Apr 19

Patello-Femoral Syndrome (PFS) is the medical name for a condition that causes pain in and around the front of the knee and effect all ages in all walks of life.

The patella (kneecap) is designed to move smoothly within a ready made   groove on the femur (thigh bone)

When the patella is not moving or “ tracking” properly within its’ groove, anterior knee pain can develop.  Noises are often associated with PFS, and in some cases , can be disregarded. Some people will just have loud  knees when they squat, lunge or go up steps!

It is always best to have this assessed sooner rather than later to avoid further deterioration.

 

Causes of Patello-Femoral Syndrome?


Muscle imbalances in the quadriceps ,especially the inner quadricep (the VMO)  can be due to many contributing factors. This imbalance can place stress on the patella, causing it to sit or move incorrectly within its groove and placing stress on the surrounding knee tissue resulting in pain. More pressure may then be placed on the cartilage underneath the patella.  In time, the pressure may cause damage to the articular cartilage which can lead to arthritis.

Issues contributing to imbalances of the quadriceps can be:

  • Your walking mechanics including foot alignment
  • Weakness around the hip ( hip drop or weak gluteals)
  • Poor single leg balance
  • Your knee leg alignment and joint shape that you inherit genetically
  • Walking on a bent knee due to pain, stiffness or following surgery


Signs and Symptoms:

  • Pain with steps, squatting, getting up and down from a chair
  • Pain with driving or prolonged sitting
  • Knee occasionally feeling like it could give way secondary to pain.
  • Pain with hills, bike riding, step machine, gym classes

 

What treatment is available?

Having been identified as suffering PFS you may be recommended to trial a brief course of physiotherapy over a 6 week period to achieve favorable results.  Our research suggests that 85% of Patello Femoral pain will resolve within 6 weeks of a specific specialized program.

You will be required to do some very basic exercises and sometimes a short course of taping to assist in reducing pain around the knee. Reducing your pain will again encourage a quicker recovery process in which YOU are in control of!

If your alignment is an issue, you may be asked to see a Podiatrist to issue devices (orthotics) that can help in correcting both foot and knee alignment together.

PFPS can be treated successfully with physiotherapy and is the most commonly recommended option of management by knee specialists.

Mar 29

Cholesterol is a hot topic in 2012.  The focus is set off by a change in the pharmaceutical drug industry.  No longer will one pharmaceutical company have the rights (patent) to sell a medication aimed at reducing cholesterol.  This medication is called Lipitor.  It is the highest selling medication in Australia, millions of prescriptions are written for it each year.

One of the reasons the medication is in high demand is because so many people have high levels of cholesterol.  There are many natural treatments for cholesterol, these are without the side effects of the pharmaceutical drugs.  Muscle pain is a very common side effect of taking medications called statins that include Lipitor.

Vitamin D has been shown to increase the effectiveness of these medications, which means being able to reduce the amount of drug required, as well as improving cholesterol levels on it’s own.

Other natural treatments that have been scientifically proven to improve cholesterol levels include diet and lifestyle changes, omega 3’s-particularly EPA from fish and krill oil.

For natural ways to improve your cholesterol and vitamin D levels email or visit Whole Life Naturopathy at The Sports Injury Clinic.  We stock quality Krill oil, Fish oil and vitamin D supplements.  The Naturopaths can also prescribe diet and lifestyle changes to improve your cholesterol levels.

 

Mar 29

The most common Arthritic conditions we see:

  • Osteoarthritis, Rheumatoid Arthritis.

Other less-common Arthritic conditions we see:

  • Juvenile Arthritis, Psoriatic Arthritis, Reactive Arthritis, Fibromyalgia.

 Stats:

  • 10% of the population are diagnosed with OA/ Rheumatoid disorders.
  • Approximately 62% of people with Arthritis are of working age (15-64 years of age).
  • Over 70 years of age greater than 80% have some symptoms of the disease but only 25% are aware of it.

 Common functional limitations

  • Interferes with weight bearing and ADLs (All Daily Living) activities.
  • Early stages – pain end of day with continued weight bearing or lower limb activities.
  • Progressive degeneration – increased difficulty rising from chairs, stairs, bathing, toileting and dressing i.e. putting on pants socks etc.

