An ongoing series of informational entries about the world of Neurological Physiotherapy 

Exercise and Bone Density

June, 2019

An important aspect of our overall health that we rarely think about is the density of our bones. Bone density is the measure of bone minerals in our bone tissue which helps make our bones fit and strong. The stronger our bones, the more resistant they are to fracture and injury. 

As we age or if we experience long periods of physical inactivity, our bones become less dense and therefore we become more at risk of injury. This is particularly significant because as we age our balance can also begin to deteriorate which then increases our risk of falls and therefore increases our risk of fracture again. Fractures may seem like a simple fix, just pop a cast on it and let it rest up. But fractures can be particularly dangerous as we age as we become more likely to suffer from hip and spinal fractures which result in longer periods of physical inactivity and decreased strength and mobility.

As scary as this sounds, we can decrease the decline in our bone density or increase it! Exercise is a safe and effective way of ensuring that our bones remain healthy and strong. Our bones respond to gravity and resistance, therefore by training our muscles with weights and walking or using a treadmill or a stationary bike we can limit bone loss and continue to increase our overall strength. Exercise also helps to develop our balance, therefore reducing our risk of falls, therefore,  the positive effects go full circle. 

If you have any concerns about our ability to exercise or if you are safe to exercise please contact your GP for clearance prior to beginning any exercise programme.


An ongoing series of informational entries about the world of Neurological Physiotherapy 

Managing Fatigue in MS

May, 2019

Fatigue in Multiple Sclerosis is still not completely understood. What is known is that it is different from normal ‘tiredness’ and can be one of the most debilitating and poorly managed symptoms of MS. Although there is no single cure for fatigue, if self-managed correctly it can drastically improve the quality of your life. People often describe fatigue as an overwhelming sense of tiredness, which is not necessarily linked to an increase in physical function. The key to improvements in fatigue is Self Management. We must be completely in tune with our body and prepare, prioritise and plan our days to see improvements in neurogenic fatigue. 

There are two types of fatigue and it is imperative that you can differentiate between them as the type of rest required is also dependant on the type of fatigue you are experiencing at the time. 

1. Physical Fatigue: Physical fatigue is when your body feels tired. Your mind may feel like it can go on but your body just does not have the energy to do anything further. Maybe your legs even start to give way, or you are not able to finish unloading the dishwasher. This type of fatigue is also described as motor fatigue. Co-ordination can also suffer from motor fatigue and speech might begin to slur.

2. Cognitive Fatigue:  Cognitive fatigue might also be described as ‘brain fog’ it becomes increasingly difficult to follow a though plan, you may struggle to find the right word to use and concentration can also be reduced. Cognitive fatigue is usually related to an overwhelming desire to close your eyes and sleep 

Scheduling Rests: Scheduled rests can be a fundamental part of fatigue management for some people. Resting does not necessarily mean sleep, it may also mean quiet time and/or meditation. The important thing to remember is the type of rest you need is dependent on the type of fatigue you are experiencing! 

Physical Fatigue: resting should incorporate reading a book, solving a puzzle or maybe even listening to music- anything that does not require you to use your muscles and expend energy. On hot days, it is appropriate to cool yourself down with a cool towel, which should also help fatigue levels

Cognitive Fatigue: it is imperative that your resting periods do not include electronics, reading or TV. This is not giving your mind a rest. People who suffer from cognitive fatigue respond much better from relaxation and meditation time where they can give their mind a rest. Something as simple as taking 10minutes to sit in the car and work on relaxation breathing before rushing off to complete your next task can make a huge difference to your fatigue levels. 


An ongoing series of informational entries about the world of Neurological Physiotherapy 

How do we make Neuro-plastic changes in Physiotherapy?

October, 2016

The brain is constantly in the process of making Neuroplastic changes that enables us to learn, change and adapt. To put simply in terms of neurological deficit, if an area of the brain is not functioning at optimum capacity, then bypassing this area of the brain by creating new pathways can lead to improved function, this is what we would call Neuroplasticity. This concept is nothing new to the physiotherapy world, in fact, the brain is making thousands of neuroplastic changes every second, it is how we use the concept of neuroplasticity to our advantage within our practice that really amplifies our results.