Aging Together – Part 3

In my final Aging Together series, we will shift our focus to identifying the signs and symptoms of vision, hearing, weight, and mobility issues. In addition, I will also give some suggestions on how aging can be slowed down. More importantly, my role as a physiotherapist is to help older adults maintain independence or improve their mobility.

Signs and symptoms to look for:


  • Severe, sudden eye pain
  • Recurrent pain in or around the eye
  • Hazy, blurred, or double vision
  • Seeing flashes of light or sudden bright floating spots
  • Seeing rainbows or halos around lights
  • Seeing a “curtain coming down” over one eye
  • Sensing a “cup filling up with ink” in one eye
  • Unusual, even painful, sensitivity to light or glare
  • Swollen, red eyes
  • Changes in the color of the iris
  • White areas in the pupil the eye
  • Itching, burning, or a heavy discharge in the eyes


  • Muffling of speech and other sounds
  • Difficulty understanding words, especially against background noise or in a crowd of people
  • Trouble hearing consonants
  • Frequently asking others to speak more slowly, clearly and loudly
  • Needing to turn up the volume of the television or radio
  • Withdrawal from conversations
  • Avoidance of some social settings


  • Sudden loss of appetite
  • Sudden loss of weight without any reason
  • Changes to toileting habit or timing


  • Difficulty in performing ADLs
  • Changes in sleeping or sitting habits
  • Easily fatigued


Way to “slow down” aging

Playing Crosswords Puzzles or Sudoku

High cognitive engagement (such as doing crossword puzzles) may prevent or slow deposition of beta-amyloid, perhaps influencing the onset and progression of Alzheimer’s disease. It will also improve memory and brain function. On top of that, it helps overcome boredom and it encourages you to be sociable when you play in a group.

Playing musical instruments

It improves concentration, memory control, and fine motor skills. It helps older adults to build self-esteem and connect with people.


Walking is a form of simple physical activity which helps reduce blood pressure in some people with hypertension, improve your balance and coordination, and decrease your likelihood of falling. It also increases your confidence and mood, and helps older adults feel better all round which reduces anxiety or depression.

Resistance training

Resistance training builds muscle strength, muscle mass, preserve bone density, and promote independence. In addition, resistance training also has the ability to reduce the risk of osteoporosis and the signs and symptoms of numerous chronic diseases such as heart disease, arthritis, and type 2 diabetes,


How can I help you?

As mentioned, my role as a physiotherapist is to help people regain independence or maintain their current mobility state. I facilitate independence through the use of strength training, gait training, mobility exercises, soft tissue work, pain management or education. There is no hard and fast rule so I am unable to recommend my interventions professionally until I have assessed the individual. The only recommendation I will make is to encourage the carer to be present for all the physiotherapy sessions. This will enable them to understand, learn and manage the older adult

If you are not sure, we can have a brief phone consultation 03-62117533. Otherwise, you can book an appointment to see me through email or Whatsapp +6018-9828539.

Aging Together – Part 32018-08-30T15:05:32+08:00

Aging Together – Part 2

In my previous post, I discussed about how aging affects your loved one. In today’s post, I will write about how an aging loved one might affect you, what can you do about it and what are some important aging signs to look for.

An aging loved one can affect you in many ways:

       Time- transportation, specialist visit, daily support

       Finance- special diet, extra care, nursing/helper

       Mental health- stress, depression, anger

       Relationship- family tension, disagreements

       Fear- overprotective, negligence, indifferent

What can you do about it?

Person-centred care is a priority

Each elderly person has their own preferences and the right to be heard.

Give them their autonomy.

Offer your loved ones options instead of orders.

Dignity is crucial when working with elderly people

Many elderly people feel pain, sadness, boredom and loneliness. Their dignity is easily compromised, particularly if they require personal care needs.

Have social support

Learn, share and get advice from your friends/family

Striving to understand can make you a better carer

It’s important to remember that they may say things that don’t make sense, be impatient, or express outdated views, but they still deserve compassion.