Impairments

  •  Pain with mechanical stress or excessive activity
  • Pain at rest in the advanced stages
  • Stiffness after inactivity
  • Limitation of motion
  • Muscle weakness
  • Decreased proprioception and balance
  • Functional limitations in ALD’s

Benefits of a soft tissue (massage) regime for Arthritis sufferers

Massage therapy is beneficial to reduce the impact of the muscular effects of most of the arthritic conditions we see. Due to decreasing joint mobility and inflammation the muscular system becomes stiffer and therefore more conducive to increased joint pressure, stress and pain.

 Massage treatment can assist in:

  • Reducing mechanical joint stress of surrounding soft tissues
  • Reducing muscle aches and cramps
  • Increasing circulation
  • Increasing range of movement of joints
  • Improve neuromuscular control, strength and muscular endurance
  • Improve balance
  • Improve physical conditioning
  • Improve sleep and general feeling of well being
  • Massage trial results (2006)

Perlman, A.I., 2006. Massage Therapy for Osteoarthritis of the Knee: A Randomized Controlled Trial.

 

Relaxation (Swedish) techniques are safe and effective for reducing pain and improving function in patients with symptomatic OA of the knee at 8 and 16 weeks.

Treatment plan:

  • Weeks 1-4 twice weekly (1 hour session)
  • Weeks 5-8 once weekly (1 hour session)

Common myths dispelled

  •  “People with arthritis shouldn’t exercise.”
  • “There are always people making claims that Arthritis can be cured.”
  • “Arthritis is an old person’s disease.”
  • “Cracking joints causes Arthritis.”
  • “Massage will increase inflammation.”

 

**Our Remedial Massage & Myotherapists are highly qualified and are fully covered under their alternate Associations. They are also claimable against private health rebates for Remedial Massage & Myotherapy.

 

For more information on Massage and Myotherapy for any of these conditions please use this link:

http://www.arthritisvic.org.au/pages.asp?d=5A4C5A717251477C7008060F060209

 

 

 

 

Mar 29

As a parent you are always concerned for your child’s well being, so what do you need to be aware of?  Children are prone to getting different injuries than adults due to their musculoskeletal immaturity.  Have you ever hear the expression kids are like rubber?  The reason being is that their ligaments (structures supporting joints) are very lax, which makes their bones more vulnerable to injuries and breaks.  The situation reverses once they have reached maturity and as an adult you are more likely to damage your ligaments before breaking bones.

When a child starts developing pain they will start compensating for it immediately.  Different compensation strategies commonly seen are limping, awkward running patterns or they become apprehensive when participating in school sports.  If you notice any of these behaviour’s with your children then it is imperative that you seek advice from your regular doctor or physiotherapist.  If biomechanical abnormalities are picked up from an early age physiotherapists are able to reduce the likelihood of orthopaedic issues down the track.

 

Common conditions that physiotherapists treat in children are:

  • Scoliosis (back)
  • Hip dysplasia
  • Sever’s disease (heel)
  • Osgood Schlatters (knee)
  • Sinding- Larson-Johansson (knee)

 

For further information please log onto www.tsic.com.au/yourinjury

 

The Most Common Sports-Related Injuries in Kids

Although sports injuries can range from scrapes and bruises to serious brain and spinal cord injuries, most fall somewhere between the two extremes. Here are some of the more common types of injuries.

Sprains and Strains

A sprain is an injury to a ligament, one of the bands of tough, fibrous tissue that connects two or more bones at a joint and prevents excessive movement of the joint. An ankle sprain is the most common athletic injury.

A strain is an injury to either a muscle or a tendon. A muscle is a tissue composed of bundles of specialized cells that, when stimulated by nerve messages, contract and produce movement. A tendon is a tough, fibrous cord of tissue that connects muscle to bone. Muscles in any part of the body can be injured.

Growth Plate Injuries

In some sports accidents and injuries, the growth plate may be injured. The growth plate is the area of developing tissues at the end of the long bones in growing children and adolescents. When growth is complete, sometime during adolescence, the growth plate is replaced by solid bone. The long bones in the body include:

  • the long bones of the hand and fingers (metacarpals and phalanges)
  • both bones of the forearm (radius and ulna)
  • the bone of the upper leg (femur)
  • the lower leg bones (tibia and fibula)
  • the foot bones (metatarsals and phalanges).

If any of these areas become injured, it’s important to seek professional help from an orthopaedic surgeon, a doctor who specializes in bone injuries.

