Over the last 3 years the clinic has been present at the Anual Health Fair organised by the American Embassy.
Over the last 3 years the clinic has been present at the Anual Health Fair organised by the American Embassy.
Over the last 4 years the clinic has been volunteering at the international Frisbee tournament in Phnom Penh. An average of 150 people, a mix of Cambodians, expats and frisbee lovers from from all over Asia, enjoying their passion over the weekend.
The clinic provides advise to prevent injuries, medical taping and first aid injury care.
Check out the full article here: http://cambodiagolftoday.com/cambodia-golf-today-issue-15/
Check the link for the Full Article!
Check the link for the Full Article!!
Cambodia’s national football league has embraced the services of Dutch physiotherapist Lidwina Niewold, who advises and massages felled players in humid heat and pouring rain alike. That the skilled sportsmen are willing to dart to the sidelines in order to seek her ministrations shows a growing acceptance of her role in a country where the concept of manual therapy is, for many, relatively new.
Manual therapy is an umbrella term for practices such as chiropractics and physiotherapy, which seek the root of musculoskeletal pain. Chiropractors emphasise the correction of the spinal column, while physiotherapists are more interested in muscles, but both use techniques that can alleviate joint pain or general aches, aid mobility and promote rehabilitation after an injury or surgery.
“If your spine is misaligned, it can create an interference in the nervous system, which leads to a symptom — pain,” says Dr Christophe Savouré, of the International Chiropractic Clinic in Phnom Penh.
“Pain is demobilising. My goal is to remove all interference to allow the body to work better,” adds the French chiropractor, who once stopped a man’s feet from stinking after manipulating his back, demonstrating the relationship between spine and nervous system.
While in many countries a trip to the physiotherapist or chiropractor is often a go-to solution for a strained muscle or an out-of-whack back, professionals say that both fields remain relatively unknown in Cambodia.
At Physiotherapy Phnom Penh practice, patients include stroke victims and those suffering from sporting injuries, though “participation in Phnom Penh’s traffic” still brings in the most clients, according to physiotherapist Dick van der Poel.
Cambodian patients make up just 20 percent of clientele, adds his Physiotherapy Phnom Penh colleague Niewold, with most stopping by out of curiosity or being drawn in by word of mouth.
Kanha Neth, a 25-year-old Cambodian physiotherapist who has previously worked at Rose Cambodia Rehab Centre at Chey Chumneas Referral Hospital, explains that pills remain the primary means of pain relief in Cambodia. With potent painkillers readily available over the counter, experts say that such drugs may mask muscular or skeletal pain, rather than fixing the base cause. “Pain tells you something is wrong with your body. Shooting the messenger solves nothing,” says Dr Savouré.
Traditional massage is another popular way to relieve muscle and joint problems, says Neth. While it can ease tension, Niewold stresses that a lack of communication or medical training makes most masseuses unsuitable for uncovering the cause of pain or mobilising joints.
“Physiotherapists try more to focus on why the muscle is tensed up. Is it because of bad posture behind the computer?” she adds. “If you’re not going to do anything about the actual reason, it will come back.”
Experts agree that in some cases surgery can be avoided, and in others physiotherapy can at least enhance post-surgery rehabilitation. “You can wake up after a moto crash with five screws in your back,” adds Van der Poel. “The surgeon may have done a perfect job, but if you get an infection afterwards or don’t exercise to regain movement, you’re stuck.”
And while a physiotherapy diploma is available for Cambodians at the Technical School for Medical Care, Neth — who won a scholarship for her training — explains that finding a relevant job can be tough. The approximate 30 graduates per year are not always prioritised in hospitals and often work as pharmacists or in other understaffed areas, she says.
Many professionals in the field would also welcome more referrals. “We’d love to see more patients. Especially patients from within the hospital,” says Erin Hooper, an Australian volunteer at the Rose Cambodia Rehab Centre.
Progress is being made, as clinics such as Rose Cambodia, Physiotherapy Phnom Penh and the International Chiropractic Centre increase understanding of manual therapy in medical fields. Some invite local doctors to their premises to explain the role their practice can play in rehabilitation, with others conducting seminars in hospitals, more of which are planned.
“If doctors don’t know what we can do for patients, they can’t help their patients,” says Niewold, whose work with the national football league is also raising the profile of her profession, while opening eyes to both treatment and career opportunities.