Communication abilities can vary

If they have suffered a stroke for example, speech may be affected. Many older individuals also struggle to hear and carers may need to say words clearly. Anyone who works with the elderly should explore different methods of communication.

Determine what help is needed 

Make an honest assessment of what kind of help your loved one needs and which service might work best.

Depend upon your spouse.

You may find that your parent is more comfortable relating to your spouse than to you. Your spouse and your parent are peers to a degree that you and your parent can never be.

Prepare for sibling insanity.

Expect the worst from your sibling(s). Inheritance, assets etc

Take care of yourself 

Care for yourself and have fun.

Pray or meditate.

Open yourself up to God, whatever that might mean to you.

I am available for advice, just send me an enquiry on the contact us tab and I will revert back to you.

Aging Together – Part 22018-08-30T14:59:38+08:00

Aging Together – Part 1

In medicine, more than 65 years old is defined as elderly. How many of you are living with a loved one that are considered elderly? I am by no means an expert, but I have had the experience of working with the elderly throughout my career. Some people suggest that we should treat them like babies as they need a lot of cajoling and there is some truth in it…

My thoughts and indeed the purpose of this series of articles is to help give insight on how to manage and deal with the elderly.

What do you think about when you see the word Aging?

Superficially, it involves:

  • White hair
  • Wrinkles
  • Flabby skin
  • Canes/walking aids
  • Dentures
  • Illness, disease & weakness
  • Medication

Physiologically, it involves:

  • Musculoskeletal – decrease in lean body mass, muscle mass, total body water and mobility
  • Hearing – loss of high-frequency hearing
  • Endocrine – increase in bone mineral loss, insulin resistance and glucose intolerance and incidence of thyroid abnormalities
  • Visual – increase time for reflexes (constriction & dilation) and decrease time in lens flexibility
  • Cardiovascular – increase amount of collagen and fat in cardiac muscle, thickening and rigidity of valves and decrease in coronary artery blood flow
  • Immune – decrease in T-cell and B-cell function
  • Respiratory – decrease in elasticity of lungs, vital capacity and increase in residual volumn
  • Nervous – decrease in number of neurons, protein synthesis, senile plaques, lower rate of conduction in peripheral nerves and slower reflexes
  • Digestive – decrease in gastric acid secretion, emptying of esophagus and stomach and lower number of taste buds

How are your loved ones affected?

  • Vision – They may have poor vision and even blindness as they age. Cataracts and glaucoma is common and normally does not require any intervention. When their vision is compromised, they tend to lose balance and fall.
  • Hearing – Hearing loss is common and some may require hearing aids. Some might not like the idea of having a hearing aid because it’s visible, but hearing aids are getting more compact.
  • Taste – Food will never taste the same again and not being able to taste food can be quite frustrating.
  • Movement – The inability to move is restricting. They lose their independence to move around and that will limit their social life.
  • Cognition – Logic, reasoning and decision making can be affected.
  • Emotion – They can be sensitive at the things you tell them. Emotions go out of control; they become angry, sad or reserve unreasonably.
  • Self-esteem – They use to be independent and the need to ask for help or be cared for will lower their self-esteem especially if they require help in grooming.

Stay tuned for my Aging Together Series 2 on my next blog.

Aging Together – Part 12018-08-30T14:50:48+08:00

Personal Protection & Safety Awareness

In today’s hectic social climate, it is often easy to take one’s safety and security for granted. As an initiative from Healthworks, we are currently providing training in Personal Protection and Safety Awareness that cater to personal, group, or corporate settings. Our trainer U-waye Chong is currently spearheading this initiative to help all interested individuals gain the necessary advantage and confidence to keep them and their loved ones safe.  He is the Training Director for PTK-SMF Asia, a professional organization for Filipino Martial Arts Instruction and Specialized Training Programs for Civilian, Law-Enforcement, Military and Executive Protection.

