrouvez partout en France des rencontres organisées avec professionnels de santé spécialisés dans le sommeil et chercheurs.

Estelle B., Docteur en Pharmacie

Sources

– Effectiveness of behavioral sleep interventions on children’s and mothers’ sleep quality and maternal depression: a systematic review and meta-analysis. nature.com. Consulté le 15 mars 2022.
– Le sommeil des enfants et de leurs parents en 2022. Programme de la 22e Journée du Sommeil® 18 mars 2022. Institut du sommeil. institut-sommeil-vigilance.org. Consulté le 15 mars 2022.
The 10 Best Exercises for Relief.

The 10 Best Exercises for Relief. | Thierry Payet

It’s that time of year where (if we are lucky enough) we spend most of our time in flip flops or enjoy walking on the beach. But unfortunately, it is also the time of year where some of us will experience pain in in the base of our foot. The most common cause of this pain is PLANTAR FASCIITIS! So what is it? What Causes it? How Do I Treat it? and Can I stop it from coming back? All of these questions will be answered in the blog as we will give you the background and give you the best 10 exercises to help treat, rehabilitate and prevent it reoccurring.

Plantar Fasciitis

Plantar Fasciitis is an overuse condition affecting the plantar fascia (tensile tissue under your foot) at the point where it attaches to your heel. Most people describe it as a sharp stabbing pain in the base of the foot. The area of pain is usually down the build up of inflammation at its attachment point. Plantar faciitis is responsible for around 80% of heel pain complaints in the UK.

So, What Causes it?

There are a few possible causes for Plantar Fasciitis, with the possibility of one or a few of the causes actually causing the problem. These possible causes are;

  • Lack of Support from shoe (Most common cause, usually flip flops or sliders in the summer)

  • Running on Hard Surfaces

  • Arch problems (high arches or flat feet)

  • Training Errors (Incorrect technique when training legs)

  • Overuse (Are you walking/running excessive mile, especially in the heat)

  • Over Pronation (Does your foot roll in?)

  • Poor flexibility in your calves

  • Tight Achilles tendon

What Can I Do if I have it?

Immediate treatment – Rest and Ice are your best friend, as this will allow the inflammation to reduce. Anti-inflammatories are also key in this phase.

What Next?

After the immediate treatment – Rehabilitation and Prevention

  • Massage Therapy – this allows the plantar fascia to relax and also loosens the calf muscles and Achilles tendon.

  • Stretches/Exercises – these help to relieve pressure on the plantar fascia and to strengthen the surrounding structures to help prevent it from coming back.

  • Manipulation – Manipulations can help with any bio-mechanical dysfunctions and joint malpositions in the foot, knee, pelvis and low back.

  • Taping – this can be used to support the foot and decrease the pressure on the plantar fascia.

  • Heel Pads or Orthotics – These help to support the foot (Consult a Health Care Practitioner before buying).

  • Acupuncture – This has been proven to release the tension in the plantar fascia.

The 10 Best Exercises and Stretches fot Plantar Fasciitis:

*If you experience any severe pain during these exercise stop immediately and seek advice from either us or your local healthcare provider*

1. Ice Bottle or Ball Release.

This can be performed using a bottle or frozen water (better in intial stages) or using a hard ball (tennis, hockey, cricket even a golf ball). Ideally barefoot, roll the bottle or ball on the soft arch part of the foot. DO NOT push onto the heel bone (Sore bit). Start lightly and increase the pressure gradually. You should feel less soreness and/or tightness when getting up to walk.

2. Marble Pick-Ups

This is another enjoyable exercise where you can stand or remain seated. You should aim to spend 5 minutes a day doing this exercise with each foot.Place a bowl on the floor and some marbles or similar sized small balls or objects (such as stones) in front of you.Pick up each marble using just your toes and transfer them to the bowl.