Repetitive Motion Injuries

Painful injuries such as stress fractures (a hairline fracture of the bone that has been subjected to repeated stress) and tendinitis (inflammation of a tendon) can occur from overuse of muscles and tendons. Some of these injuries don’t always show up on x rays, but they do cause pain and discomfort. The injured area usually responds to rest, ice, compression, and elevation (RICE). Other treatments can include crutches, cast immobilization, and physical therapy.

Heat-Related Illnesses

Heat-related illnesses include:

  • dehydration (deficit in body fluids)
  • heat exhaustion (nausea, dizziness, weakness, headache, pale and moist skin, heavy perspiration, normal or low body temperature, weak pulse, dilated pupils, disorientation, and fainting spells)
  • heat stroke (headache, dizziness, confusion, and hot dry skin, possibly leading to vascular collapse, coma, and death).

Heat injuries are always dangerous and can be fatal. Heat-related injuries are a particular problem for children because children perspire less than adults and require a higher core body temperature to trigger sweating. Playing rigorous sports in the heat requires close monitoring of both body and weather conditions. Fortunately, heat-related illnesses can be prevented.

Preventing and Treating Injuries

Injuries can happen to any child who plays sports, but there are some things that can help prevent and treat injuries.

Prevention

  • Enroll your child in organized sports through schools, community clubs, and recreation areas that are properly maintained. Any organized team activity should demonstrate a commitment to injury prevention. Coaches should be trained in first aid and CPR, and should have a plan for responding to emergencies. Coaches should be well versed in the proper use of equipment, and should enforce rules on equipment use.
  • Organized sports programs may have adults on staff who are Certified Athletic Trainers. These individuals are trained to prevent, recognize, and provide immediate care for athletic injuries.
  • Make sure your child has—and consistently uses—proper gear for a particular sport. This may reduce the chances of being injured.
  • Make warmups and cool downs part of your child’s routine before and after sports participation. Warmup exercises, such as stretching and light jogging, can help minimize the chance of muscle strain or other soft tissue injury during sports. Warmup exercises make the body’s tissues warmer and more flexible. Cool down exercises loosen muscles that have tightened during exercise.
  • Make sure your child has access to water or a sports drink while playing. Encourage him or her to drink frequently and stay properly hydrated. Remember to include sunscreen and a hat (when possible) to reduce the chance of sunburn, which is a type of injury to the skin. Sun protection may also decrease the chances of malignant melanoma—a potentially deadly skin cancer—or other skin cancers that can occur later in life.
  • Learn and follow safety rules and suggestions for your child’s particular sport. You’ll find some more sport-specific safety suggestions below.

Treatment

  • Treatment for sports-related injuries will vary by injury. But if your child suffers a soft tissue injury (such as a sprain or strain) or a bone injury, the best immediate treatment is easy to remember: RICE (rest, ice, compression, elevation) the injury. Get professional treatment if any injury is severe. A severe injury means having an obvious fracture or dislocation of a joint, prolonged swelling, or prolonged or severe pain.

Keep Kids Exercising

Luckily for Raoul, his injury wasn’t serious. In a few weeks, he will be fully recovered and able to play again. Even though Raoul got hurt, it’s important that he continue some type of regular exercise and sports involvement after the injury heals. Exercise may reduce his chances of obesity, which is becoming more common in children. It may also reduce his risk of diabetes, a disease that can be associated with a lack of exercise and poor eating habits. Exercise also helps him build social skills and provides him with a general sense of well-being. Sports participation is an important part of learning how to build team skills.

As a parent, it is important for you to encourage your children to be physically active. It’s also important to match your child to the sport, and not push him or her too hard into an activity that he or she may not like or be capable of doing. Teach your children to follow the rules and to play it safe when they get involved in sports, so they’ll spend more time having fun in the game and be less likely to be sidelined with an injury. You should be mindful of the risks associated with different sports and take important measures to reduce the chance of injury. For sport-specific suggestions, see the information below.

Sport-Specific Safety Information

Here are some winning ways to help prevent an injury from occurring, so you are less likely to get that alarming phone call like Raoul’s mom did.