Thanks to photographs of her work being posted on Facebook, a girl who wants to follow in her footsteps contacted her online. “That she wants to do what I do is not a compliment for me, but a compliment for the fact I am there on the field, in public,” says Niewold. “It’s a compliment for the physio profession.”
Before sunrise, at Phnom Penh’s Vietnamese Monument, a small group equipped with mats, water and towels gather in a semi-circle on the rusty red tiles. At a time when most are sleeping, save the monks chanting over the nearby wat’s loudspeaker, the seven members—led by a trainer and motivational music from a smartphone—begin planking and two-step dashing in quick succession. Ponytails fly, grunting steps up a notch and breaths shorten, as the moves pile on at a manic pace.
This is Metafit bodyweight training—a 30-minute metabolic workout designed to last a full day. The class is part of a growing number of niche fitness offerings invading the capital that focus on high-intensity interval training (HIIT)—involving fast-paced, short periods of intense anaerobic exercise interspersed with less-gruelling recovery periods. The interval training regimes have become a global craze in the last few years, and the trend is now catching on in the Kingdom. This includes CrossFit, Insanity and Metafit training–all new to Cambodia–along with upgrades to traditional high-intensity workouts like boxing.
Experts argue these workouts are superior to extended, steady cardio work on a treadmill or bike and improve fat-burning potential. The regimes also offer exciting potentials for long-term health. “Research nowadays is showing that bringing this type of workout into anyone’s fitness program is able to help reduce the onset of chronic diseases, cardiovascular disease, diabetes, stroke and arthritis,” says Metafit and Insanity trainer Andy Wenhlowskyj.
The science behind the magic? In short, exercising at maximum levels results in anaerobic conditioning. When oxygen intake is limited, muscles are depleted of glycogen, which sets in motion a process to increase oxygen for replenishing it. So for 24 hours after the workout, metabolism increases, which burns calories, aids in fat loss, builds lean muscle mass and improves fitness, claims Wenhlowskyj.
At Wat Botum Park, the exercise group moves on to the dreaded “burpee” move, a term now synonymous with the world of high-intensity workouts. It is a full-body movement combining a squat, jump, straight-arm plank, and often a push-up—and described by attendees as akin to torture.
The participants grunt their way through and are rewarded with a mere 10-second break. Then the whirlwind of action continues, advancing to skaters, commando crawls and explosive jacks. From a nearby bench, two women with paper facemasks gape at the moves, and a young passer-by emulates them from a safe distance. When not participating himself, Wenhlowskyj provides gentle corrections and a steady stream of encouragement.
The beauty is in the pain, according to the 31-year-old trainer. “This program isn’t designed just to be a walk in the park,” he says. “[It] teaches you that your body’s capable of more than you think, and pushes you to those maximums.”
As the founder and operator of HIIT Fit Phnom Penh, Wenhlowskyj was the first to offer Metafit and Insanity in Cambodia. The sessions focus on bodyweight exercises, with cardio conditioning involving jump training, strength work and core conditioning. “If you’re time poor, like a lot of us, then you can rock up to a class, and in 30 minutes walk away and know you’ve done the exercise your body needs for the day,” says the Melbournite.
Metafit participant Lauren Della Marta says she prefers the short, hard-hitting exercise to an hour-long jog, as well as being outdoors to gym-bound. “You feel like something’s happening right away; it’s like instant results,” she adds.
But the appeal stretches beyond the physical impact. Though a plethora of online, at-home workouts exist—particularly catered to high-intensity training—many fitness-seekers still opt for group classes to form community.
“Because everyone is in the same boat, you’re suffering together and laughing about how hard the exercises are, it’s definitely a chance to meet people and go for a coffee afterwards,” says Della Marta.
This is particularly true at the country’s first CrossFit gym, CrossFit Amatak, which opened in August. “The community is what pushes you further,” says founder and owner, Corbett Hix. “When you go through shit together, it brings people together. Everyday we put people through an hour of shit, and that creates bonds, even if they’re coming from completely different tracks of life.”
As the mid-day heat sluggishly settles in, 11 people gather for the hour-long session at CrossFit Amatak. While a soundtrack of Cee Lo Green and Red Hot Chili Peppers competes with whirring fans and surrounding Toul Tom Pong construction, the gender-balanced participants practice Olympic-style snatch lifts using blue PVC pipes, with prompts such as, “drop and drive,” from head coach and manager Mike Titzer.
