Tag: Cumberland Physiotherapy

Tibialis Posterior Tendinopathy

Posted on

 

CUMBERLAND PHYSIOTHERAPY PARRAMATTA The tibialis posterior muscle sits just inside the shin, halfway up the lower leg. The muscle travels downwards and runs along the inside of the heel, with the tendon attaching at the base of the arch of the foot.    

The role of the tibialis posterior muscle is to move the foot and ankle downwards and towards the midline of the body. The tibialis posterior also helps to support and maintain the arch of the foot. Tendinopathy is a broad term that refers to painful pathologies of the tissues in and around a tendon, usually related to overuse. 

What are the symptoms?

Signs and symptoms of tibialis posterior tendinopathy can include pain and/or stiffness over the tendon, clicking or ‘crepitus’ sounds with movement and swelling. Pain can be felt both when you touch the tendon or with movements that involve contraction of the tibialis posterior muscle, such as when going up on to your toes, hopping or running.  

As the condition progresses, the tendon might be come weaker and elongated, providing less support to the arch of the foot. This might become more noticeable over time as the lack of support in the foot further aggravates the damaged tendon.   

Pain may become so severe that eventually running becomes too painful to continue and even walking may be sore. In some cases, the affected tendon may be weakened but painless. For some, a complete tear of a weakened tendon can be the first sign that anything is wrong. 

What are the causes?

Like most tendinopathies, overuse and biomechanical errors are the main cause of tendon pathology. Prolonged or repetitive activities that place excessive strain on the tibialis posterior tendon can cause degeneration and disorganization of collagen fibres within the tendon.   

Excessive pronation or rolling in of the foot while walking can place the tendon under extra stress as it acts to support the arch. Unsupportive footwear can exacerbate this process as it allows the foot to roll inwards. Often, a person may not have any issues until they begin to increase their training. If tendons are subjected to too much load too quickly, they can begin to breakdown, developing into a tendinopathy.

Being overweight, muscle weakness or tightness, poor warm up and insufficient recovery periods can all contribute to the development of tendinopathy. As you might expect, runners are most affected by this condition, along with other athletes of sports that require lots of running. Non- athletes can also be affected with day-to-day activities causing tendinopathy.  

How can physiotherapy help?

Your physiotherapist can help by making an accurate diagnosis in clinic, which can be confirmed by MRI or ultrasound. Your physiotherapist can also identify which factors may be involved in the development of this condition, helping to address them and reduce pain as quickly as possible. 

For most tendinopathies, a period of relative rest is required and a graded training program to help strengthen the tendon has been shown to have the best evidence for recovery. Other interventions such as ultrasound, ice or heat treatment, soft tissue massage, stretching and joint mobilization may be used. Arch support taping, biomechanical correction, bracing and footwear advice may also be added.

None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.  

Ten Surprising Facts about Tendons

Posted on

CUMBERLAND PHYSIOTHERAPY PARRAMATTA:Tendons are found all over the body and while you may know a little about them, you might be surprised to learn a few of these facts. 

1. Tendons can be found at the ends of muscles. Tendons are simply connective tissues that attach muscles to bone and help them move our joints when they contract. 

2. Tendons come in many shapes and sizes. While the most recognisable shape is the long thin kind (such as the Achilles tendon), they can also be flat and thin or very thick, depending on the shape of the muscle and attachment of the bone. A thin flat tendon is also known by the name aponeurosis.

 3. Tendons are able to act like elastic bands, they can stretch and bounce back into shape. Like elastic bands, if too much force is applied they can stretch or tear. 

4. Unlike elastic bands, tendons are living tissue and their properties are affected by many different factors. Seemingly unrelated things such as hormonal changes, autoimmune disorders and nutrition can all affect a tendon’s ability to withstand load. 

5. Tendons don’t only attach muscles to bone, they can attach to other structures as well such as the eyeball. 

6. Tendons can tear however; more often they are injured through overuse. Healing of tendons can be quite slow as they have less blood supply than other tissues of the body, such as muscles. 

7. Tendons are mostly made of organised collagen fibres. Areas of tendon degeneration have been shown to have collagen fibres that are disorganised, with this area having less strength and elasticity. 

8.The Achilles tendon is the strongest tendon in the body. This connects the large calf muscles to the back of the heel to point the ankle away from the body. Most tendons are simply named for the muscle they attach to, however the Achilles has it’s own name, named for the mythical Greek character who’s heel was his only point of weakness.