Below is an article detailing some of the training benefits of the PTK-SMF Methodology by Radius Factor Founder, Joel Levan. Joel is a long-time colleague of U-waye’s and a Certified Professional Instructor of PTK-SMF within Philadelphia, Pennsylvania. There are many benefits of the weapons training of PTK-SMF, including utilizing equalizers, greater athleticism, increasing overall fitness levels, stress relief (that’s right, stress relief)…

But here are 10 major ways everyone can benefit:

Mindset and Observation. It’s effective training for your main operating system: the brain. Sensory perception and processing will be enhanced along with the development of a strong, strategic mindset and greater situational awareness. Even from day one you’ll begin to observe your environment differently. You’ll learn what to look for and why. The more you train the more skill and understanding acquired to realistically identify and counter the flow of any attack with proper range, timing, intent and dynamic of the engagement with or without the use of weapons. If you can identify a potentially threatening situation, you can take the initiative by getting ahead of it, possibly without having to engage at all.

Mental Conditioning. Being better equipped to observe and identify any attack and act accordingly with proficiency is crucial.  In a very short amount of time, the training process supercharges your awareness and sense of spatial relationships – that’s a valuable attribute for dealing with weapons and a standard of PTK-SMF.

A resulting effect of weapons training is that, ultimately, you fully understand the dynamic and threat that exists with weapons – because you would have trained with weapons. Having that understanding further develops your mindset and needed tenacity. The mere sight of real weapons can cause some people to cower. For instance, when a person brandishes a handgun or the flash of a polished steel knife is seen. Familiarization, desensitization, and learning to manage stress levels when dynamically interacting with them becomes even more essential.

Physical Conditioning. The Filipino Martial Arts, like PTK-SMF, also have great health benefits, including the mind-body training that reduces stress. With the progressive nature of the training methods, your physical state of readiness will increase dramatically and you’ll obtain a level of performance (e.g speed, power, agility and endurance) absolutely critical for a fight in addition to the skill of using the tool itself.

Tactics. Through the training of tactics, you’ll learn to understand realistic scenarios in order to adapt more effectively and hold the initiative. (In addition to how much force is needed or legally justifiable.) By the way, the word tactics has become a buzzword and is not to be confused with techniques. Think of tactics as the set of actions needed to carry out an objective using a combination of relevant and interconnected elements, including maneuvering, executed with particular intent in order to support a defined strategy.

Maneuvering (also a tactic). A common breakdown and counterproductive approach with many self-defense programs is the lack of maneuvering to stay protected. Not to mention, many training programs focus on “waiting” for the attack to happen instead of supplying the training that develops initiative and awareness, identification of cues or the true dynamic of an attack itself.

Maneuvering with dynamic footwork – with or without weapons – and possibly including running short intervals if capable, can be utilized during evasion. Understanding range and staying mobile will make you more difficult to grab, tackle, struck, or assaulted with a weapon all the while you’re able to turn the fight around and gain the advantage with your own offensive measures. Legally justifiable, of course.

Equalizers. If you’re up against a stronger, faster assailant, multiple assailants, or assailants with weapons, you’ll need an equalizer. Meaning, a type of weapon, personal defense tool, or something from your environment that when utilized will equal the intent or force needed to counter an assailant and closes the disparity between you and the threat. When trained properly, equalizers give you a tactical advantage that empty-hand striking and grappling alone won’t give you for personal protection. That said, an effective training method is necessary to operate safely and purposely. PTK-SMF training will ensure just that.

Integrated Training. While training with PTK-SMF edged/impact weapons for personal protection, you will have already learned tactics and techniques for empty-hands at the same time. (It also makes it cost-effective.) In the absence of the weapon (i.e. a long impact weapon, short knife, or tactical light), simplistic and dynamic empty-hands are deployed with the same striking techniques and maneuvering skills without having to learn a completely separate system. So, countering common unarmed attacks like grabs, pushes, punches, kicks, locks, holds and takedown attempts are all easily countered.