Basketball

  • Common injuries and locations: sprains; strains; bruises; fractures; scrapes; dislocations; cuts; injuries to teeth, ankles and knees. (Injury rates are higher in girls, especially for the anterior cruciate ligament (ACL), the wide ligament that limits rotation and forward movement of the shin bone.)
  • Safest playing with: eye protection, elbow and knee pads, mouth guard, athletic supporters for males, proper shoes, water. If playing outdoors, wear sunscreen and, when possible, a hat.
  • Injury prevention: strength training (particularly knees and shoulders), aerobics (exercises that develop the strength and endurance of heart and lungs), warmup exercises, proper coaching, and use of safety equipment.

Track and Field

  • Common injuries: strains, sprains, scrapes from falls.
  • Safest playing with: proper shoes, athletic supporters for males, sunscreen, water.
  • Injury prevention: proper conditioning and coaching.

Football

  • Common injuries and locations: bruises; sprains; strains; pulled muscles; tears to soft tissues such as ligaments; broken bones; internal injures (bruised or damaged organs); concussions; back injuries; sunburn. Knees and ankles are the most common injury sites.
  • Safest playing with: helmet; mouth guard; shoulder pads; athletic supporters for males; chest/rib pads; forearm, elbow, and thigh pads; shin guards; proper shoes; sunscreen; water.
  • Injury prevention: proper use of safety equipment, warmup exercises, proper coaching techniques and conditioning.

Baseball and Softball

  • Common injuries: soft tissue strains; impact injuries that include fractures caused by sliding and being hit by a ball; sunburn.
  • Safest playing with: batting helmet; shin guards; elbow guards; athletic supporters for males; mouth guard; sunscreen; cleats; hat; detachable, “breakaway bases” rather than traditional, stationary ones.
  • Injury prevention: proper conditioning and warmups.

Soccer

  • Common injuries: bruises, cuts and scrapes, headaches, sunburn.
  • Safest playing with: shin guards, athletic supporters for males, cleats, sunscreen, water.
  • Injury prevention: aerobic conditioning and warmups, and proper training in “heading” (that is, using the head to strike or make a play with the ball).

Gymnastics

  • Common injuries: sprains and strains of soft tissues.
  • Safest playing with: athletic supporters for males, safety harness, joint supports (such as neoprene wraps), water.
  • Injury prevention: proper conditioning and warmups.

Treat Injuries with “RICE”

Rest: Reduce or stop using the injured area for at least 48 hours. If you have a leg injury, you may need to stay off of it completely.

Ice: Put an ice pack on the injured area for 20 minutes at a time, four to eight times per day. Use a cold pack, ice bag, or a plastic bag filled with crushed ice that has been wrapped in a towel.

Compression: Ask your child’s doctor about elastics wraps, air casts, special boots, or splints that can be used to compress an injured ankle, knee, or wrist to reduce swelling.

Elevation: Keep the injured area elevated above the level of the heart to help decrease swelling. Use a pillow to help elevate an injured limb.


Play It Safe in the Heat

  • Schedule regular fluid breaks during practice and games. Kids need to drink 8 ounces of fluid—preferably water—every 20 minutes, and more after playing.
  • Have your child wear light-colored, “breathable” clothing.
  • Make player substitutions more frequently in the heat.
  • Use misting sprays on the body to keep cool.
  • Know the signs of heat-related problems, including confusion; dilated pupils; dizziness; fainting; headache; heavy perspiration; nausea; pale and moist or hot, dry skin; weak pulse; and weakness. If your child experiences any combination of these symptoms or doesn’t seem quite right, seek medical attention immediately.

Adapted with permission from Patient Care magazine, copyrighted by Medical Economics.


Safety Tips for All Sports

  • Be in proper physical condition to play the sport.
  • Follow the rules of the sport.
  • Wear appropriate protective gear (for example, shin guards for soccer, a hard-shell helmet when facing a baseball or softball pitcher, a helmet and body padding for ice hockey).
  • Know how to use athletic equipment.
  • Always warm up before playing.
  • Avoid playing when very tired or in pain.
  • Get a preseason physical examination.
  • Make sure adequate water or other liquids are available to maintain proper hydration.

Adapted from Play It Safe, a Guide to Safety for Young Athletes, with permission of the American Academy of Orthopaedic Surgeons.



 

 

Feb 13

The events on Sunday the 8th January 2012 at round 2 of the Ironman Series at Portsea was an amazing site to see, I have been at many sporting events in my life but never one of these, I had seen a few on the news over the past few years but never really thought of going down or trying to get involved.

