JOB Summary

To provide high quality administrative support to the Partners, Physiotherapists and patients at The Carmichael Clinic and to ensure the smooth running of all day-to-day administrative tasks. To have a strong communication channel and work seamlessly with the other admin team member (whose job description does not include the financial/accounting aspects). Previous experience in a medical, healthcare or similar professional environment would be advantageous but not essential.

Desirable Experience:

Experience in the any of the following would be particularly beneficial:

• Working within a physiotherapy, medical or healthcare clinic
• Dealing with private medical insurance companies
• Healthcare or medical invoicing
• Clinic diary or patient management software
• Credit control or following up outstanding accounts

PERSONAL QUALITIES

The successful candidate will need to be comfortable dealing with a wide variety of people, have a calm approach when the clinic is busy and be confident taking responsibility for the administrative side of the practice.

The Eyes

Most people rely heavily on the eyes to keep their balance. As we age, our eyes may be more affected by sudden changes from light to dark, or lose their ability to focus as easily. Often we need spectacles to improve our vision. Cataracts, glaucoma, and the effects of diabetes or other conditions can alter our vision as well. Often people will choose bifocal or varifocal lenses for convenience. Over time, these can affect your depth perception causing you to trip on curbs or uneven surfaces. A study from Australia in 2010 found that 300 long time users of bifocals had twice as many falls as 300 people with separate reading and distance glasses.

Vision checks are recommended every 2 years or every year if you are over 65 years of age.

The Feet

Being able to feel the ground under our feet is an often overlooked part of being steady. Children enjoy bouncy castles because of the challenge of keeping their balance (and they don’t get hurt if they fall over). Many things can cause this ability to fade as we age. Poor circulation due to smoking, excessive alcohol, diabetes, and other things can cause nerves in the feet to die off. Feet can be left feeling numb or having pins and needles sensations. Arthritic changes in the small joints of the feet or in the lower back can change how we feel the ground beneath us as well.

If you can’t feel the ground beneath you it is difficult to know where you are and it can feel bouncy or wobbly when you walk.

These changes can be prevented by taking healthy steps early, such as quitting smoking, adopting healthy diets and seeking regular foot care from a podiatrist or chiropodist. We can also make wise choices about footwear that are supportive, firm, and fit correctly. Shoes with soft, squishy soles can seem very tempting particularly for people with bunions or other arthritic changes in their feet. Be careful about these types of shoes and trainers as it can be like walking in a bouncy castle all day.

Good strength in muscles is needed to be able to act on the messages the brain receives from vision, joints and movement planning centres in the brain. Maintaining strength through daily activity also helps circulation, lungs, and helps joints be less stiff.

A qualified Physiotherapist, Doctor, or Audiologist may be able to help you perform this manoeuvre and normally people feel better very quickly. The risk of developing this condition is increased by having diabetes and/or being low in vitamin D, head injury or whiplash. It is important to remember that dizziness is not just a part of aging. You should seek professional advice if you do become dizzy.

Nobody intends to fall over and hurt themselves and you shouldn’t go through life in fear because fear of falling actually increases your risk of falling. However, we can be proactive and do things that reduce the risk. 1 in 3 people who fall are over the age of 65.

4. Malnutrition and dehydration

If you, or someone you care for, feel unsteady, dizzy or lightheaded, speak to your GP, nurse practitioner, or physiotherapist for advice on how to make positive changes to stay active. Falling doesn’t have to be a part of getting older. Dizziness and imbalance can be prevented, managed and corrected with the right treatment and exercise. If you are in good health, remember to stay active.

Do things you enjoy; dancing, yoga, Tai-Chi, golf, bowls, swimming, anything that gets your heart rate up and keeps your muscles strong. If your health prevents you from exercising speak to your GP about seeing a Physiotherapist. A Physiotherapist will be able to put together an individual movement and management programme that will reduce your risk of falling.

Katrina Humphreys is our Specialist Vestibular Physiotherapist.

The information in this post is taken from ‘The Effect of Age on Balance and Dizziness’ from the ACPIVR – THE ASSOCIATION OF CHARTERED PHYSIOTHERAPISTS INTERESTED IN VESTIBULAR REHABILITATION.

Common growth-related sports injuries

Osgood-Schlatter disease

Sever’s disease

Stress injuries

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.

Following a stroke people can experience reduced strength, sensation, and coordination on one side of their body. Many patients describe difficulties in lifting their foot to step and the inability to weight bear on the affected side, leading to trips and falls. This can affect the individual’s confidence and desire to complete everyday tasks for example pushing a trolley around the supermarket or weeding the garden.

Physiotherapy can help improve balance post stroke through providing goal directed training to achieve the desired functional outcome.

Treatment for reduced Balance

• High intensity leg training
• Balance exercises on flat and uneven surfaces
• Gait re-education
• Assessment and provision of foot drop devices
• Repetition of a specific task to achieve individualised goals

Balance physiotherapy can be provided within the clinic or community.

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