And since they’re integrated into your bio-mechanics and encoded into your brain, you can transition from your empty-hand techniques directly to index/locate your carry tool (on your person), then draw and utilizing it when needed… all at the right time and range.

Proven Standard Methods. Tested and proven through generations of combat in the Philippines – including modern-day elite Armed Forces – the PTKGO/PTK-SMF standard is the understanding of proper range, timing, intent and energy of dynamic and continuous offensive and counter-offensive attacks (of any weapon). This means you’ll learn to effectively dominate any threat (or ambush) of an untrained assailant by learning to fight and succeed against a trained opponent. With the training methods of PTK-SMF, you’ll immediately learn to validate your training.

Confidence. Gaining true confidence is a by-product of PTK-SMF training. In turn, it enables you to project awareness and power, which is also a deterrent, and communicated in your posture, alertness, and other non-verbal communication. Being able to identify a bad situation, adapt, and validate your training and your skills go a long way.

It’s Highly Enjoyable (and Safe). Did I forget to mention that part? Enjoying what you train is a great benefit, but it’s even more important to remain as safe as you can. Getting injured while training – enough that it hinders your development or ability to train – is counterproductive to personal protection! While all self-defense, combatives and weapons training can pose some obvious risk, PTK-SMF has a particular training method that’s precise and progressive (an authentic method) which allows you to remain as functionally safe as possible while having fun at the same time. Win-win.

Personal Protection & Safety Awareness2018-08-30T07:10:56+08:00

Is tingling or numbness a trend with desk job workers?

Just recently, Healthworks was invited to organize a spinal health screen amongst desk job workers. Within two days, we’ve managed to screen roughly about 120 people. Interestingly enough, numbness and tingling in the hand was one of the major symptoms that were reported during the health screen. So is numbness and tingling a trend amongst desk job workers?

According to a study of causes of hand tingling in Visual Display Workers (VDT), tingling in the hand is one of the most frequent symptoms amongst desk job workers. Of course, this study has excluded the possibilities of vascular diseases, inflammation, tumour, trauma, endocrine, and nerve system disease. It is also noted that the myofascial pain syndrome was the biggest cause of hand tingling on the VDT workers in this study.

The next, in order, was cervical radiculopathy, rotator cuff syndrome, carpal tunnel syndrome, and tenosynovitis. Myofascial pain syndrome is pain and inflammation in body tissues. It may involve either a single muscle or a muscle group. Sometimes, the pain generated may not be localised, ie. pain referred from neck muscles to palm of hand. With it, abnormal sensation like numbness or tingling can be induced. Certain muscles like the trapezius, subscapularis and infraspinatus were able to refer numbness or tingling sensation to the fingers.

Radiculopathy, a term for pinched nerves, which is caused by the mechanical compression of the nerve root.  When the nerves in the neck are being “pinched”, symptoms like neck pain, numbness and tingling and weakness in arms and hands can be noted.  Nerve roots of C6—C8 are the common areas of compression. According to dermatomal pattern, this would mean that tingling or numbness would happen in the hands.

At Healthworks, clients who exhibit these symptoms, usually are secondary to spinal issues like disc degeneration, OA or even due to the degeneration of the spinal joints. Repetitive work requires maintaining specific posture while the specific muscles and tendons are used consistently and it damages on the soft tissue and can create restriction on the pain and movement due to inflammation. This could be seen with carpal tunnel syndrome. The powerful and repetitive movement of hands and wrists, and the use of vibrational tools were known as the work-related risk factors. However, this could only be seen with repetitive and awkward position during typing. If the wrist structures are placed in an awkward position for a long time, this allows the tendons or nerved to be inflamed causing a restriction in the tunnel which result in the compression of the median nerve. Numbness or tingling sensation is one of many symptoms that can be due to the spine.

If you are currently experiencing these symptoms, consult your chiropractor or physiotherapist today to help you with your symptoms.

