Haddad and Holloway Physiotherapy

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Haddad and Holloway Physiotherapy are looking for an individual to join our team in providing a comprehensive physiotherapy service to our community. If you are interested or know of anyone who would suit this position, please email your CV's to [email protected]. Alternatively please share this post. Thank you!

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WHAT IS T4 SYNDROME?

T4 syndrome, also known as Upper Thoracic Syndrome refers to the pain in the upper back and is a much under-recognized or diagnosed condition. The spinal cord is divided into 5 segments: Cervical, thoracic, lumbar, sacral and coccyx.

T4 syndrome typically indicates pain in the 4th vertebrae of the thoracic segment of the spine. T4 syndrome is 3-4 times more common in females than in males.

The Typical Symptoms of T4 Syndrome or Upper Thoracic Syndrome Include:

-Diffused pain in arms
-Paraesthesia in whole arm or the fore-arm
-Extreme hot or cold temperatures of hand
-Heavy feeling in the upper extremities
-Non-dermatomal pains or aches in the forearm or arm
-A crushing or tight band like pain
-Recurrent complain of discontinuous pain in and around the scapular region or posterior thoracic pain
-Sensations like tingling of pins or needles or numbness of the arm.

What Can Cause T4 Syndrome or Upper Thoracic Syndrome?

The reason for the development of T4 syndrome depends on injury to the T4 segment of the spinal cord due to repeated bending, arching, lifting or twisting type of movement thus causing injury to the facet joints in that area.
It can also be caused due to poor posture like protruding the head forward while sitting or standing, and slouching. It is common in people with cervical lordosis or cervico-thoracic kyphosis.

Women are more prone to develop the syndrome due to their structural differences from men. As the breasts develop, there is an increase in the amount of weight in the frontal part and to maintain that many would bend a little forward. The heavier the breast, the chances are more to develop T4 syndrome in women.

Treatment for T4 Syndrome or Upper Thoracic Syndrome

The treatment of T4 Syndrome solely depends on physiotherapy. An experienced physiotherapist will provide manual therapy with an impairment based approach. The sessions would start with manual therapy and slowly would progress to home exercise. The sessions would include some or combinations of the following techniques:

• Joint manipulation and mobilization of the thoracic and cervical spine
• Soft tissue massage
•Taping or bracing
• Electrotherapy viz., ultrasound or laser
•Dry needling
•Training in Pilates
• Postural correction
•Stretching
•Exercises for flexibility and stabilization of the core

A ‘Slipped’ disc

Contrary to popular belief, a disc (found between each vertebrae) does not slip out of position. It can bulge or the fluid inside can be forced through cracks in its outer fibrous wall to cause herniations.

These conditions can be caused by trauma or degeneration of the discs caused by ageing and wear and tear.
Sometimes these herniations can result in neural pain if it impinges on a nerve. Sometimes discs can herniate and we are none the wiser.

For those that are symptomatic i.e.. Painful over the lower back, buttocks and down the leg or pain in the neck, shoulder and arm, we start with conservative treatment.

This involves taking pressure off the disc, releasing soft tissue and mobilising the affected nerve.

It’s important to note that there is no quick fix for this condition so perseverance and patience is key. Nerves take their time to heal.
There are instances where surgery is indicated but is used as a last resort.

If you are concerned about any of these symptoms, speak to your physiotherapist to get assessed and decide on a way to manage it further.

You don’t have to live with pain.

BPPV
Benign Paroxysmal Positional Vertigo

This type of vertigo is triggered by a change in position of the head in relation to gravity.

An individual will present with feelings of spinning or floating. General imbalance, nausea and light-headedness is also common.
This condition is caused by crystals that enter the semi-circular canals of the ears.

Common causes can involve:
• Head trauma (7-17%)
• Vestibular Neuronitis (15%)
• Meniere’s disease (5%)
• Migraines (

Its 10 days to Cycle Tour Sunday!

You’ve done the hard work up to now and you’re preparing to taper off for the last week.

However, this is where we become aware of niggling discomfort threatening to derail your enjoyable tour.

Over the years of treating cyclists, these are the most common issues leading up to race time:

1. Neck/ shoulder pain: spending hours in the saddle causes an imbalance in the neck + shoulder muscles resulting in strain and even headaches.
2. Low back pain: Predominantly caused by an unstable pelvis relying then on the back muscles to stabilise and develop repetitive strain.
3. Glut pain with referral into the thigh: Occurs as a result of a unilateral pelvic instability which then recruits the glut and outer thigh.
4. Knee pain: A maltracking patella can cause pain as it rides incorrectly with every stroke while pedalling.

These are all conditions that can be successfully treated by Physiotherapy to make sure your hard work pays off on the day.

All the best for a successful Cape Town Cycle Tour 2022!