3.Towel Scrunch

This exercise is one of the easiest to do as you remain seated for the whole duration of it. Aim to complete two sets of this exercise with each foot a day.Begin by laying out a towel on the floor and place your foot flat on top.Now draw the towel towards yourself as you scrunch your toes (make sure that your heel remains in contact with the floor throughout the exercise).

4.Heel Raises

Weakness of the calf muscle can contribute to the development of plantar fasciitis, as it directly affects how the foot moves. Heel raises can strengthen calf muscles and are simple to carry out. Aim to complete 3 sets of heel raises and 10 repetitions a day.Start by standing and resting both your feet flat on the floor. If you require support feel free to hold onto something.Push up with the balls of your feet and raise your heels off the ground. Hold this tip-toe position for a couple of seconds then lower yourself back down slowly.

5. Tip Toe Walking

Spend a couple of minutes every day walking around on your tiptoes to strengthen your calf muscles as well as improve the control and stability you have around your ankles. It may help to use a support such as a walking frame or walking stick.

6.Single Leg Standing

You can easily build this simple step into part of your daily routine. Just lift one foot off the floor and balance on the other foot, for 5 minutes twice a day. This can help you improve your balance and the control you have in your feet and ankles, which makes it an excellent exercise for preventing plantar fasciitis.

7. Towel Stretch

This is an easy stretch you can do while sitting on the floor or on your bed.Sit down on the floor or bed with both your legs outstretched in front of you.Place a towel which is rolled up underneath the balls of your feet and hold the towel from both ends.Gently pull the towel towards yourself while keeping your knees straight.Hold this position for half a minute and you will feel some instant pain relief, as well as being able to stretch out your muscles and ligaments on the base of your foot.

8.Toe Stretch

Aim to do this stretch twice per session, several times a day.Sit on a chair and extend the leg of the foot which is affected by plantar fasciitis, make sure that your heel is on the floor.Reach down and pull your big toe upwards and back towards yourself away from the floor.Hold this position for up to thirty seconds.

9. Heel Raises on the Stairs

This is very similar to the exercise as above, however a little more challenging. Do this in sets of 10, 3 times a day.Stand on a step with your heels over the edge of the step.Push up on the balls of your feet and complete a heel raise.As you lower yourself back down make sure that your heel does not drop below the level of the step.

10. Calf Rolling (Foam Roller or Ball)

Start sitting on the floor with legs extended out in front of you. Place the roller or ball under left calf. Rest right foot on the floor or cross right ankle over left for extra pressure. Use your hands to press hips off floor, then roll from the ankle to below the knee. Rotate left leg in, then out. Repeat on right calf.

#PainRelief #PlantaerFasciitis #HeelPain #Exercises #Osteopathy #Stretches #FlipFlops #FootPain

Treating children is simple and deep

Treating children is simple and deep | Thierry Payet

Treating children is simple and deep Newborns tell their pre-, peri- and postnatal history, possible trauma experiences and dysfunctions through gestures, posture, facial expressions and other signs. A trained perception enables treatment approaches, as well as the sequence, progression and termination of therapeutic touch sequences. This treatment can be further deepened by the integration of […]

Healthy habits for 2020 — Full Circle Osteopathy

Healthy habits for 2020 — Full Circle Osteopathy | Thierry Payet

This sounds easy, but for many it’s a big struggle. We are a sedentary world compared to the past. We have everything at our fingertips with supermarkets, stores and online shopping providing everything we need. Phones, tablets, TV, gaming and desk jobs mean people tend to sit a lot, even during leisure time. There is a huge obesity issue in our world. Did you know that since 1975, obesity rates have tripled and continue to rise?! That is a very worrying stat. If you want to do all you can to avoid becoming overweight or obese, then one very simple thing to do is move more. Your bodies are designed for it and will love you for it. We suggest going for a short walk or bike ride on a regular basis to keep the heart healthy and the waistline in check. If you get the train or bus to work, try leaving a bit of extra time and get off a few stops early to walk the rest of the way. Park at the back of the car park and walk that little bit further into the shops. You’ll soon get your steps in. Better still, go with a friend or family member… After all, exercise feels less of a chore when you have company.

