Sam Leeson – M.C.S.P

• Persistent knee pain that worsens with activity
• Morning stiffness or stiffness after periods of inactivity
• Swelling around the knee joint
• Reduced range of motion
• Grinding, clicking, or cracking sensations
• Difficulty walking, climbing stairs, or standing for long periods

2. Weight Management

Excess body weight places additional stress on the knee joints. Even modest weight loss can significantly reduce pain and improve function.

Research suggests that losing 5–10% of body weight can lead to meaningful improvements in symptoms for many patients with knee OA.

3. Pain Relief Medications for Knee Osteoarthritis

• Paracetamol
• Ibuprofen
• Naproxen
• Topical NSAID gels
• Topical capsaicin (chilli extract) creams

Patients should consult a healthcare professional before long-term use, especially if they have heart, kidney, or gastrointestinal conditions.

5. Heat and Cold Therapy

• Heat therapy can reduce stiffness and improve flexibility.
• Cold therapy can help decrease swelling and relieve pain after activity.

Which should you trust for exercise advice?

The downside of AI Online Advice

• Generic advice is provided and this may not be appropriate for your particular problem. Two people with similar symptoms may need completely different exercises
• Risk of incorrect exercises
• No clinical diagnosis – pain is complex and affected by a range of personal factors such as work, lifestyle, sport, and other medical problems
• Conflicting information from different sites recommending completely opposite approaches

Why Personalised Physiotherapy Advice Matters

• Exercises are chosen specifically for your body and condition
• Technique and progression are monitored Exercises can be adapted if symptoms change
• Underlying causes are addressed, not just symptoms

Finding the Right Balance

Personal thoughts on living with MS from Joanne, one of the partners of the clinic.

 #MSAwarenessWeek

 The last week of April sees all the MS charities coming together to focus how MS makes people feel, think  and act and to raise awareness of the reality of living with MS. 

When I was suddenly diagnosed with relapsing remitting Multiple Sclerosis 7 years ago, I felt devastated. Some people wait years for the diagnosis, living with unexplained symptoms until their suspicions are finally confirmed. For me, it was completely unexpected. I had a sudden onset of numbness as if someone had drawn a line down the centre of my body and everything on the left was numb. Initial investigations ruled out a stroke, but confirmed the typical picture of patches of demyelination in my brain. Symptoms of MS are diverse and vary from one person to another. As well as numbness, I had muscle spasms, severe pain, fatigue (I pretty well slept for a month during the worst phase), bladder irritability (every 30 minutes during the initial days of the relapse), loss of balance, unable to walk properly, unable to talk properly – the wrong words just kept blurting out or I couldn’t find words. My family learned not to laugh when I said “Pass me that thing you use to stir a cup of tea”. Infuriating!

 I remember thinking that my life as I knew it was over. I love my work as a physiotherapist and acupuncturist. I’m a keen mountain hiker and love skiing and I really couldn’t imagine a day when I would do those things again. My bucket list had a couple of big things on it – I wanted to go back to Yosemite National Park to climb Half Dome, which had defeated me years earlier and I wanted to go heliskiing with my son and husband.

 I tried to keep a positive outlook, but I felt quite miserable about it all if I’m honest. I couldn’t stop thinking about the possibility of further relapses making my condition worse or developing progressive MS, for which there are less effective treatments at the moment. Eventually, the worst of the symptoms began to settle or be controlled with medication  and I returned to work after a couple of months.

 Fast forward 7 years and life is really pretty amazing! 

I have learned how to manage my symptoms and they are really well controlled with medication. Some days they really annoy me, so I just take things easier. I am back working full time doing the job I love. Most people have no idea I have MS, although sometimes I do tell people in case they think I’ve been drinking! 

I needed to get back to walking, so started building up from 1/2 mile. My close friend and walking buddy started walking with me again, initially on the flat, then taking in some hills. After two years we made it to the top of a French Alp, which gave me hope that Yosemite was a possibility and the following year, my son, husband and I summited Half Dome. We took our time, doing it over 4 days carrying 40lb backpacks, wild camping and with a mountain guide. (The first time we did the whole 28 miles in a day, except I bottled out near the top!). In a way, the whole thing was more stunning, less rushed and I felt amazing achieving something that 3 years earlier I had crossed off my to do list. I admit to a very emotional cry at the top.