“CrossFit is constantly varied, high-intensity functional movements performed in a community environment,” explains Titzer, emphasising the conditioning program promotes both endurance and strength in short packages. Workouts can move from pull-ups to deadlifts and sprinting for power, speed, accuracy and balance.
“All of our work is meant to have a real-life analogue to it,” adds Hix. Each exercise relates to daily movement, with a deadlift comparable to picking up a child, and a push press to storing a piece of luggage in an overhead bin, says the 38-year-old Texan. “We want to prepare the body to be able to do that over the course of its life.”
With the gym—or box, as CrossFitters call it—decked out with bumper plates, a pull-up rig, kettlebells and large tractor tyre, it’s easy to see why Hix says his first impression of a CrossFit gym was “a playground for adults”—or “superhero training”. The equipment is a distinction of CrossFit, which has grown in popularity since being established in 2000, with about 11,000 affiliates now operating worldwide.
These hard-hitting offerings also challenge traditional perceptions of gyms, fitness and beauty. “I think a lot of the ethos started as a reaction to the global gyms, which have become more spas than anything else,” says Hix.
The new trainings bring it back to the basics—stripping away air conditioning, televisions and mirrors. In the case of Metafit and Insanity, even equipment is shed, allowing workouts to be performed anywhere.
“We try to challenge people’s traditional perceptions of why they might come into a gym, to take it away from the aesthetic,” says Hix. “Don’t live by the scale. Come in and say I want to be a healthier version of who I am currently.”
These workouts are well represented by females, and in the case of CrossFit are often women’s first exposure to weightlifting. “I think it’s quite empowering,” adds Hix. “To me, if a woman can throw me across the room, she’s a badass. I would love to help challenge those perceptions of beauty.”
By catering to small groups, programs provide a cross between a gym and a personal trainer, and eschew the commercial gym trend of making money from members who stop coming after New Year’s resolutions fade. This approach limits memberships, and therefore a two-way commitment is central to CrossFit.
The regimes also place responsibility on participants, and coaches act as motivators rather than drill sergeants. “When people rely on someone yelling at them, then when they try and maintain fitness themselves, they can’t,” says Wenhlowskyj. “It’s a better holistic view adding this program to an overall fitness lifestyle.”
As the sun sets, similar fitness takes place across town, but this time in cages. Set in a large, dome-roofed warehouse near Aeon Mall, Prokout gym offers high-impact training through boxing, kickboxing and cardio conditioning classes. The space boasts battle ropes, boxing bags, monkey bars, speed balls and a cubby hole stacked with boxing gloves and shin guards.
“Boxing is good for fitness because you use your whole body—arms, legs, knees, abs. It’s very, very high intensity,” says French owner Théodore Bitcheff, 24, who has fought professionally since the age of 17. “Now a lot of people do boxing because they want to get fit, not just because they want to box.”
Near Bitcheff, who sits beside a life-size dummy in an octagonal black-and-white cage, two men spar in the opposite ring, jabbing and crouching while rotating around the well-branded rectangle. “They motivate themselves,” he says of the participants. “Because they see the result.”
Opened in December, Prokout—the Khmer word for fighting—now has more than 100 members. Bitcheff, who grew up in Cambodia and speaks fluent Khmer, has been particularly successful in drawing Cambodians, who represent 65 percent of the gym’s attendees—with female Khmers making up 30 to 40 percent of fighters. He says local interest has grown “step by step”, and attributes this partly to social media, where interval training videos are widespread.
For Wenhlowskyj, exposing Cambodians to new regimes has been an opportunity to present more general information about the delayed onset of soreness, and distinguishing good and bad pain.
“I had no idea what it was like; your body is in pain [because] of moves you’ve never experienced,” says 35-year-old Insanity attendee Channa May. “Cambodians are more interested [in the workouts] once they understand the impact—telling alone may not work, but proving results to them [will].”
Challenges remain in language barriers, trainer certification procedures, which usually require leaving the country and testing in English, and economic realities. “Fitness, in all truth, is a luxury,” says Hix. The programs are seeking to enlist more Cambodians, and anticipate interest will increase as the country develops.
High Risk, High Reward?
But with workouts promising everything from lean muscles to increased energy and endurance, they could prove, for some, too good to be true.