9. The smallest tendon is located in the inner ear, attaching to the smallest muscle in the body. 

10. Tendons and muscles work together to move your joints and are called a contractile unit. 

Facts about Osteoporosis

Posted on

 CUMBERLAND PHYSIOTHERAPY PARRAMATTA: Osteoporosis is a condition characterised by very low bone mass or density. This is caused by the body either losing too much bone, not making enough or both. Osteoporotic bones become weak and fragile and can break from small forces that would normally be harmless.

In osteoporotic bones, as well as loss of bone density and mass, there may also be abnormal changes to the structure of the bone matrix, which further contributes to the bone weakness. 

Osteoporosis is an extremely common bone disease and women are more affected than men. As it is a progressive disorder that worsens with age, while the disease process might begin earlier, the effects are usually only noticed and diagnosed in people who are 50 years and older.

What are the Signs and Symptoms?

Often called a silent disease, many people with osteoporosis will have no idea that they have the disease, as there are no obvious symptoms. In fact, sometimes the first sign that an individual has osteoporosis is when the first bone is broken. Along with fractures, which are the most serious signs of this disease, osteoporosis can cause the upper back to become excessively hunched (itself often a result of spinal wedge fractures) and there maybe widespread pain as bony tissue is increasingly unable to withstand normal forces. 

Fractures are a serious problem, especially in the elderly population. Bone breaks due to osteoporosis occur most frequently in the wrist, spine or hip. When the spine is affected by osteoporosis, people may develop a hunched or stooped posture, which can itself lead to respiratory issues and places pressure on the internal organs. Osteoporosis can severely impact a person’s mobility and independence, which can have a huge impact on quality of life.

What Causes It?

As this is primarily a metabolic disorder, there are a variety of things that can cause osteoporosis if they either interfere with the body’s ability to either produce bone tissue or encourage excessive breakdown. This can be anything from gastrointestinal conditions that prevent absorption of calcium, lack of dietary calcium or low levels vitamin D, which is essential for absorption of calcium. 

Certain medications may also cause bone loss especially if they are taken for a long time or in high doses. A good example is the long-term use of steroids. Although steroids are used to treat various conditions, it has been proven that steroids can cause bone loss and eventually, osteoporosis. 

As bones respond to force and weight bearing by building more bone, having a sedentary lifestyle or doing activities with low impact can also lead to osteoporosis and this has been shown be an issue amongst professional swimmers and cyclists.

How Can Physiotherapy Help?

Physiotherapy can help you to improve your overall bone health, avoid or recover from fractures. Physiotherapy exercises can direct you to safely increase your weight bearing, which can help build bone mass. Balance training is also an important factor as this can reduce the risk of falls. Your physiotherapist can also educate you on how to adjust your lifestyle, at home or at work, to protect your bones and improve your posture.

None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual condition. 

Tips for Helping Kids of Today Stay Active

Posted on

 CUMBERLAND PHYSIOTHERAPY PARRAMATTA:Research shows that many children today are struggling to meet their daily-recommended targets for physical activity. We know that inactivity is a risk factor for a multitude of chronic diseases and many of the habits that shape our adult lives are set in childhood. Physical activity is important for a growing body as movement and weight bearing have a large impact on bone strength, muscle and tendon health. Here are some tips to make sure your child is staying as active as possible. 

1. Find an activity that suits your child’s personality and abilities. 

Children who are very coordinated and excel in competition may find team sports both increase their self-esteem as well as keep them fit. For other children, being a part of a team can cause embarrassment and they may say they dislike exercise, when in fact what they dislike is feeling like a failure and letting down the team. 

These children may prefer a sport where success measured by improving on their own performance, rather than being compared to other children. Surfing, yoga, martial arts, dancing or gymnastics may be activities that suit your child if competitive and team sports cause them to be discouraged. 

2. Do get injuries checked out by a professional and invest in proper rehabilitation.

While children do bounce back quickly from injuries, they also may have difficulty expressing themselves and their worries when they have pain. A niggling pain that won’t go away may cause your child to say “I don’t like sport” rather than mentioning that they are in pain.

Some children may retain worries that they will hurt themselves again because of a previous injury and avoid exercise because they don’t feel completely confident.  Your physiotherapist can help to identify any issues that your child is having and help to resolve them. 

3. Set fun and challenging goals for them to complete during their daily routine. 

As less children are walking and riding to school, try to find ways to fit extra activities into the day. Have a daily long jump competition in the back yard at the same time each day or have bed making time trials. Have a routine before bed of age appropriate exercises, such as star jumps, hopping, balancing and running on the spot. You can make this part of the night or morning ritual, just like brushing your teeth.

Talk to your physiotherapist for more tips on how to increase your child’s activity levels. Finding an activity that matches your child’s age level is key to keeping them engaged and active. None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury. 