LOW BACK PAIN

Low back pain (LBP) remains the most common complaint resulting in chronic discomfort, poor quality of life and impaired function.
LBP can have numerous causes:
• Strain and sprain of ligaments and muscles.
• Degenerative changes in the spine and pelvis.
• Biomechanical imbalances caused by weakness, poor or prolonged postures (sitting), trauma (falls) etc.
• Stress, anxiety and depression which has an effect on how we perceive pain.
• Previous back surgeries.

Having your back assessed helps to get an understanding of what is happening and how to go about managing it.
Physiotherapy aims to diagnose the issue and provide treatment and guidance in managing the condition further.

SPORTS INJURIES

With the relaxation of Covid restrictions, we’re seeing a return to sport for all individuals; be it kids at school, amateurs or professionals.

After a 2 year hiatus it’s safe to say that we have deconditioned in many ways and specifically physically.

So going back to the physical activities we love needs to be gradual to avoid any serious injuries.

As a Physiotherapist, we can guide you on this journey and assist with any niggles that could be preventing you from enjoying your sport and treat any injuries effectively.

So let’s get 2022 off to a good active start!

HIP PAIN

Hip pain can be debilitating for anyone at any age.
There can be many different causes for hip discomfort and many of them are treatable through conservative management.

The following are main causes of hip pain:
• Osteoarthritis
• Labral tears
• Bursitis
• Poor pelvic biomechanics (sitting for long periods)
• Tendonitis

Hip pain leads to poor gait patterns as a result and starts to affect other areas via compensatory patterns.
Have your hip assessed by a Physiotherapist to determine the cause and live a more comfortable life.

Anxiety.
What is anxiety?
Anxiety is a stress response that's out of proportion to the impact of the event. It's the inability to set aside worry and restlessness.
How does it present?
Some of us will experience irritability, lack of concentration, racing thoughts, fatigue, sweating, excessive worry, fear, insomnia, nausea, palpitations or trembling.
This also leads to poor breathing patterns and reduced oxygen levels leads to brain fog and poor concentration. We also hold our tension over the shoulders and neck area causing persistent headaches. Tightness over the ribcage restricts our breathing as well.
Physiotherapy not only addresses the muscular tightness but also teaches you how to regulate your breathing, increase oxygenation and guide you on relaxation techniques.
Contact your Physiotherapist if you think you are suffering from Anxiety and you need help to overcome the symptoms.

Unfortunately the land-line at our practice is not working today due to technical issues!

Please contact us on 0760553290

Kind regards
Haddad & Holloway Team

Shoulder and arm pain!

There are a number of reasons why we experience arm pain.
The following are the most common causes:

1. Neck involvement i.e. herniated discs and degenerative joints.
2. Tendonitis of the rotator cuff muscles.
3. Overuse injuries such as tennis elbow.
4. Carpal tunnel syndrome.
5. Biomechanical imbalances of the shoulder girdle.

The last one accounts for a huge percentage of the shoulder and arm pain we see at the practice. The increase in tension, anxiety and long working hours, our shoulders bear the brunt of this and it leads to abnormal muscle tension around the blades. This results in pain around the blade, into the neck and down the arm.
Physiotherapy assists with releasing the muscles, correcting the biomechanics and education on future prevention of injury to minimize chronic issues.

If you feel you're experiencing any of these symptoms, speak to your Physiotherapist to evaluate it and get advice on what can be done to assist you.
You don't have to live with pain.

Cervical Vertigo

What is it and why is it currently so prevalent?

C.V is a condition related to neck dysfunction causing dizziness, disorientation, nausea, the inability to concentrate, headaches, neck pain and general brain fogginess.

There are a number of causes which can bring this on. Arthritis, surgery and trauma to the neck can restrict blood flow to the brain and inner ear, resulting in these symptoms. Tight muscles and strained tendons prevent the receptors in your neck from communicating with your brain and causes the disorientation and dizziness.

Currently, we are seeing a lot of patients presenting with these symptoms. It is believed that under the current circumstances we are all having to carry our stress over long periods (i.e. > a year) and this is manifesting physically as thoracic pain (between the shoulder blades), into the neck and producing persistent headaches. Working from home has presented us with a whole new set of challenges; especially in relation to ergonomics resulting in poor neck posture.

Treatment for this condition involves releasing tight tissue and joints, strengthening the muscles, education of a healthy posture and movement, and holistic wellbeing.

If you feel that you could be suffering from Cervical Vertigo, ask your Physiotherapist for assistance. There is no need to live with this pain, as it can be treated.

South Africa is now in Level 4 lock down after the family meeting that took place on Sunday the 27t of June. The good news is that Haddad & Holloway is still open during these times from 8am to 6pm weekdays.

Our staff members have been vaccinated against Covid-19. We encourage everyone to take the opportunity to get vaccinated!

Haddad & Holloway Team

Workman's Compensation Act

Did you know you may be entitled to Physiotherapy if you have been injured at work?

All employees should be able to access medical treatment for injuries sustained at their workplace by accessing benefits that fall under the COID (Compensation for Injuries on Duty) Act.