“High-intensity training comes with fast adaptations, so you can become strong very fast,” says physiotherapist Mark Chen, of Physiotherapy Phnom Penh. “It also comes with a higher chance of getting injured.” As a result, Chen sees overuse injuries such as tendonitis and inflamed muscles. Though these can occur from traditional workouts, increased impact brings higher risk, he says.
Often the root issue is muscular imbalances resulting from behavioural and postural problems, particularly from desk jobs. “If you take those into a high-intensity setting, it can create problems,” he says, adding many people jump from a sedative lifestyle to advanced training. “If you haven’t been doing anything for 10 years and eat a lot of crap, and you’re looking at complex movements with weight, you might want to take a step back,” he adds. “High-intensity training is not for everyone.”
However, there are safe ways to participate in these workouts, according to Chen. Being under the guidance of a properly trained instructor reduces injury risk, along with education about diet and injury management. “You have to know what kind of limitations you have and respect that,” he says, referring to genetics, age and experience. “If you know how your body works and have good technique, you can keep going for a long time.”
The long term is key, as those who swear by the workouts say high-impact training is here to stay. “It might sound like a fad because it’s a buzz word, but this type of exercise has been done by athletes for decades,” says Wenhlowskyj “If you were doing this 20 years ago, [or] in 20 years’ time, you’re still going to get the same benefits, and no one will ever disagree with that.”
Trainers recommend starting slow and mixing workouts with other regimes, such as resistance training, running and yoga, as well as allowing for recovery time.
But the top recommendation is not to let the intensity intimidate, and to give it a go. With attendance up, current offerings look set to further expand, and new places are sure to follow behind—the perfect time to dust off New Year’s resolutions, and tackle fitness afresh.
“And don’t be scared of the word burpee,” says Wenhlowskyj. “Learn to love it.”
When Tim Hartman, an American tourist, crashed his motorbike in Kep he was left with two broken ribs, whiplash, a concussion and a hyperextended shoulder. After the shock wore off, he saw few viable options for recovering in Cambodia and thought of returning to the US to heal.
“That is when an Australian nurse in Sihanoukville referred me to Physiotherapy Phnom Penh,” said Hartman. “Before coming here I couldn’t turn my head to the side, or use my shoulder. Luckily, for my head, I was wearing a helmet,” he said.
Still bandaged, Hartman sat in the lobby of Physiotherapy Phnom Penh II—the clinics new office which officially opens today—on Monivong Boulevard, a block north of The Royal Raffles Hotel.
“If it wasn’t for Dr Dick, I wouldn’t be making progress and wouldn’t be able to continue on my journey,” he said, describing how after a few treatments that mobilized his spine, his neck is healed and a full range of motion has returned to his shoulder.
Dr Dick van der Poel, the lead practitioner out of a group of four Dutch-certified staff and one part-time British, first opened Physiotherapy Phnom Penh near the Russian Market in 2010. Since then, his practice has grown first through word-of-mouth, and now by referrals from some of the capital’s largest hospitals and established clinics.
“We help people get back on their feet again,” said Dick. He went on to describe how in a country that lacks western style facilities, he bridges the gap between the emergency room and full rehabilitation by focusing on the musculoskeletal system. The musculoskeletal system is what actually binds the body together and includes everything from bones to muscles, cartilage, tendons, ligaments and joints. It is what makes the body move and function, and it is also what is most prone to injury.
Although, unsurprisingly, a number of his patients have been involved in motorbike accidents, he also specializes in sports medicine, surgical rehab and chronic pain caused by previous injuries or inadequate office conditions, he explained. He is also trained in Chinese medical practices like acupuncture, thus creating a synergy between eastern and western practices.
“When a patient comes in we ask them why they have an ailment. Then we do a full mobility test to provide an overall assessment to find the underlying cause of the pain,” he said, noting that a lot of his patients have been previously misdiagnosed.
From there, he develops individualized treatments to get his patients back to work or out on the soccer pitch.
“We also teach about the value of stretching, and the difference between bone and muscle injuries and how the body functions so that patients can integrate this knowledge into everyday life,” he said.
Although his patients are predominantly foreigners at an estimated 80 per cent, he hopes that Cambodians will become aware of the need to maintain proper physical health through prevention and education, rather then just treating the injury through medication that ignores the root cause of the pain, he explained.