Where is Your Pain Really Coming From?

Posted on

 

CUMBERLAND PHYSIOTHERAPY PARRAMATTA: Have you ever been to see a physiotherapist for pain in one part of your body and when they treated you, they focused on a completely different area? While this can be a strange experience, it can be even more puzzling when the treatment actually works. So what is going on, shouldn’t pain be treated where it is being felt?

When pain is felt at a different location from where the pain is being caused, this is called ‘referred pain’ and is actually more common than you think. Exactly why this happens is a little complicated, and in fact, we don’t yet understand everything about the way that pain is processed. 

Pain is usually felt when something causes damage to the body, sending an electrical impulse to the brain. The brain receives this information and process it to make sense of which part of the body the signal is coming from and what kind of pain it is. When the brain thinks that the pain is coming from a different area than where the damage or signal is actually coming from, this creates the phenomenon of referred pain.

Sometimes referred pain is easy to explain, such as when a nerve becomes injured or irritated, causing the pain to be felt along the length of the nerve. This often feels like a sharp, burning pain that runs in a strip, along the skin. Other examples of referred pain are more difficult to explain and in some cases seem to defy explanation. Perhaps you have heard about the strange phenomenon of phantom pain where amputees continue to feel pain as though it was in the place where their limbs used to be. 

Muscular trigger points can also cause referred pain. The mechanism behind this is a bit trickier to understand, but is thought to be explained by tight bands of muscle tissues that cause pain to be felt in predictable patterns around the body. 

Adding to this, we know that other tissues of the body can cause pain to be felt in a different location, including discs of the spine and internal organs. Many times the internal organs can refer pain in peculiar patterns and this can actually lead to serious illnesses being mistaken for muscular aches and pains. Kidney pain can be felt in the lower back and tragically, some people fail to recognize that they are having a heart attack because they feel pain in their neck and arm, not in their chest. 

We also know that not understanding or being afraid of pain can make pain feel stronger. In rare cases, people who have pain in one hand can feel pain just by seeing their other hand moving in a mirror. There are many other fascinating aspects to pain, and understanding how it works is an important part of managing your symptoms.  

To understand how referred pain may be affecting you, chat to your physiotherapist who can help with any questions. None of the information in this newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your individual condition.

Spinal Stenosis

Posted on

CUMBERLAND PHYSIOTHERAPY PARRAMATTA: What is spinal stenosis? 

The spinal cord, nerves and arteries are housed by the spine, which acts as a hard electrical casing to support and protect these vulnerable structures. The spine has a hollow column that allows the spinal cord to run from the brain to the rest of the body. At each spinal segment, nerves exit the spine and supply the tissues of the body. There is also an intricate network of small veins and arteries that provide blood to the spinal cord and vertebrae, providing them with the nutrients needed to operate. 

Spinal stenosis is characterised by a narrowing of the spaces that house the spinal cord, nerves and blood supply. A variety of factors can cause spinal stenosis, however overwhelmingly it is caused by degenerative changes to the spine as we age. Many people over the age of 60 will have spinal stenosis; however, not all will have pain. Clinically, spinal stenosis is used to describe the painful symptoms of this condition rather than just the narrowing itself.

What are the symptoms? 

Pain with walking or standing that radiates into the hips, thighs and even feet is the hallmark of spinal stenosis. Usually, this pain will be reduced with rest and forward movements of the spine. Spinal stenosis is a progressive condition and symptoms will gradually increase over time. The pain is often described as a deep radiating ache and can be associated with fatigue, heaviness, weakness and numbness. It can affect just one leg, however more often will be felt in both legs.  There will often be associated back pain; however, leg pain is usually the most severe complaint. 

How can physiotherapy help?

There are many conditions that need to be excluded before a diagnosis can be made. Your physiotherapist is able to conduct a thorough examination and accurately diagnose this condition. In some cases, imaging may be requested. As mentioned earlier, many people have stenotic spinal changes without symptoms. Surgery to decompress the restricted nerves and stabilise the spine are used in very severe cases.  

For mild to moderate cases of spinal stenosis, physiotherapy can be extremely beneficial.  Your physiotherapist can help you manage your pain through hands-on techniques and by providing a targeted exercise program based on biomechanical assessment. They are also able to help you to understand and manage your day in a way that helps to reduce flare-ups and maintain muscle strength.

If surgery is the right choice for you, your physiotherapist is able to guide you through this treatment pathway, helping you to prepare and recover from surgery to get the best outcome possible. 

None of the information in this newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your condition.  

Femoroacetabular Impingement (FAI)

Posted on

 

What is it?