Employers are obligated to report an injury on duty incident within 7 days from the date the employee has reported the incident, or the Employer became aware of it. This should be done through the Compensation Fund’s Compeasy online system. A claim number will be generated on the system. The injured employee needs to see a medical doctor as soon as possible to fill in a medical report (not all doctors treat IOD (Injury On Duty). The relevant doctor then manages all medical services required.
It is important to ensure that all the requirements are met, and all documents are filled in accurately.

Physiotherapy services can be accessed if the doctor managing the case gives a referral for Physiotherapy.
Haddad & Holloway treat injuries covered by the Compensation Fund at our practice, as well as those that are insured through FEM (Federated Employers Mutual Assurance), and RMA (Rand Mutual Assurance), as long as all the documentation is in order, with a doctor’s referral.

If you are unsure, try giving us a call for tips on how to manage the process!

Haddad & Holloway Team

Covid-19 Long-term Effect Series:

Managing Fatigue associated with Long-Covid

“Apply the 3 P’s Principle: Pacing, Planning and Prioritising”

Pacing:
Break activities up into smaller tasks and spread it through the day and plan rest breaks between activities. You may continue until you feel tired, but not exhausted. It will take longer to recover if you push yourself to exhaustion.

Planning:
Putting some thought into how you will go about an activity will help you to be as efficient as possible. Collecting all items you need beforehand will improve your efficiency during a task. Utilizing available help from family, visitors and co-workers can reduce the physical demand of the task. Planning your rest breaks and think carefully which time of the day will be best for the activity will help in managing how tired you get during tasks. A weekly activities chart for things such as gardening, laundry and food shopping on different days will help with recovery between tasks.

Prioritising:
There are some daily activities that are necessary while others aren’t. Ask yourself the following questions to find out which of yours are necessary:
What do I need to do today?
What do I want to do today?
What can be put off until another day?
Can I ask someone else to do it for me?

Other energy conserving tips:
Do not hold your breath during any task; don’t lift, push or pull objects that are too heavy and get enough good quality sleep.

If you continue to struggle with fatigue issues in your daily life post-covid, you may need to seek professional help from your Doctor or a Physiotherapist.

Covid-19 Long-term Effect Series:

The novel Covid-19 virus has affected individuals across the world as well as the health system as a whole. Research shows that most people who contract the virus recover well, while some continue to suffer from certain symptoms. This has been named Long-Covid referring to the long term effects the virus can have on the systems of the body. These include:

- Fatigue
- Shortness of breath
- Persistent cough
- Joint / chest / muscle pain
- Headaches
- Fast or pounding heart beat
- Loss of smell or taste
- Memory and concentration issues "brain fog"
- Sleep disturbances

If you have been experiencing any of these symptoms after your initial recovery from Covid-19, you may want to seek medical advice from a General Practitioner or a Physiotherapist. These symptoms may present in individuals who have had mild to moderate cases.

For more information on this topic please click on the link below.
https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwihtOCU5LbvAhXYWRUIHRIsBRUQFjAAegQIAhAD&url=https%3A%2F%2Fwww.tamesidehospital.nhs.uk%2FDocuments%2FTamesideandGlossopPostCOVID19PatientInformationPack.pdf&usg=AOvVaw1D5vuhnZHPOWEhVT0P4dgO

Haddad and Holloway Physiotherapy updated their website address.

Meet the Team!

Jessie Haddad

"I was qualified as a Physiotherapist at Wits University in 1994. I spent most of my career in Private practice, in the Clovelly and Fish Hoek areas. I like to approach treatment from a holistic perspective with a strong focus on prevention of further occurrences in the future, through rehabilitation and working to educate and empower patients to self manage their health and well-being. I completed the national pain course in 2014, which has helped me develop my work in the field of chronic pain."

Meet the Team!
Lanice Holloway

“I started my Physiotherapy career in 1999 in the military at the Institute for Maritime Medicine in Simon's Town. During this period I assisted at many military and civilian sports tournaments. I was the physiotherapist for a professional Muay Thai kickboxing team and was chosen as the Navy physiotherapist for the Commonwealth Navy Rugby Cup in 2006. With a developing interest in sport physiotherapy I completed my SPT1 course in 2007 while in private practice at Longbeach Physiotherapy in Noordhoek. In 2010 I opened my own private practice in Plumstead where I still am today. With my partner, Jessie Haddad, we decided to pool our experiences and open Haddad and Holloway in Fish Hoek. Together with Marlene Beuster and Andrew Kleyn we hope to provide a comprehensive, accessible physiotherapy service to our community.”

Meet the Team!
Marlene Beuster

“I have many years of experience in various fields of Physiotherapy, including Orthopaedics (especially back and neck conditions), Respiratory conditions, TMJ conditions, Work-related injuries and post-operative breast cancer complications. I am currently continuing my education on pain management. I enjoy working with a variety of patients of all ages, but particularly assisting older patients to stay as active as possible. My approach to Physiotherapy is holistic, encouraging healthy lifestyle changes and empowering my patients to manage their conditions more effectively.”