Have a routine

This follows on nicely from our last point. As part of your promise to move more, why not have a little exercise routine that you can bust out on those nights you choose to stay in and watch your favourite show or movie. It doesn’t matter what you do, but doing something is better than just sitting there vegging out. We’re all for chill time, however, aim to work on your body a little every day and the results will be seen in no time. Have a yoga mat, resistance bands, light weights and a foam roller nearby and get to work on them whilst you are enjoying an episode or two. Fifteen minutes is all that is needed. If you want help working out a suitable routine, speak to us next time you are in for a session.

See your osteo regularly

So, you are in for a session with us, good work! Who better to ask for help than an professional expert in body and health? We know a lot of people go to osteo’s when they are in pain, but we’re here for you in the pain-free times as well. Osteopathy is a way of life – it’s not just about bones and backs! Yes, we love to work with people to perfect their bodies, but we also love to give lifestyle advice too. Whether it’s dietary, exercise, sleep or working out which sofa to buy (OK, the last one is all you, but feel free to ask us anyway!), we can help. If you have some new year aches and pains, then don’t let them build. Come and see us right away and we’ll get you on the path to full health. Lifestyle advice included!

Less screen time

Here’s some lifestyle advice for you. Aim for less screen time this year. It’s so easy to get dragged in to being on your phone or tablet all the time. They travel round in our pockets, we use them to talk, email, check the news, play games… The list is endless! How many of you wake up and the first thing you do is check your phone? How many of you also put the phone down last thing at night before closing your eyes? The long-term effects of increased screen time are not yet known and probably won’t be for years to come, but some recent research shows that increased screen time correlated to lower scores in thinking and language tests in children. Other negative effects include sleep disturbance, lack of creativity and becoming disconnected from your social circle. We don’t think any of this is particularly good, so why not vow to reduce screen time and instead dust off the board games. You’ll get awesome family time, lots of laughs (hello happy hormones!) and a happy brain. Win win win!

Cut down on treats

We had to include something dietary here. At the end of the day, you get out what you put in. So, put in more good stuff than bad stuff (we’re not against treats altogether) and your body will shine. The body loves plant-based foods as they are easy to digest, low in calories, and full of good nutrients. We won’t tell you to cut anything out altogether, but try substituting a few treats for some fruits, veggies or yummy yoghurt. Your insides will thank you forever, and you’ll be ticking one more box towards a healthier, happier you.

There you have it. Five easy steps to take in 2020. Let’s make this a winning year! If you would like to discuss any of the above points in detail, please ask us next time you are in and we will be happy to chat and offer our top-notch advice. Happy New Year people!

References:

1.     World Health Organization. 2019. Obesity and overweight. [Online]. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. [Accessed 11 Dec 2019]

2.     National Institute of Mental Health. 2016. Adolescent Brain Cognitive Development (ABCD) Study. [Online]. Available from: https://www.nimh.nih.gov/research/research-funded-by-nimh/research-initiatives/adolescent-brain-cognitive-development-abcd-study.shtml. [Accessed 11 Dec 2019]

3.    Harvard Medical School. 2019. Screen time and the brain. [Online]. Available from: https://hms.harvard.edu/news/screen-time-brain. [Accessed 11 Dec 2019]

Should I see an Osteopath or Chiropractor?

Should I see an Osteopath or Chiropractor? | Thierry Payet

Should I see an Osteopath or Chiropractor?

I had to do some research into this field on account of my ridiculous back. Without rhyme or reason every now and again I am unable to walk!

Nothing had happened that I know about, and yet I can be bed ridden for 2-8 days at the whim of an evil god somewhere.

Enough was enough, I wanted help, but did not know the correct way to turn.

I am a wimp-let’s put it out it out there! I am extremely scared about being popped clicked or manipulated, but feel I have very little option if I wish to live a normal life.

I decided to do a consultation with both and Osteopath and Chiropractor and decide then.