When the two surfaces of the hip joint move over each other, they usually move freely without any friction. If there is an alteration to either the socket part of the joint (the acetabulum) or the ball (the head of the femur), irritation may occur as the two surfaces move over each other. This is known as Femoroacetabular impingement (or FAI) a common disorder of the hip, characterised by pain and stiffness.

Femoroacetabular impingement can be classified as cam, pincer or mixed. A cam FAI occurs when the femoral head junction is flattened or a small bump is present. Pincer type of impingement occurs when the acetabular rim extends slightly, causing the femur to be impacted. Cam impingement is more common in men while pincer impingement is more common in women. However, most cases of FAI (about 85%) are mixed, meaning they both have cam and pincer types of impingement. 

What are the symptoms?

The most common symptom of FAI is pain located in the hip or groin when resting in certain positions or with specific movements. Some patients also report pain in the back, buttock or thigh. Other symptoms include stiffness, loss of movement range (particularly of the hip), locking, clicking or a feeling that the hip is about to give way.

Activities that cause the incongruous surfaces to move over each other repeatedly are naturally the main culprits for causing symptoms. These can include prolonged sitting, twisting, sitting with crossed legs, squatting and climbing stairs can all aggravate the pain caused by femoroacetabular impingement.

What are the causes?

There are many factors that may cause an individual to develop femoroacetabular impingement including; 

  • Hip dysplasia or malformation during infancy/childhood
  • Repetitive stress on the hip
  • A femoral neck fracture that did not heal properly (malunion)
  • Small bony growths around the joint called osteophytes.
  • Normal anatomical variation

How can physiotherapy help?

Femoroacetabular impingement is a complex condition and researchers are still determining the best possible treatment. It is thought that untreated FAI can lead to osteoarthritis of the hip down the track and there are both surgical and non-surgical options for treatment.  Conservative (non-surgical) management for FAI involves core stability training, strengthening exercises for the lower limb specifically the hip and postural balance exercises. This program aims to improve the hip’s neuromuscular function. A hydrotherapy program can also helpful as it reduces weight through the joint, making movements more comfortable. Lastly, a home exercise program is made for patients, so they can continue treatment at home. For many people, physiotherapy is enough to resolve their symptoms and prevent future problems, however others may require surgery.

With surgery, hip arthroscopy is the most common procedure for this disorder and is used to change the shape of the joint slightly so that there are no points of irritation with movement. After surgery, patients are usually referred to physiotherapy for rehabilitation. 

None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual condition. 

Patellofemoral Pain Syndrome

Posted on

What Is It?

The knees function as hinges, allowing your legs to swing forwards and backwards smoothly as you walk, kick and run. The kneecap, also known as the patella, sits at the front of the knee and has a variety of functions, including guiding the muscles that straighten the knee, protecting the knee joint and absorbing forces when the knee is bent. When something goes wrong and the kneecap doesn’t move up and down smoothly, the soft tissue between the kneecap and the knee can become irritated, causing pain in a predictable fashion. This is called patellofemoral pain syndrome (PFPS), sometimes also referred to as PFJ syndrome or runner’s knee.

Pain is usually felt on the inside of the kneecap when you put pressure on your knees by running, squatting, bending, using stairs, or hopping. Sitting for long periods of time or keeping your knees bent could also result in pain.

What Causes It?

The kneecap sits in a shallow groove at the front of the knee and usually moves up and down as the knee bends and straightens without too much trouble. The quadriceps muscles, located at the front of the thigh, contract and pull on the kneecap, which then attaches to the lower leg and act to straighten the knee. If one side of the quadriceps is stronger or tighter than the other, it can cause the kneecap to pull to one side and over time become irritated. 

The cause of muscle imbalance or weakness can be for many reasons. In general, the outer muscles of the thigh tend to be stronger and tighter than the inside muscles. If you have poor posture and hip position, this often causes the outer muscles to work harder and the inside muscles to become weaker. Lack of arch support in your feet or simply a physical abnormality of the knees can also cause this condition.

How Can Physiotherapy Help?

Diagnosing patella-femoral pain syndrome correctly is important because pain on the inside of the knee can also be caused by injury, dislocation, inflammation, arthritis and a variety of other less common diseases.

With that in mind, it is helpful to know that your physiotherapist can diagnosis PFPS and identify its likely causes.

Whether it is due to poor posture, a lack of arch support in your feet, or poor running technique, your physiotherapist will assess the problem and provide a specific treatment program to best approach your condition. PFP syndrome usually responds quite well to biomechanical analysis and correction of any muscular weakness and imbalance. Having the correct shoes and orthotics can also make a huge difference. There are some short-term treatments, such as patella taping, try needling, trigger point therapy and ultrasound, which may help alleviate symptoms quickly and keep you active while you address the other factors contributing to your pain.

