Four Surprising Reasons Why Your Pain Is Not Improving

CUMBERLAND PHYSIOTHERAPY PARRAMATTA: Most tissues in the body have healed completely in six to 12 weeks following an injury, however, many people have severe pain that lasts much longer than this. We know that the intensity of the pain you feel is not always associated with a similar amount of damage. In some cases, there can be a severe amount of pain with almost no detectable damage. With this in mind, we explore some reasons why your pain might not be getting better, long after the tissues have healed. 

You’re afraid of the pain. 

Pain can mean many different things, for some of us pain can affect our ability to work or can be a symptom of a serious disease. What you believe about your pain can either amplify or reduce the symptoms you experience. If you feel that every time you experience pain you are causing more damage, you will naturally pay more attention to this and your nervous system will amplify the signals in an attempt to keep you safe. 

If you understand the cause of your pain and know that while there is discomfort, you are not in danger of causing more damage, often the pain will feel less severe. This is one of the benefits of seeing a physiotherapist after your injury as they can help you to understand your pain, giving you more control over your recovery.

You started moving differently after the injury.  

Immediately after an injury, it’s natural to change the way you move to avoid painful movements. After a while, these changed movement patterns can become maladaptive and actually begin to cause pain and discomfort on their own due to the altered stress patterns placed on your body. 

Correcting these adaptive movement patterns can often go a long way in reducing pain after an injury. You might not have noticed these changes and might need a physiotherapist to identify and help you to return to your usual movement pattern.

You have lost muscle strength since the injury. 

While a certain amount of rest following an injury is always helpful, if we stop moving altogether, our muscles can lose strength. This can mean that our posture changes, we fatigue easier during our usual activities and that we are more susceptible to further injury. Less movement also means we actually focus on the pain more when it does happen. Physiotherapists are able to advise you on the right types and amounts of excercise for you in the period following your injury.

The pain has affected your lifestyle.

When pain affects your ability to sleep, work and even concentrate, it’s not surprising that this can have a negative affect on your overall wellbeing and mental health. This can create a negative cycle of anxitey and depression that perpetuates and increases the experience of pain. If your pain is really getting you down, speaking to a mental health professional can actually be a valuable part of your physical recovery.  

 

Strengthen to Lengthen- Does it work?

CUMBERLAND PHYSIOTHERAPY PARRAMATTA: Improving flexibility by stretching is a core tenant of most exercise programs. We have all heard the adage to stretch and warm-up before exercise to help prevent injuries and there is no doubt that stretching can just feel amazing! It can be surprising to learn that sometimes, the answer to improving flexibility can actually come from strengthening muscles, not just stretching them. 

Why is this? 

The muscles of the body are primarily responsible for its movement. By contracting and shortening they move their attachments closer together or by relaxing they allow their attachment to move apart in a controlled manner. The stronger and more coordinated muscles are, the more efficiently muscles are able to move the body more precisely and against more resistance. 

This likely comes as no surprise, however what you may not realise is that muscles also play a large role in providing stability to the body, particularly around the more flexible joints such as the hip and shoulder. If needed, they will often prioritise their role as stabilisers over that of movers. 

What does that mean? 

If muscles are too weak to allow safe and controlled movement when needed, they might ‘tighten up’ to provide the stability necessary to keep your body upright. The less movement through range, the less blood flow muscles will be receiving, which can also lead to reduced muscle health and greater risk of injury. Increasing the strength of muscles can allow them to relax and move more freely, improving flexibility.

One of the reasons why strengthening to improve flexibility may seem counter intuitive is because many of have experienced muscle pain and stiffness after a strength workout, which can add to the perception that strengthening muscles shortens them. This pain and stiffness is usually short lived, reducing over 48 hours as muscle tissues return back to normal. 

Do any strengthening exercises work?

While improving strength and coordination may allow muscles to ‘relax’, there is one type of strengthening exercise that will actually physically lengthen muscles by creating new muscle cells. Eccentric exercises, or ‘controlled lengthening’ have been shown to have a very beneficial effects on muscle health, length and even improve tendon health. Having a targeted eccentric training program to strengthen muscles has been shown to improve flexibility and reduce injuries overall. 

Ask your physiotherapist for tips on training muscles to their optimal health to promote flexibility. Your physiotherapist is able to assess any muscles for weakness and reduced length, giving you a targeted program to improve function and reduce injuries. 

Five Physio Tips to Help Improve Your Health

CUMBERLAND PHYSIOTHERAPY: There’s no doubt that doing the right thing for your health can be difficult. Whether that involves eating healthier, exercising more, flossing your teeth or even doing your physio exercises, the best choice is not always the most comfortable. 

Once a habit has formed and become part of your routine, making the right decision for yourself can become a lot easier. Getting to that point is much easier said than done. Here are a few tips to help you reach your health goals.

