MedGym - What conditions do we treat?

General strength and fitness

As we age we lose approximately 1% of muscle mass per year from the age of 40. At 60 we have about 20% less muscle mass than at age 40. It is very important to maintain muscle strength. Weakness can lead to falls and fractures, inability to compensate when out of balance, difficulty getting out of bed or a chair, getting up stairs, fatigue and pain. We all want to live a long but also active life. The vast majority of nursing home admissions are due to weakness, falls, and mobility issues. One could argue that as we age strength and fitness through regular exercise is more important than at any other age.

Diabetes

Diabetes is a group of chronic conditions where the body has difficulty in maintaining appropriate glucose levels. It is a progressive condition with many complications such as heart attacks, strokes, and permanent kidney, eye, and nerve damage. Very important in the process of halting or slowing the progression of diabetes is diet and physical exercise. We know that in diabetes the fat around the tummy and internal organs is the most damaging. Exercise burns glucose lowering its levels, mobilises fat burning and can lead to weight loss.

Balance and Osteoporosis

Balance issues can arise from many issues: poor eyesight, muscle weakness, nerve damage from diabetes or other conditions. Balance can be improved through specific exercises where the body's muscular and neurological systems are trained. Falls due to balance problems can lead to injuries and fractures. The most dreaded fracture is a hip fracture: according to statistics a third will die within a year of a hip fracture, another third will require nursing home placement. Risk of fractures is greatly increased with osteoporosis - this is a weakening of bones due to a variety of causes. See you GP to get a Bone Mineral Density scan (on Medicare if 70 or over) as there is no other way to diagnose this condition until a fracture. The primary treatment for osteoporosis is weight bearing exercise - which means performing such sports or exercises where bones are stressed through weight loading. Dumbbell or gym based exercises are excellent. Walking is good but does not load your arms (wrist fracture risk if osteoporosis). Exercise such as swimming is not useful for osteoporosis. Our Exercise Physiologists can devise a specific program for you for both balance and osteoporosis.

Osteoarthritis

Osteoarthritis is destruction of the cartilage within joints. You can be affected by osteoarthritis anywhere there are joints in the body. Some joints can be replaced such as knees and hips but this is not always an option in other joints such as the spine. There is a misconception that osteoarthritis is the result of 'wear and tear' of the joints and that exercise wears the joints even more - we now know this is not the case. Exercise is of utmost importance in management of osteoarthritis - keeping the muscles, tendons and ligaments strong around the joints actually prevents further deterioration and can improve function and pain. Often exercise therapy can delay joint replacement, or if replacement is inevitable then strengthen the muscles for faster and better recovery from surgery.

Cancer

Cancer is always a difficult challenge. As a cancer patient you may require surgery, chemotherapy, radiotherapy and other treatments. It can also be a difficult psychologically. Logic would tell us that after exhauting chemotherapy or radiotherapy one needs rest and recover but that is not the case. Exercise has been shown in many studies to improve cancer outcomes. We don't understand the exact mechanism but it has been shown that exercise strengthens the immune system creating more cancer-killing immune cells. Other chemicals are also released which improve our sense of wellbeing. This is now such a strong association that cancer units worldwide are installing gyms so that patients can exercise immediately after cancer treatments.

Cardiovascular

Cardiovascular disease is a widespread collection of conditions that affect the heart and blood vessels. Exercise is an important element in managing these conditions. The Heart Foundation and other such organisations worldwide advocate a minimum of 150 minutes cardio exercise weekly which equates to at least 30 minutes a day for 5 days a week - better still every day of the week. The Heart Foundation has released a free smartphone app for you to record your daily activity - mainly walking steps. Regular exercise reduces blood pressure, often reduces arrhythmias of the heart, improves exercise tolerance of the heart, and improves shortness of breath.

Pelvic Floor Weakness

Pelvic floor problems can be a source of embarassment in cases of unexpected urinary incontinence. There are two types of incontinence - urge (needing to go now and unable to hold) and stress (leaking when coughing, sneezing, lifting or bending). In other cases, pelvic floor weakness leads to prolapse - symptoms include heaviness or a dragging sensation and effects on bladder and bowel function. Specific pelvic exercises have been shown to help and are often the first line therapy. Unfortunately medication is not always helpful and surgery can be quite major.

Prostate Issues

Much is made of pelvic floor weakness in women but men can also have issues especially when they have had prostate surgery. Men after the diagnosis of prostate cancer focus on the treatment which is often the full removal of the prostate gland. Little is thought of or done about the likely consequences of surgery. Most men will have some degree of incontinence and erectile dysfunction. Many studies have now shown that specific exercise therapy to improve the pelvic floor can help to a large degree. Importantly this should be started before surgery!

Pre and Post Surgery or Medical Rehabilitation

Surgery is a disruptive treatment. If surgery or a medical condition lead to an extended stay hospital or lengthy period of inactivity then muscle wasting occurs almost immediately. For a good recovery, a targeted and specific exercise program needs to be constructed and implemented. In the case of joint replacement surgery, it is key to start a rehabilitation program before the surgery and continue afterwards. It is now routine to send patients straight home after a few days after joint replacement surgery (studies show patients recover faster with 'outpatient' rehab than with 'inpatient' rehab).

Depression and other mental health conditions

Mental health conditions strongly respond to regular exercise. Most doctors will tell patients that 30 mins of exercise per day is the equivalent of an antidepressant medication. The issue is however, that many of those with depression find it difficult to motivate and mobilise to do regular exercise. A structured program with exercise sessions set in a diary has been shown to help with compliance. Our Exercise Physiologists can act as your motivational support person.