In the rare case that your condition is not helped by physiotherapy, surgery is also considered as last resort. For more information, please feel free to ask your physiotherapist.

None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury. 

Can Poor Balance Lead to Ankle Sprains?

Posted on

CUMBERLAND PHYSIOTHERAPY PARRAMATTA Ankle sprains are one of the most common sporting injuries and most people have experienced one at least once in their lifetime. While they are common, this doesn’t lessen their negative impacts. Surprisingly, having poor balance might be increasing your risk of ankle sprains. Here we discuss a few facts about balance and what you can do to reduce your risk of ankle injuries.

Why are ankles particularly vulnerable to injuries related to poor balance?

Our ankles have to support our entire body weight when standing on one foot. To provide us with agility as well as stability, our ankles have the ability to move from side to side as well as back and forwards. There is a complicated process constantly operating to keep your foot in the correct position while supporting all this weight, particularly with quick changes of direction, activities done on tiptoes, jumping and landing. 

If the ankle rolls excessively inwards or outwards, the ligaments on the outside of the ankle can be damaged and torn. Balance is an important part of keeping the ankle in the correct alignment and not twisting too far to either side during challenging activities.

A study of high school basketball players  by Timothy McGuine et al. in 2010 showed that students with poor balance were up to seven times more likely to sprain their ankle than students with good balance. Other studies have shown that balance training is an effective way of preventing falls in elderly populations. 

Balance can vary from one leg to the other. 

Most of us tend to favour one side of our body for all activities. This is more obvious in the upper body, with most of us identifying as either left or right handed. The same is also true for our lower body, with each of us favouring one leg over the other for balance activities. This can mean that one leg has better balance and strength than the other, leaving the other leg more vulnerable to injury. 

Reduced balance can mean your body has to work harder to perform activities, with muscles activating in a less coordinated way. Improving your balance can also improve your body’s efficiency of movement, which can, in turn, improve your overalls performance without actually improving your muscle strength. 

Balance can be trained rapidly. 

Balance is one of the most overlooked dimensions of physical health however, the good news is that it can be improved relatively quickly. Do a quick check to see if you can stand on each leg for two minutes with your eyes closed. If this is difficult you might find that improving your balance is a great next step in your training program.

Your physiotherapist is able to identify any deficits in your balance is and is able to develop a training program for you to improve your balance. Come and see us for an appointment to see how we can help. None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.  

Muscular Trigger Points

Posted on

What Are They?

Muscular trigger points are better known to most of us as muscle knots and can feel like painful, hard lumps located inside muscles. These knots can both be painful to touch and refer pain in surrounding areas. It is thought that trigger points form when a portion of muscle contracts abnormally, compressing the blood supply to this area, which, in turn, causes this part of the muscle to become extra sensitive.  Trigger points are a common source of pain around the neck, shoulders, hips and lower back. 

What Causes Trigger Points?

Many factors can cause trigger points to develop; repeated stress, injuries, overuse and excessive loads are common examples. Inflammation, stress, nutritional deficiencies and prolonged unhealthy postures may also contribute to the formation of these painful areas. Generally speaking, muscular overload, where the demands placed on the muscle mean that the fibres are unable to function optimally, is thought to be the primary cause of trigger points. This is why you might notice trigger points in weaker muscles or after starting a new training program. 

Signs and Symptoms

Pain caused by trigger points can often be mistaken for joint or nerve-related pain as it is often felt in a different location to the site of the trigger point. Trigger points feel like hard lumps in the muscles and may cause stiffness, heaviness, aching pain and general discomfort. They often cause the length of the affected tissues to shorten, which may be why trigger points can increase the symptoms of arthritis, tennis elbow, tendonitis and bursitis. 

How Can Physiotherapy Help?

Your physiotherapist will first assess and diagnose trigger points as the source of your pain. If they feel that treatment will be beneficial, there are a variety of techniques that can help, including dry needling, manual therapy, electrical stimulation, mechanical vibration, stretching and strengthening exercises. While these techniques may be effective in treating trigger points, it is important to address any biomechanical faults that contribute to their development.

Your physiotherapist is able to identify causative factors such as poor training technique, posture and biomechanics and will prescribe an exercise program to address any muscle weaknesses and imbalances.  If you have any questions about how trigger points might be affecting you, don’t hesitate to ask your physiotherapist. 

The information in this article is not a replacement for proper medical advice. Always see a medical professional for an assessment of your condition.