​Pacing is the term given to the strategy of managing fatigue and other symptoms in chronic conditions including post-viral fatigue, Long Covid, fibromyalgia, chronic fatigue syndrome (ME/CFS) and many others.
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What this looks like can be slightly different for everyone, but it essentially means being strategic about how you coordinate your life scheduling rest around activities and listening to your body, stopping before your body reaches tipping point. This requires understanding your baseline (which can unfortunately fluctuate), recognising your triggers and structuring your day, week and even month accordingly.

The idea with pacing is to be one step ahead of your body to avoid flares and reduce the severity of post-exertional malaise otherwise known as PEM. PEM is a delayed exacerbation of symptoms (especially fatigue) that occurs in response to mental or physical exertion. For example, having to go out to a doctor’s appointment and doing a load of washing in one day could lead to a significant worsening of symptoms in the days following before returning to baseline. Some of you will know this pattern all too well! 

So, how can you get the most out of pacing?
Here are my 3 top tips for effective pacing.

​While we would love for the government to invest more in Australian’s musculoskeletal health, currently the only way to see a Physiotherapist using Medicare is if your GP has referred you under a Chronic Disease Management Plan – formally and still commonly called an Enhanced Primary Care Plan or EPC for short.
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​What’s an EPC?
An EPC (or Chronic Disease Management Plan) is a plan created by your GP for their patients who suffer from a chronic or terminal medical condition to see other medical providers – such as physiotherapists!

Am I eligible to get an EPC?
A chronic medical condition is one that has been (or is likely to be) present for six months or longer, for example, asthma, cancer, cardiovascular disease, diabetes, musculoskeletal conditions, and stroke. There is no list of eligible conditions, so it is up to the clinical judgement of your GP and the general guidelines set out in the Medicare Benefits Schedule. 

Winter’s here and now more than ever we’re all scrambling to find ways of improving our immunity and warding off the myriad of viruses that are waiting in the wings for a viable host.

​​Using food as medicine is a tool that we all have in our toolkit. We all eat right? So why not make your diet work for you and throw in some foods that have been scientifically demonstrated to reduce the frequency and severity of the winter bugs.
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Here are my top 5 flu flighting foods to add to your diet ASAP….

You may have seen the headlines recently about a new trial giving hope to millions suffering from back pain. This research was assessing to see if there were different outcomes between participants who received ‘Cognitive Functional Therapy’ (CFT) and those who received ‘usual care’.

(if you are interested you can read the abstract of the article on this link https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00441-5/fulltext)

Low back pain costs the Australian health system 4.8 billion annually (1) with the overuse of medicines, spinal surgery and passive treatments that focus on short term relief.

Historically our treatment options for persistent low back pain haven’t been very good…

Pain medications, bed rest and surgery are now recognised to have a limited role in helping most cases of low back pain. In fact, in some cases, these options can delay recovery and sometimes lead to further loss of capacity.
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However, there is hope and management is getting better…

Dysautonomia is the inability of the autonomic nervous system to regulate itself and is a common feature of Chronic Fatigue Syndrome (MECFS), Postural Orthostatic Tachycardia (POTS), Fibromyalgia and Long COVID.
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The autonomic nervous system consists of the parasympathetic (relaxation) and sympathetic nervous system and controls involuntary actions in the body including heart rate, blood pressure, digestive and bladder function. When the autonomic nervous system is constantly out of balance it can leave people with some debility symptoms which severely impact quality of life.

Chocolate, chocolate, chocolate! Easter is just around the corner and chocolate is everywhere.
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Celebrating and showing affection using chocolates and sugar filled treats has become an important and unavoidable part of our culture. It can be a difficult time for some of us who have health concerns around consuming so much sugary and processed foods. Maintaining moderation can be a huge challenge but there's no need to restrict yourself from this tasty treat altogether (unless you're allergic...please don't eat it!). You can however use the following tips and tricks to help reduce the impact of its many negative side effects!

With the recent pandemic it is estimated that up to one third of people who test positive for the spicy cough will experience ongoing symptoms for months and sometimes years after their acute infection. Unrelenting fatigue is by far the most common.
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Chronic fatigue can occur after any infection however there are some viruses that have earned a reputation for this. Glandular fever (Epstein Barr Virus), Ross River virus, influenza viruses and of course our new favourite SARS-CoV19 are all common culprits. The biological impact of viruses on our human health is complex and there is still much to learn however there are few things we do know about why we might feel such extreme ongoing fatigue after infection.

MITOCHONDRIAL DAMAGE
Viruses can alter the internal workings of the mitochondria to allow them to replicate more efficiently. This can cause damage to the mitochondria resulting in a reduction of ATP (energy) production, increased oxidative stress (free radicals) and increased cell death. When mitochondria are impaired by viral damage our capacity to produce energy is significantly reduced.

CHRONIC LOW-GRADE INFLAMMATION
The invasion of a virus triggers the release of several pro-inflammatory cytokines (chemicals that promote inflammation). This response can continue some time past infection and higher levels of certain inflammatory chemicals have been observed in patients with post-infectious chronic fatigue syndrome (ME/CFS) and long COVID. When the inflammatory process doesn’t resolve the way it should, ongoing chronic inflammation can result and this is thought to play a role in ongoing post-viral symptoms.
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As pre-season begins, it is common to sustain injuries as there is a sudden increase in the exercise load. Due to the high impact nature of soccer it is common for patients to sustain ankle and knee sprains, calf strains, bone fractures and head injuries; with muscle and tendon injuries being the most common.

In order to prevent the development of injuries particularly within this period of pre-season, it is important to incorporate an effective warm-up program, as well as implementing strength, balance and plyometric (explosive movement) exercises outside of training.

Christmas is just around the corner. What’s your celebration food? Seafood is my celebration food! This year I decided to make this beautiful salmon wreath cold platter.

This is a delicious sweet treat that is quick and easy to prepare. They are gluten and dairy free and have a higher protein content to most baked goods. They are also low in sugar and kids love them!
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Ingredients
1 3/4 cups almond meal
1 tsp baking powder (GF)
1 large mashed banana
2 eggs
1/4 cup olive oil
1/4 almond milk (or other milk of your choice)
1 tbsp honey
1 tbsp Chia seeds