First was the chiropractor. Chiropractors from what I can tell tend to focus mainly on the alignment of the spine as the primary means to relieve problems. This was the focus of the session, and he showed me the various stresses being placed upon my body due to misalignment and bad posture, various models of the spine and vertebrae. He said he could treat me after a further scan, the treatment programme was explained to me and I walked away very confident in the process.

Next was the Osteopath appointment. Whilst waiting, I read some of the pamphlets in the waiting room and was able to learn a little about the discipline. Whereas chiropractors focus primarily upon the skeletal structure, osteopaths look at the body as a whole, drawing from many methods to help and improve it’s efficiency, function and work towards correcting the structure. It treats a broad range of problems throughout the body- from digestive and circulatory, to muscular, soft tissue and nerve related issues.

The appointment was similar at the beginning, although the lifestyle and medical questions that I had to answer were much more extensive than at the chiropractor. My examination was certainly more hands on. The osteopath gave me a full physical before recommending and discussing further information he would like before proceeding. To my surprise, I was actually treated on the day, at the consultation, and I left the property with a core/hip exercise to engage my muscles to strengthen/prevent further problems.

This little “hip trick” really worked for me, it involved engaging a core muscle before doing anything-sitting down standing up, rolling over. It was difficult at first, but a re-learning how to bend when doing anything truly was a revelation! On the strength of this I decided to opt for the Osteopath option-The great variety of techniques to influence the body’s own healing mechanisms appealed to me more than the thought of permanent adjustments.

I am happy with my choice, I am sure that chiropractors are very good with the back, but my problem was with my hip and back- and the holistic approach, ethos and treatment style of an Osteopath just seemed a better fit for me. I also experienced some unexpected positive side effects! After a few sessions I noticed a welcome reduction in headaches and digestive problems that I had been having. It turns out that these symptoms are often related to injuries in other areas.

Don’t be scared of treatment! Try it, it has improved more than just my bad back!

 

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Back problems!

Back problems! | Thierry Payet

Back problems!

Could you be to blame?

Back pain can be completely life changing, and is caused by a collection of seemingly unavoidable, innocuous and sometimes contradictory sins! Activity, inactivity, working, childcare, driving-you know, all the things that it is almost impossible to avoid and lead a relatively normal existence.

The causes and solutions are far too numerous to cover completely here, but what follows is a brief discussion of the avoidable, self-inflicted behaviours that can commonly cause injury.

The back will unfortunately deteriorate as we age and live. It is a race against time to straighten, strengthen but if we are not careful we can start a race toward chronic back issues and mobility problems.

THE TORTOISE repeated behaviours that have slowly built up stress over time.

THE HARE one off, untried or unusual activities, where we have attempted something new, been too ambitious and exerted ourselves unwisely.

 

THE TORTOISE

Underestimate, Underprepare, underperform! – Understand?

We pay little attention to that which we do every day. It is great to have all of the equipment, support, nutrition and knowledge to help us perform in the gym, but how long do you spend in the gym vs your bed, office or car? Do you have an ergonomic bike or multi-gym, but not an ergonomic chair, keyboard or mouse?

It is just as likely that bad lifestyle habits routinely repeated will be the cause of your back pain as it is to be caused a one off trauma or strain. If you knew what these were, you wouldn’t do them, so consulting a professional is a good way to break this cycle. Their objectivity and experience can help uncover something you are doing regularly and unconsciously.

A visit to any Osteopath, physiotherapist or chiropractor will involve trying to understand which behaviours could the source of your back problems.  This is cannot be achieved merely by touch and examination, they will ask you numerous lifestyle questions- you are the most important information resource here. They cannot observe you every hour of every day, so help them by paying attention to everything you do in your daily routine. Your posture, seated and standing, screen time, recreation, footwear, work responsibilities. If your pain hasn’t been caused by a specific event, Identifying as much about your life as possible is key to creating a profile for treatment and prevention.

THE HARE

Overconfidence, Overenthusiasm, Overexertion,

The back injury is often the unforeseen consequence of well-intentioned plans to strengthen and improve other aspects of our health.