I was set up in the Red bull tent with a massage table alongside my colleague Sarah Kenner waiting to see if we could be of any assistance but they all had their own staff and plan before the race.  To be there and witness the meticulous preparation and personal rituals of each athlete from blaring an iPod to psych themselves up or to the few that sat and meditated on what they were about to do, to the preparation by all the other hand whether it be family or friends,  this offered a fresh perspective on the sport.

The atmosphere was very different when compared to the old club rooms of the local footy team, it was quiet with an undertone of seriousness. Everyone was in direct competition they travel and compete with each other all summer, they know who and what to watch for, surveying the beach and planning their approach to the surf. After the race there was an instant change, all smiles and congratulating one and other, talking tactics and complementing each other on their performance.

Sarah and I were not needed until the Ironwoman had finished their race then we preformed the warm down and got a chance to talk to these athletes, despite there achievements they are still just like us, after the ironmen had finished they were more interested in going home having a shower and a quiet beer at the pub to discuss what unfolded during the day.

For me it was a great introduction to the sport and a wonderful experience to meet these people. I still remember standing on the beach watching them swim out to the first buoy and joking at about half way “well that would be me done”, I have a great respect for people with such drive and determination and I would be glad to do it again next year.

Feb 13

2012 Physio For You – Active for Summer  Click on this link to read aout getting active this summer safely.

Jan 24

The most common type of elbow pain is known as ‘tennis elbow’ occurring on the outside of the elbow where the tendons that assist with grip strength attach to the bone. ‘Golfer’s elbow’ is a less common but similar injury that occurs on the inside of the
elbow. Overuse of the elbow joint causes low grade tendon damage, or ‘tendinopathy’ and can include small tears to form in the soft tissue of the tendon, particularly where the tendon anchors to bone. These injuries can also occur as a result of a variety of sports and occupations.

If the pain occurs over a long period of time, they can cause pain and also reduced movement of the elbow joint. Depending on the location and severity of the injury, full recovery can take months and requires the correct diagnosis and a structured physiotherapy plan. Investigations can now be carried out to view the tendon and determine if any medical intervention is needed. We tend to not use cortisone for these injuries as the tendon does not actually have inflammation cells inside of it despite previous theories. Modern day management of tendons is very specific.

If you have pain with daily tasks our Physiotherapists can show you different ways to use your elbow and arm that is correct and take the load out of the tendon your are damaging without realizing! If your sport is contributing to your elbow pain then this
can also be assessed and recommendations to improve technique and exercises to strengthen may help.

Symptoms

Some of the symptoms of elbow pain include:

  • Pain in the elbow joint, especially when straightening the arm
  • Dull ache when at rest
  • Pain when making a fist or gripping and twisting
  • Soreness around the affected elbow bump
  • Weakness in your grip
  • Difficulties and pain when trying to grasp objects, especially with the arm stretched out.

A range of causes

Some of the many conditions and events that may contribute to elbow injuries
include:

  • Lack of strength or flexibility in the forearm muscles
  • Lack of strength in the shoulder muscles
  • Static use of elbow/wrist at the computer. Outstretched arm using the mouse.
  • Instability of the elbow joint
  • Poor technique during sporting activities (especially tennis and golf) that puts too much strain on the elbow joint . Our Tennis Physios can help sort out your technique or give you some strength work to do to recover more rapidly
  • Inappropriate sporting equipment, such as using a heavy tennis racquet or having the wrong sized grip on a tennis racquet or golf club
  • Repetitive movements of the hands and arms, such as working on an assembly line
  • Continuously making the muscles and joint take heavy loads
Dec 15

Keen runners may be familiar with a muscle called ‘Tibialis Posterior’.  Usually the familiarity comes as a result of feeling deep posterior shin pain, a runner’s condition seen more commonly as the weather improves from now and people take to running, or running more often.

Initially, it may seem as a little niggle behind the inner ankle bone or shin. But the little niggle often gets worse over time as the stress on the muscle or tendon continues. It is often felt when walking or when lifting up on to the ball of the foot or when pointing the toes. It can be especially painful when walking on uneven surfaces, as this requires further stabilisation of the foot. Eventually, the pain can become very debilitating.  

Active ‘trigger points’ are tender hyperirritable spots in taut bands of muscle.  In Tibialis Posterior these trigger points can cause referred pain in the Achilles tendon above the heel and can radiate through the midcalf and over the entire plantar surface of the foot and toes.

