Lifestyle Overhaul?

Do you have a niggling feeling that your lifestyle needs an overhaul? Do you know what the signs and symptoms are that you need to make some changes? Find out about Metabolic Syndrome and if it could apply to you…….

Metabolic syndrome is not a disease in itself.  It is actually a group of risk factors which can increase the risk of heart disease, stroke, and diabetes.

The five different risk factors that make up Metabolic Syndrome are:

1: Excess visceral (belly) fat

2: Increased blood pressure

3: High blood sugar level (insulin resistance)

4: High triglycerides (“bad cholesterol”- measured by a blood test)

5: Low level of HDL (“good cholesterol”)

Metabolic Syndrome is diagnosed if a person has excess fat around the waist in addition to any two of the above risk factors.


Signs and Symptoms

There are various ways of measuring visceral (belly) fat. One simple tool, is waist to height ratio. Ideally your waist measurement should be less than half your height.  

Excess thirst and / or an increase in the number of times you urinate may indicate high blood sugars (warrants an appointment with your GP.) 

In lots of cases though, the signs and symptoms are not very obvious to people.  In fact, it is estimated that between 25% and 43% of the world’s population may have MetS, with a significant number unaware of this.


Implications of having MetS

Metabolic syndrome can have a significant effect on your overall health.  The syndrome can give rise to Type 2 Diabetes and heart and blood vessel disease.  These complications can be chronic and can often take a lot of effort and medication to effectively manage and treat them.

Why is too much belly fat considered a problem?

Adipose tissue (fat), does not quietly sit in the background, in fact, it is metabolically active. This means that it is causing cellular changes within your body.  Adipocyte (fat cells) can get enlarged and stimulated to produce excess amounts of adipocytokines (messenger molecules.)  One of these adipocytokines are called Free Fatty Acids (FFA).

These FFA’s in turn inhibit the uptake of glucose into healthy muscle tissue.  This means that there is excess glucose circulating in your blood, and optimal muscle contraction and repair is impaired.  The result is sub-maximal muscle performance, increasing risk of injury and pain.  The metabolic disturbance can also affect the quality of your tendons (achilles tendon for example) by way of overproducing Type III collagen in the tendon.  Type III collagen is stiffer and less elastic and can be a factor in achilles tendon pain.

Sub-par muscle performance, can indirectly impact on your joints, such as the knee or hip, increasing the risk of pain and pathology in the joint.   

In addition to creating extra load on joints, excess body fat leads to widespread low grade inflammation throughout the body.  This can contribute to a feeling of “aches and pains all over” and make local joint problems feel more painful.

Management of MetS

So that’s the science.   In practice we often find that this patient group can feel really stuck!  They may know that they need to overhaul their lifestyle and increase their exercise but have a problem such as back/hip/knee/foot pain that makes it difficult to get started.  This is where your chartered physiotherapist can help, though a combination of treating the problem that is making exercise difficult and prescribing a tailored exercise programme to help you become more active without aggravating your current injury.  A combination of positive diet and exercise changes can reduce the risks (associated with MetS) of developing cardiovascular disease significantly.

If this resonates with you, and you’d like an appointment, please click here



Rotator Cuff Related Shoulder Pain

What is Rotator Cuff Related Shoulder Pain?

“Rotator Cuff Related Shoulder Pain”

The rotator cuff is made up of a group of muscles that help keep the head of the humerus bone (‘the ball’) in the shoulder socket.  The rotator cuff muscles are also involved in moving your arm up and out to the side and rotating the shoulder.

“Rotator cuff related shoulder pain” is commonly seen with people who perform repetitive overhead activities such as painters, swimmers, tennis players etc. “Rotator cuff related shoulder pain” can also develop after a one-off event such as a fall or a quick jolt.

People who have “rotator cuff related shoulder” pain may have pain on the outside of the upper arm that is usually made worse when lifting the arm overhead.  It can also be painful to lie on the affected side.  In more severe cases, the pain may be constant, rather than only on specific movements. 

Types of Rotator Cuff injuries

Injuries to the rotator cuff muscles and/or tendons are quite common.  Anytime we use our hands and arms for any day to day task or sport, we are simultaneously using our shoulder muscles.  Injuries to the rotator cuff can occur at any age.  As well as the rotator cuff muscle and tendon complex, there are other structures in the shoulder that can cause pain.  Here are three of the more common causes of “rotator cuff related shoulder pain”.

1: Rotator Cuff tendinopathy

Tendinopathy can be acute (recent occurance) or chronic (lasting for weeks or months).  It is where there is degeneration or inflammation of the tendons, which causes pain.  This may be caused in some cases by repetitive overhead activities, a recent increase in shoulder exercise, or even a return to previous levels of activity, after a long period of inactivity.

2: Rotator Cuff tear, partial or full-thickness

This is where one of the rotator cuff muscles or tendons tear partially or fully.  This can happen due to a trauma, degeneration, or indeed from repeated microtraumas.  

3: Bursitis / sub acromial pain / impingement

You may hear the above terms in relation to shoulder pain.  Sometimes in reports such as an MRI report, bursitis may be reported, or sub-acromial impingement.  A recently published International Consensus Paper (Requejo-Salinas, Lewis et al, 2022) recommended that the above three terms were not clinically useful and that the term “Rotator Cuff Related Shoulder Pain” be an overarching term to include ‘bursitis’ and ‘impingement’.

Can Physio help?

Yes! We will start with a comprehensive assessment.  This is important so that we determine the reason for your shoulder pain, and start you on the right path to recovery.

Rehabilitation for “rotator cuff related shoulder pain” often involves a combination of manual therapy, and a graduated programme of strengthening exercises.  The exercises will be sepecific to you, depending on your contributing factors.  The exercise programme is not a ‘one-size fits all’ approach.

We will also investigate lifestyle factors specific to you (ergonomics, sports technique, posture, sleep etc.), so that your rehabilitation programme is tailor made, giving you the best possible results.

Start your recovery today, book online at: 


What is a ‘Sports Physio?’



The term ‘sports physio’ is used a lot, and you if you are involved in sport and get injured, you may be advised to seek out a ‘sports physio’. 

So, what is a ‘Sports Physio’?

Sports Physiotherapy’ (or sports physio) is a specialist area of physiotherapy that involves assessment, treatment and rehabilitation of sporting related injuries.

Chartered physiotherapists that specialise in musculoskeletal injuries are experts in treatment of all sporting injuries and for all age groups.

At IONA Physiotherapy clinic in Drumcondra, our team is made up of clinical specialists and senior musculoskeletal Physiotherapists.  Our physiotherapists have previously worked in professional sport and performance with Leinster Rugby and Riverdance among others.

If you are looking for a ‘sports physio’, then please contact our experienced team for a thorough assessment and rehabilitation program.