It is important to set yourself achievable goals, sympathetic to your body. Marketing in the fitness industry is geared towards immediate results and intensive programmes- a boot camp culture. It is easy to get caught up in this and try and move too quickly-perhaps going straight to MMA is not the best starting point after 15 years on the sofa! Ambition is great, use it, bottle it, let it drive you to succeed-but do some low impact prep work before jumping in at the deep end! Work on cardio, strengthening and stretching the areas that you will be using, and build up slowly listening to your body. The weeks/months of recovery time needed after a back strain occurs is a high price to pay for going too big, too fast or for too long.

If you are new to any activity, unfamiliar movements can be easy way to put strain on your back. Key techniques and sensible body positions are taught to youngsters entering any new sport/activity, but not necessarily the keen but rusty/uninitiated adult. There is more information out there than ever on Youtube and online, but this can be as dangerous and misguided as it is useful. Swallow your pride, do a short course, however knowledgeable you think you are in the field-the likelihood is that a lot has changed since your heyday-see a professional who is up to date with all the newest advice.

You have taken the conscientious steps to get your body ready, and your techniques well practiced and sound-don’t overdo it! All that effort will be useless if you try too much, too soon.

Our team can help

Bodilight  have worked hard to assemble the team you need to understand and treat your long term or newly discovered back problems. Prevention is better than cure here, and our Osteopaths or sports physios will work with you on a plan with you to improve awareness, decipher the origin of the injury, and work towards prevention moving forwards.

 

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Aching Muscles?

Aching Muscles? | Thierry Payet

Sports massage is not only for the benefit of professional athletes. It can also help for those of us who simply exercise regularly and feel a few aches and pains. The aim is to use fast, vigorous strokes to warm up your muscles prior to an activity or to ease your muscles for a faster recovery afterwards.

 

What are the advantages of a sports massage?

If it is a relaxing, gentle massage you are after then this is definitely not for you. This type of massage involves the focused and deeper manipulation of soft tissue, skin, tendons, muscles, and ligaments. Sports massage is designed to correct the problems that have arisen through strenuous or repetitive physical activity, or even a trauma.

Advantages include:

  • Relaxation of your muscles
  • Easing swelling around joints
  • Helps fight muscle fatigue
  • Decreases recovery time
  • Removes tension
  • Boosts circulation
  • Reduced risk of injury
  • Increases flexibility

Sports massage can be used to detect any weaker muscle areas or softer tissue spots and help to strengthen these…Prevention is better than cure.

It can also be used as part of rehabilitation, alongside advice from your medical professional, for any back related strains or injuries.

How does a sports massage work?

Bodilight’s therapists are trained in understanding the different muscle groups as well as the skeletal framework of the body. Each massage will be tailored to your needs or specific injury, ensuring a session that will benefit you.

The strokes used during a sports massage are often directed towards the heart, a technique that increases the blood flow. The therapist may also use shorter strokes, in the opposite direction as this is designed to stretch the fibres in your muscles.

Different techniques will be used for different outcomes throughout your session. The treatment will begin with a form of massage involving varying, pressured, stroking movements, where the hands will glide over the skin in order for you to become accustomed to the therapist’s touch. This is known as effleurage. It is designed to allow the therapist to pinpoint any tender spots so that less pressure can be applied to these areas later on. These strokes will warm and stretch the superficial tissues and relax the muscles as well as increasing the blood flow.

They will then move on to working the deeper tissues and stretching the muscle fibres. This is done with movements, known as petrissage, designed to compress and release the soft tissue. It is commonly used for a greater effect than the effleurage and increase the lymphatic return, which helps in the removal of waste products.

The third part of your sports massage is the most forceful, where the therapist applies the most pressure. Frictions are small movements that are applied using the fingers and thumbs to isolated areas. The aims of this is to separate the bonds between the fibres and this can help to break down any scar tissue. It restores elasticity to your muscles and stimulates the healing process. If this starts to feel uncomfortable it is important to let the therapist know in order for a gentler pressure to be applied.