The newest addition to their team, the energetic Mark Chen who is certified in physical fitness training and sports medicine, is heading up a new program to diversify their services away from just rehabilitation with the “Back in Action” programme. The 10 week training programme uses education and medical training to strengthen the lower back.
“[The programme] restores muscle balance and encourages postural changes, which can take awhile to be corrected,” said Chen.
Chen also offers one-on-one personal training classes to increase overall fitness, as well as group fitness programmes. The individual classes are offered on a per session basis, while the group programme includes 10 sessions. The individual classes allow for fitness training one hour a week, or two hours twice a week.
“These types of classes have been very successful in Holland,” he said, “and now we have the correct facilities to educate people on how to exercise properly and avoid injuries.”
An action shot of Lidwina working with some of the young talented Cambodian boys that joined the AFC qualifiaction tournament in Myanmar.
The champions of the Metfone league 2013/2014 with Lidwina as the club physiotherapist
So what’s the story behind Phnom Penh Crown’s mould-breaking female physio, Lidwina Niewold? For mega clubs like Chelsea its almost common practice to employ female medical staff, but for a team in the Cambodian League it’s unheard of. “As a teenager, my dream was to help professional footballers with their injuries. I come from a football-playing family and played for a girl’s team as soon as I could. But I suffered an injury when I was 20 and didn’t get it treated properly. So I know from my own experience how important it is to make sure players get the best possible treatment. I’m addicted to football, I love it. The fact that I can be involved on the pitch and use my physio skills at the same time is like living my childhood dream.” Brummen, in east Holland, is home for Lidwina. A twin, she has four brothers and a sister and football for girls was popular in her area of Holland, enabling her to play regularly and to help train a girl’s team for a couple of years. She studied physiotheraphy in Utrecht for four years including an internship in Indonesia for six months. “That was an amazing experience. I worked in a hospital and then a small health care center in the countryside, and with disabled children.”
Lidwina arrived in Cambodia in November 2011 to work with Dick van der Poel at the Physiotheraphy Phnom Penh Clinic. Early on she treated one of the Crown Academy boys and things kicked off from there. She attended a few Academy games, took over the rehabilitation of Kouch Sokumpheak and was then invited by head coach Sam Schweingruber, to get involved with the senior team. “I’m trying to make the players conscious about their body, and what to avoid. I can treat them with manual physiotheraphy, massage, medical taping or exercising. My goal is to get them back as soon as possible but without risk of more damage. Sokumpheak is a good example. He is coming back from a serious knee injury. Step by step he’s been doing more exercises to strengthen his muscle, coordination and stability. The aim is to get him back playing matches but also to avoid further injury.” She’s only too aware of what can happen if injuries are not treated correctly. “I am my own worst example. When I was 20 I twisted my ankle and damaged my ligaments. Because I couldn’t wait to play again, I didn’t get enough rest, I didn’t do my strengthening exercises properly and it took me a really long time to recover. Now I realize how stupid I was, I just wanted to play and failed to take good care of my ankle. My job now is to make sure that doesn’t happen to the Crown players, and of course, to my clients at the clinic.”
For now, Lidwina is enjoying her involvement with Cambodia’s most go-ahead and proactive football club. Always prepared to try something different, Crown have a recent history of Croatian, British and Swiss coaches, a British press officer, the country’s first-ever youth academy, its own artificial training facility, a fan and community engagement agenda and now its own foreign female physio. “We’d like to have a Cambodian physio working with me, specializing in sports injuries. Not only for now but for the future. Clubs and coaches need to understand what physiotheraphy is and that with physically fit players you can win competitions. If players keep going with small injuries, the body gets weaker and the risk of serious injury grows. Sportsmen are difficult patients. They want to recover as soon as possible and I have to stop them or push them, depending on the extent of the injury. Football is and will always be a man’s world, but nothing is impossible if you have a dream and you follow that dream.”
Since our Physiotherapist, Lidwina Niewold, was responsible for the youth National teams of Cambodia, she was invited to join the AFC Football Medicine Regional Course, organised by FIFA, AFC and FFC
Rehabilitation and prevention of injuries
''Treat the root of the injury, not the pain'
Camsport magazine, April 2014
''The mind and body connection is crucial to understand pain and treatment''
Asia Life Phnom Penh, August 2009