1. Choose a friend to join you for accountability.

One way to guarantee that you show up for an early morning gym session is to have a friend who you partner with. You might be comfortable sleeping in for yourself, but not so much when you have someone else you’re letting down. Sharing difficult tasks with a friend can make them more enjoyable and you can also set up a competition between them if you need a little extra motivation.

2. Combine tasks with an activity that you do like. 

Love a true crime podcast? The gym can be the time to catch the latest episode or even stream your favourite show. Anything you do that helps to increase the enjoyment of the activity you’re avoiding is going to help you get started.

3. Batch tasks to be more efficient.

Are you trying to drink more water, floss and also complete your physio exercises? Why not do all three in the same sitting? Combining tasks can be a surprisingly effective use of time and a way to remind yourself to complete them.

3. Use positive reinforcement for good behaviour, rather than punishments. 

Many people will feel bad when they fail to reach their goals and try to restrict themselves in another area to compensate. It can be a much more effective motivation strategy to reward yourself after completing a task, rather than punish yourself for not doing it.

4. Get your foot in the door.

Putting your shoes on can be the hardest part of going for a run. If you’re struggling to complete a task, sometimes all you have to do is tell yourself you only need to do five minutes. Once you’ve started quite often you’ll want to do more, but setting small goals can be the trick to getting started.

Once a habit is in place, the easy part is to increase the intensity or length of time you’re doing it. It only takes 21 days of completing a task for a habit to be formed, where you will do it automatically as part of your routine. For more tips and tricks on how to reach your health goals, speak to your physiotherapist. 

Five Reasons To See a Physiotherapist After Injury

 There is no doubt that the human body can be very resilient. Short of regenerating new limbs, our bodies are capable of recovering from large amounts of damage, including broken bones. With this in mind, many people are happy to let nature take it’s course following an injury, thinking that seeing a physiotherapist will only act to speed up already healing tissues.

The speed of recovery, however, is only one measure of healing and despite our bodies’ incredible capacity for repair; injury repair can be less than straightforward. Here are a few things about injury healing you may not have been aware of.

1. Scar Tissue is more likely to form without treatment. 

Scar tissue can cause ongoing pain and stiffness in skin, muscles and ligaments. Physiotherapy can prevent excessive scarring from forming through advice regarding movement, massage and other hands-on treatment. 

2. Your ability to sense the position of your body, known as proprioception, is often damaged after an injury and can be retrained. 

Impaired proprioception is a major factor in re-injury. If you’ve ever heard someone say “my knee/ankle/shoulder still doesn’t feel 100%” then this could be why. The good news is that with a specific exercise program, proprioception can be improved and recovered.

3. Once healing has finished, your body may not be exactly the same as before.

Following an injury, ligaments may be lax, joints may be stiffer and muscles are almost always weaker. While the pain may be gone, there might still be factors that need to be addressed to prevent more complicated issues in the future. 

4. You may have picked up some bad habits while waiting for the injury to heal. 

While in pain, we often change the way we do things, this can lead to the development of poor movement patterns and muscle imbalances. Even though the pain has gone, these new patterns can remain and create further problems down the road. 

5. Injuries don’t always heal completely.

 On rare occasions, injuries may not be able to heal completely on their own. The most serious example of this is a fracture that cannot heal if the bone is not kept still enough. Other factors that may prevent an injury from healing include poor circulation, diabetes, insufficient care of the injury and poor nutrition. 

Your physiotherapist can assess your injury and develop a treatment plan that will both restore you to the best possible function and prevent further injuries. 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.  

Focus on Calf Tears

 What are they?

The calf muscles refer to a group of muscles at the back of the lower leg that act to point the foot away from the body and play an important role in walking and running. A tear or strain of these muscles occurs when some or all of the muscle fibres are torn or stretched. This is a common injury that can affect anyone from athletes to those with a more relaxed lifestyle.

How do they happen?

Calf tears are often caused by sudden, forceful movements or overuse of the calf muscles, leading to the rupture or strain of muscle fibres. Common mechanisms of injury are a quick take off during a sports match or simply going for a long walk when not accustomed. Factors that may increase the risk of a calf tear are previous calf tears that have not been fully rehabilitated, tight and weak calf muscles, poor balance and ill fitting footwear. 

What are the symptoms?

Typical symptoms of a calf tear are sharp pain over the site of the tear, especially with movement, swelling, bruising, and difficulty walking or standing. The severity of the injury can range from mild muscle strain to a complete tear, which will determine the appropriate treatment approach.

How can physiotherapy help?

The first step in managing calf tears is accurate diagnosis by a medical professional, who is able to rule out other conditions that might mimic a calf tear. They can determine the extent of the damage and create personalised treatment plans based on the patient’s specific needs. This ensures that the rehabilitation process addresses the root cause of the injury, leading to better outcomes.