 I had been to the Chill Factor in Manchester to get myself back onto the snow and gradually learned to ski on piste again. As I progressed, we booked some lessons with a guide to get me back to doing some off piste skiing. I was really rubbish to begin with, but I was determined to get there. Eventually, I got back to off piste skiing and I honestly feel amazing when I am in the mountains. This year I went heliskiing in Canada with my son and husband so I have ticked that off my list too.

 What I have learned from striving to do these things is that my MS symptoms are loads better if I do exercise or movement of any kind. Exercise is well known to help with MS and I definitely find that. I also think that once I got over my initial negativity and decided that anything is possible, I discovered that it really is. Getting MS taught me to slow down my life a little and to acknowledge I was doing too much. It has also taught me that you really do have to make the most of life as you never know what lies ahead. I no longer dread the thought of another relapse, instead I focus on planning to do the things I love with the people I love.

Do you need Neurological Physiotherapy?

We are now pleased to be able to offer Neurological physiotherapy at The Carmichael clinic.  

My name is Cathy, I am a Neurological physiotherapist who specialises in the treatment of people who have a disorder of the central nervous system (CNS); this includes the brain, spinal cord and nerves.

As a Neurological Physiotherapist I aim to promote recovery and enhance function through stimulating neuroplastic changes within the CNS.  Neuroplasticity is the brain’s ability to rewire and restructure. Growth and reorganisation of the brain can be supported with intensive exercises.

There are a wide range of Neurological conditions including Stroke, Parkinson’s disease, Multiple sclerosis, Cerebral palsy as well as traumatic brain injuries. Many of the conditions can lead to debilitating symptoms.

Neurological conditions can lead to a loss of function, independence, and the ability to manage day to day tasks such as getting dressed, transferring in and out of the car or eating with cutlery. Neurological physiotherapy can help to improve quality of life and self-confidence.

Neurological symptoms, that I commonly treat include: –

• Muscle weakness (paralysis)
• Reduced range of movement
• Decreased sensation
• Altered coordination
• Pain
• Spasticity
• Fatigue
• Foot drop
• Loss of confidence

Following a neurological event such as a stroke, early rehabilitation has been shown to be effective leading to improved outcomes; I therefore offer assessment after discharge from hospital. Early input encourages improvement in function and helps to reduce secondary problems, which may occur due to immobility or prolonged bed rest. Education and advice regarding appropriate equipment and postural management is also important at this stage.

Following an assessment, a personalised treatment programme, including up to date evidence-based approaches will be provided. I also advocate a 24-hour approach to my patient’s rehabilitation. This may include the completion of a home exercise programme or the application of an assistive device outside of physiotherapy sessions.

The types of Neurological treatment I offer include;

• Functional task practice
• Mobility practice
• Hydrotherapy
• Standing practice
• Transfers
• Core exercises
• Balance exercises
• Falls education and exercise
• High intensity training
• Individualised exercise programmes
• Constraint induced movement therapy
• Active-assisted stretches
• Advice regarding Botulinum toxin for spasticity
• Dexterity and fine motor exercises
• Strength and condition training

Specialist equipment maybe used to enhance recovery this may include the use of:

• Walking aids
• Ankle/foot orthosis are used to reduce foot drop, improve foot clearance, and reduce falls
• Electrical stimulation is used to activate a muscle to help maintain muscle or strengthen in conjunction with active exercise
• Physiotherapy ball
• Casting
• Theraband and weights
• Standing equipment to encourage weight bearing
• Saebo equipment to promote upper limb recovery

Neurological physiotherapy can be provided within the home, clinic, gym, or nursing home.

If you, or a family member, are interested in discussing Neurological physiotherapy, please call 01565 750 035 or email for more information at info@carmichael-physio.co.uk