Myotherapy is a great way to address the painful muscular component of this overuse injury. Through the use of dry needling and deep tissue massage techniques, myotherapists can help to relieve pain and discomfort by releasing the active trigger points and decreasing muscle tightness. This helps the muscle fibres to return to their normal resting length in order to promote optimal pain-free function, strength and range of movement.

Further corrective actions may consist of running or jogging on smooth surfaces and wearing shoes with adequate arch support. The use of orthotics and/or taping of the foot and ankle can also help to offload muscles and assist with arch support thus allowing tibialis posterior to heal. A running assessment can also be beneficial to ensure optimal biomechanics and technique in order to decrease unnecessary lower limb stresses. High heels should be avoided and choosing an alternative to running such as swimming or cycling, in the short term, can help to offload the muscle whilst recovery takes place.

Dec 15

The change of season often brings us an influx of new injuries with the shoulder being the prime target! Summer sports often bring forth shoulder and arm injuries due to changes in activity levels or simply the choice of summer sports.

Over head sports such as swimming, cricket, volleyball or repetitive sports such as paddling or tennis place a greater amount of load through the shoulder and often we have lost condition over the winter months. Postural changes such as ‘rounded shoulders’ or a slouching spine also dramatically effect the way the shoulder functions and can limit reach/flexibility and the strength in your shoulder.

Physiotherapist perform shoulder screening tests to assess the condition of your shoulder to your preferred sport and can give corrective exercises and a conditioning program that is specific to your sport. This greatly reduces the chance of a shoulder injury that can effect your summer sports.

What can get injured?

The rotator cuff (see fig 1)- these muscles help to stabilize your shoulder and give you strength above shoulder level. Rest alone will not help rotator cuff injury and can make your shoulder weak and more susceptible to shoulder complaints. Our Physiotherapists can perform tests and recommend the correct scans to determine if you have a rotator cuff injury. Sometimes the rotator cuff need surgery to repair the damage. This is critical to having a shoulder that works long term if required!

The Labrum ( cartilage) and ligaments in your shoulder. This can lead to a shoulder that ‘moves too much’/ feels ‘sloppy’ or ‘clicks’ and needs a precise strength program. A lot of generic gym programs can injure these shoulders so get an expert program from our Physiotherapists  to direct you for your gym program

The AC and Shoulder Joint (gleno-humeral joint) this can lead to arthritic changes and must be assessed immediately

Frozen Shoulder (where your shoulder stiffens up dramatically). This is often missed as a diagnosis and our Physios are trained to assess and direct you for the appropriate treatment. This may involve specific shoulder injections to turn it around a little quicker as it can last for 18 months to 3 years.

 What will the Physiotherapist do?

Perform the shoulder screening tests to assess your shoulder

Give you advice on what technique changes may be needed (eg swimming /throwing/padding/tennis). Yes our physios understand your sport and can recommend better ways of perform your sport to assist in keeping you active and reducing further injury. They will also communicate with your coach if required to assist with training.

Give you a specific timeframe for your  exercises expected recovery time .You may be  referred  to a specific Shoulder Specialist if required.

 

Dec 15

Did you know that on average ½ our yearly weight gain is stacked on in the 6 weeks in and around our Christmas and New Year’s celebrations?

What the real killer is rarely is this weight lost, and accumulates over the years which can lead to serious consequences for your health. What can we do about it? Follow these simple tips, or come and see one of The Sports Injury Clinics Exercise Physiologists to help develop a plan for you to avoid becoming one of the statistics.

Simple Tips:

1 – Be realistic: Water with a slice of lime and a tuna salad will not be the food consumed on Christmas day or at the work Christmas party. Nor will a pump class or 1hr walk be high on the priority list. Enjoy these days but if you exercise effectively and eat well on the days leading up to and following these functions, the waistline won’t take such a hit.

2 – Plan: Generally speaking we have more time over the festive season to celebrate, with more time comes more opportunity – To exercise! An effective workout can take less than 30mins, sprinkle these throughout your festivities to good effect, or better still catch up with a girlfriend over a walk rather than a coffee and a cake, or walk a round of golf with a mate rather than meeting at the pub.

3 – Get out and enjoy the Sun at every opportunity: Slip, slop slap and walk, swim, ride, surf or paddle your way to a better chance of surviving the holiday period without having to make an outrageous New Year’s resolution, or buying an “ab pro” from late night advertising.

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