Is tingling or numbness a trend with desk job workers?2018-08-30T06:02:51+08:00

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Special promotion for Panora readers2018-09-01T10:02:49+08:00

Deadlift – The King of All Exercises?

The conventional deadlift is like coconut oil, chia seed, bulletproof coffee in the realm of exercises. It is widely believed to be a MUST DO exercise, which we widely believe is far from true.

Let’s explore why.

Before adding an exercise into your routine, several questions have to be asked.

Q1: “What is the purpose of this exercise in relation to my training goal?”

To Build Muscle? The conventional deadlift is not the best leg (hamstring), back (latissimus dorsi, rhomboid) or butt (gluteus maximus) builder. It is a decent exercise for these muscle groups, but there are superior movements:

Back: Bentover rows, chin Uus and pulldowns.

Hamstrings: Romanian Deadlifts, lying leg curls and stiff legged Deadlift.

Butt/ Quads: Squats, hip thrusts and leg presses.

These exercises train those muscle groups for their a) specific anatomical function, b) stress those muscles through a larger range of motion, and c) provide a much longer time under tension compared to the conventional deadlift.

To Get Stronger? Via the deadlift mechanics, the body is capable of moving a lot of weight (more so than other compound movements), true that.

But strength goes beyond how heavy you lift off the floor. Getting “stronger” can be achieved with any properly coached movement; being able to jump higher, run faster, toss further, curl heavier, curl more reps, curl with fuller range of motion equates strength gain (I’m a big fan of curls).

A beef I have with the conventional deadlift: The movement subjects everyone to lift off 211mm (bar height from floor), which makes no sense for a 6’6″ basketball player who has poor deadlift leverages compared to a 5’8″ soccer player.

In this case, a Romanian deadlift, or a Stiff-legged deadlift would reign supreme.

The shorter athlete with better success in the lift would be deemed stronger compared to the taller athlete but we’re not only comparing unjustly, but fitting everyone into a preset mold.

Just because the body is designed to mechanically lift heavy off the floor, it shouldn’t be viewed as the be all end all for strength gain. Specificity matters a lot for strength gain and it that’s when the next question can help:

Q2: “What do I need to get stronger for?”

If your goal is to get stronger in deadlift for the purpose of powerlifting, the conventional deadlift, lifted off the floor in a dead (paused) position, is the KING for that goal.

However, if your goal isn’t solely powerlifting related, not so much.

Specificity matters and I encourage everyone to discover that by revisiting Questions 1 and 2.

You don’t have to go extremely heavy 

The meteoric rise of deadlifts came with the meteoric rise of Powerlifting.

Which is amazing: Periodization, accessory exercise variations, activation exercises, mobility work, proper technique are all brought into the spotlight.

Unfortunately, it came along with the meteoric rise of heavy lifting. I’m sure we’ve all seen the beginner who lifts one rep, with said rep taking more than 5 seconds, with form that resembles a fishing rod.

Don’t get me wrong. For advanced powerlifters, heavy singles or triples have their place in training. but it shouldn’t be something you do 4 times a week if you’ve merely been deadlifting for 2 weeks. Benefits from the exercise can still be derived from much lower intensities at higher repetitions (4 to 6), a far better options for beginners dialing in technique.

4 sets of 6 reps for 24 total reps facilitates learning better than 6 sets of 1 rep, even more so if you’re executing the movement with proper form with a more manageable weight. I don’t find many fitness maxims to be true, but in this case – leave your ego at the door, the gym, your lower back, the commercial plates not designed for slamming will thank you for it.

At Healthworks, we analyze the mechanics of every exercise, even movements as straight forward as the deadlift. Details matter, and how you preform a movement can be the difference between leaving the training session better, versus leaving a training session feeling like a wreck.

Optimize your movement patterns and start exercising to improve your life, not set it back.


Deadlift – The King of All Exercises?2018-09-04T08:31:23+08:00
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