The massage is finished with the effleurage movements in order to relax you. However, you still may feel achy after this treatment. This is completely normal and the tightness should dissipate within 48 hours leaving you feeling in pristine condition. Drink plenty of water and try soaking in an Epsom salt bath to combat any soreness.

If you are seeking a sports massage for rehabilitation after an injury, it is a good idea to schedule your appointments at regular intervals. This will ensure that specific injuries are treated and progress towards your healing is as swift as possible.

Sports massage is available at Bodilight and if you are a new customer you can quote the code ‘OSTEO25’ when booking for a 25% discount. Further terms and conditions can be found on the website’s booking page.

https://connect.pabau.com/bookings.php?compid=1556

The post Aching Muscles? first appeared on Bodilight Osteopathy.

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Back to School with Osteopathy

Back to School with Osteopathy | Thierry Payet

With Thousands of Children in Swansea going back to school, the hot topic should be about back packs and how will they carry their bag this school year, but the right – or wrong – backpack can have a much longer effect on your child’s health.

Here at Health First Osteopathy we strongly support the need of a backpack, as carrying a backpack and sitting at desks all day can cause some stiffness in the back, neck and shoulders. An ill-fitting or incorrectly sized back pack may increase the risk of poor posture or possible injury.

It is important to recognise the need to protect a school-aged body, particularly during adolescence. Going into the first-term of the 2018 school year, here are some top tips to make sure your child is going back with the right backpack.

What to look for in a backpack

There are so many different styles of school bags available to purchase, that it can become difficult to choose the right one. Below are features that you should look for when purchasing a new bag:

  • Make sure the backpack is the right size – it should be no wider than the child’s chest and no higher than 3 cm above their shoulders – they should be able to look up to the ceiling without their head hitting the bag.

  • A moulded frame which conforms to your child’s back when adjusted correctly.

  • Two wide, adjustable shoulder straps with padding for extra comfort – Wearing a bag with only one shoulder strap curves the spine unnaturally, putting stress on the whole body.

  • Separate compartments that allow packing ease.

  • One made from canvas or another light-weight material.

How to wear a backpack

  • Ideally, a school bag should weigh less than 10 per cent of the child’s body weight. For instance, a child weighing 40kg should carry 2-3kg, and 4kg at the very most.

  • Both shoulder straps should always be used to distribute the weight evenly on the child’s back. Waist straps also help.

  • Don’t wear the backpack below the small of the back. The shoulder straps should be adjusted so that the bottom of the bag sits around the child’s waist – trace a line from their belly button around to their back, the bottom of the bag should sit around there.

  • The bag should not hang out from the shoulders – it should contour to your child’s back – and should not swing from side to side when your child is moving around.

Setting strong backpack habits for you and your child

To ensure your child does wear the bag correctly when you aren’t there, explain to them that it can cause serious injury to their spine, shoulders, and neck if they don’t wear it right. It is only the best school bag if it’s used the right way. Regularly check with them to see if the bag is comfortable, or if they are in any kind of pain.

By setting strong habits for you and your child, it will lessen the impact to cause significant injury to their spine, shoulders, and nick if they don’t wear it right.

The most important thing parents can do once their child is home, is to encourage them to take their shoes off and play outside, without technology for 30 minutes. 30 minutes of varied movement can unwind the body from the rigid positions a child is expected to hold throughout the day.

Take the time with your child to show them how to wear their backpack correctly, if unsure speak to us at Health First Osteopathy. Osteopaths can treat patients with back and neck pain, sports injuries, headaches, postural problems, sciatica symptoms, knee and heel pain, shin splints, arthritis and occupational injuries.

If your child does complain of neck or shoulder pain, it is a good idea to take your child to an Osteopath for an assessment. The school bag may not be the only potential source of discomfort.

#BackPain #Children #BackPack #School #Posture #Learning #Osteopathy