Online bookings: http://nataliecuttenphysiotherapy.bookem.com
Senior Physiotherapist & partner candidate
Gavaza graduated with an honours degree in Physiotherapy from the University of Cape Town (UCT). She has 10+years' experience and has a special interest in shoulders. Her passion for physiotherapy is evident through her ongoing dedication to working with patients hospitalised in ICU with complex orthopaedic injuries. She also has a passion for lung physiotherapy.
Practice owner & specialist musculoskeletal physiotherapist
Natalie has 17 years of experience as a physiotherapist. I have worked at Linksfield and Parklane hospitals as well as in Oslo, Norway. She completed my BSc in Physiotherapy in 2006 at Wits; and the South African Society of Physiotherapy (SASP) yearlong sports physio modules (SPT1).
USA
EMS Swiss dolorclass shockwave therapy is the only FDA approved shockwave machine. At Natalie Cutten Physiotherapy we have the same model used by the Springbok rugby team, and the only SWT unit in Sandton. Shockwave Therapy is a physical force that remodels soft tissue by bringing in fibroblast cells to lay down new muscle fibres. Clinical trials show EMS Shockwave significantly improved the tensegrity of soft tissue structures. Whats great about EMS Shockwave Therapy is there is no downtime. Post shockwave patients should load the affected injury to achieve maximal effect of EMS Shockwave Therapy.
Germany
Deep Oscillation Therapy from Germany is CE approved, and works collaboratively with Shockwave Therapy. The electrostatic current penetrates 8cm deep, and physically moves inflammation out of an area. The electrostatic current changes the permeability of cell membranes, which is incredibly complex. The treatment feels soothing, results are evident within 2 days. Indications we have used the device for at the practice are significant and chronic swelling post-Achilles rupture surgery, post-surgical swelling of shoulder replacements, and lymphedema in oncology patients.
The fascia is a tensile web like structure that envelops all of our organs. It is a connective tissue that groups entire muscle complexes together. Physiotherapy restores parallel alignment of the collagen fibres, restoring tensegrity; the ability of the fascia to absorb physical forces. Soft tissue release is the process of creating a mobile scar. My method of mobilising soft tissue is dynamic. Mobilising a muscle occurs in 3 phases. Firstly with the muscle off the stretch, progressing to working on the muscle on the stretch. Rehabilitation is completed with soft tissue release of the muscle whilst contracting the muscle. Movement is dynamic, therefore we need to align the collagen fibres of a muscle in a dynamic manner.
Following an injury, especially a severe one like an injury to the spine we can become fearful of moving the affected area. Due to this we may also employ compensation strategies by overusing other areas of our body. Where I come in is to re-establish safety of movement, illiminate compensation, and then progress to targeted strengthening. This entails strengthening prime movers in an acceleratory or deceleratory way. Strengthening may also entail core stabilisers of the neck or lumbar spine if indicated.
Mulligans mobilisations, or mobilisations with movement are backed by clinical evidence to provide immediate relief. They are painfree physiotherapy techniques that provide instant outcomes, and long lasting effects. Joint mobilisations entail correcting minor positional faults causing loss of joint range of movement. Repositing joint surfaces to achieve pain free resolution of musculoskeletal problems. Physiotherapy is indeed an art, not a science.
Dry Needling & taping
Dry needles are used to aid pain caused by trigger point referral. Needling works by flushing a trigger point with nutrients, contributing to accelerated healing. Kineseo taping is used to contribute to alleviating inflammation by lifting the skin. A lattice taping can be used to massively accelerate bruise healing, and contusions. Clinical evidence shows that taping with the fibres of a muscle stimulate contractility of a muscle, whereas taping perpendicular to muscles fibres inhibits muscle fibres.
Each patient is unique, and circumstances unique. Common pathologies I see are wry neck, or discogenic/facet joint related pain. These would need to be diagnosed based on movement. Another culprit that I find is contributing significantly in our busy lives is upper crossed syndrome. This occurs when sitting in a static position for many hours. We present with a poking chin, and elevated tight shoulders. Causes of this are weak neck eccentric (deceleratory) core stabilisers, elongated and weak lower trapezius muscles, overactive and tight upper traps, as well as overactive and tight pectoralis muscles. I can assist you by going through a quick practical exercise program with you. Clinical evidence shows 6 counts of 6 reps of core stabilisers exercises 3 x a week is the bare minimum to provide stability. This is certainly manageable!
Pathology of the lumbar spine includes disc bulging, facet joint immobility, and radiculopathy of certain pathways of the sciatic nerve. However, what is a commonality regardless of the pathology, is associated movement disorder of either bending forward or backwards. My flexion rehabilitation program entails cognitive rehabilitation, and eccentric control of the paraspinal muscles. It also encourages feeling safe during flexion movement. Two flexion patterns occur, either you move with the spine as a rigid board, or due to a lack of hip hitching resulting in excessive lumbar spinal flexion. I work with you doing simple exercises to correct these movement disorders, which illiminates pain immediately. Pain on leaning back (extension) follows a similar situation of fear of movement, resulting in a rigid spine, and excessively tight paraspinal muscles. By going through my guided extension mobility exercises, we can rehabilitate this pattern of movement. Current clinical evidence shows that rehabilitation of these movement patterns instead of core stability exercises is producing brilliants results in pain illimination immediately.