Reducing pain and inflammation is important in the first one to two days following the injury. The muscle may need support during this time, depending on the severity. Over time as the swelling and inflammation subsides, your physiotherapist will help to address any factors that contributed to the injury such as muscle weakness or imbalance. Calf tears often lead to stiffness and limited range of motion in the affected leg.

Physiotherapists implement targeted stretching and range of motion exercises to restore flexibility and prevent the formation of scar tissue that may impede recovery. Gradually, the patient can regain the ability to move the calf muscle without pain or discomfort.

Rehabilitation past this point will progressively challenge the calf muscles without causing further damage. Strengthening these muscles not only aids in the healing process but also reduces the risk of future calf tears.

Proprioception, the body’s ability to sense its position in space, is crucial for balance and coordination. Physiotherapy includes specialised exercises that enhance proprioception and balance, reducing the likelihood of re-injury. This aspect of rehabilitation is especially important for athletes and active individuals who need to return to high-intensity activities safely.

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 Exercising when You have Pain

 One of the most challenging aspects of living with an injury or chronic pain is how it can quickly impact your exercise routine. If you have been working towards a fitness or weight goal, this can be extremely demoralising. Here are a few tips that can help to keep you on track while you recover. Staying as active as possible during this time can mean you’re in the best position to reach your goals again once your injury has healed. 

1. Try a new activity. 

When injury strikes, it can be tempting to stop exercising altogether and rest while you recover. An injury can be frustrating, but it can also be an opportunity to try out a different sport. If you’re a runner with an ankle injury, you can keep up your fitness by swimming instead. Cycling can be an excellent option for people for dealing with knee pain, and if you’re a swimmer with shoulder pain, maybe switch to running for a while. Check with your physiotherapist for some ideas to keep you moving. 

2. Exercise within your limits. 

If you’re getting pain at 5km, this doesn’t always mean you should give up running altogether. Your physiotherapist can help you monitor your symptoms carefully and plan an exercise routine that keeps your fitness up while reducing symptom flare-ups. Staying as active as possible throughout your recovery can also mean that you a better placed to get back to your best performance once symptoms reside

3. Take the opportunity to improve your footwear and equipment. 

Injury and pain can be a great prompt to look at your equipment and technique . For example, with hip and knee pain, the type of shoes you wear can have a significant difference. Often pain has more than once cause, with technique and equipment more often than not having a substantial impact on the stress placed on your body. Your physiotherapist is an excellent source of advice in this area, don’t hesitate to ask for an assessment. 

4. Take to the water

Hydrotherapy has long been used to help patients with joint pain or muscle weakness exercise. The water helps reduce joint stress and provide extra sensory input that can reduce pain. Exercising in water can be especially helpful for sufferers of chronic pain or those who have pain with weight-bearing. Speak to your physio for a hydrotherapy program if you’re not sure how to approach exercise in water. 

Our physiotherapists are happy to discuss your condition with you and share their tips to help you stay pain-free. None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your condition.

Focus on Metatarsalgia

What is Metatarsalgia?

CUMBERLAND PHYSIOTHERAPY PARRAMATTA: Metatarsalgia is a medical term used to describe pain that occurs in the ball of the foot. This occurs due to rubbing of the long bones of the foot, called metatarsals, causing inflammation. Build-up of inflammation in the ball of the foot compresses the small nerves that run between the toes and along the foot. Inflammation and compression of these small nerves is painful. 

The pain can involve one or more joints of the foot including the big toe, second toe and third toe. It is unlikely to include the fourth or fifth joints. On occasion, the pain may involve the entire foot, or larger parts of the foot. The pain or symptoms may be made worse when bearing weight through the foot, such as walking or running. In severe cases, just standing or even wearing tight footwear can affect the foot.

How does it happen?

Metatarsalgia can be caused by a number of things. An abrupt change in the posturing of the lower back or pelvis may alter the way the foot is loaded, and cause rubbing of the long bones. Altered loading of the foot may also be caused by arthritic conditions that affect the knees, hips or pelvis.

Unavoidable factors, which may lead to the development of metatarsalgia, include increased age, and the physical shape of the foot and toe. As your body ages, the ligaments of the foot may loosen or weaken. Therefore, the bones of the foot move differently leading to altered positioning and loading of the foot.

Avoidable factors, which may lead to the development of metatarsalgia, include wearing inappropriately fitting footwear, and the type of exercise performed. Metatarsalgia is more highly associated with high-impact-type exercise such as running or gymnastics.

How can Physio help?

Your physio will determine the cause of the metatarsalgia pain and assist you with adapting your posture or improving the loading pattern of your foot. You may be advised to unload the foot by reducing or stopping exercise, changing the shoe you wear, or strengthening certain muscles in your legs.

Electrotherapeutic modalities such as icing, ultrasound or interferential therapy may be of assistance to reduce pain and inflammation in the beginning stages of treatment as well.

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