Tag: parra physio

Cauda Equina Syndrome: What is it?

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Cauda equina syndrome is a rare condition that you may not have heard of, however it can have catastrophic consequences if it is not recognised and treated quickly. This condition occurs in up to two percent of cases of herniated lumbar discs, causing loss of lower leg function, incontinence and lower back pain. It is one of the few medical emergencies related to back pain and can be devastating if symptoms persist.

What Causes Cauda Equina Syndrome?

At the end of the spinal cord, there is a bundle of spinal nerves arranged in a formation that resembles a horse’s tail. (In Latin, cauda equina means “horse’s tail”.) These nerves are housed within the spinal canal in the lumbar region.

If, for any reason, these nerves become compressed, signals to the bowel, bladder, and lower limbs can be disrupted. Left untreated, this compression can result in permanent paraplegia and incontinence. Common causes of compression include disc herniation due to disc degeneration, tumours, inflammatory disorders, spinal stenosis, or complications following surgery. Trauma-related caudaequina syndrome—such as from knife wounds or motor vehicle accidents—can affect people of all ages.

Signs and Symptoms

This syndrome can be difficult to diagnose because its symptoms mimic those of many other conditions. However, there are certain warning signs that health professionals are trained to take very seriously.

These include:

Sudden loss of reflexes in the legs Unusual and rapid onset of bladder or bowel incontinence, or sexual dysfunction Pain in one or both legs Motor and sensory loss Tingling or numbness in the saddle region (groin and inner thighs) Bilateral sciatica

These symptoms are often associated with severe lower back pain. If you suddenly experience more than one of these symptoms—particularly incontinence—seek immediate medical attention.

Treatment Options

Treatment will depend on the severity and underlying cause of the syndrome. However, in most cases, cauda equina syndrome requires urgent decompression surgery to relieve pressure on the affected nerves. The longer the delay between symptom onset and surgery, the lower the chances of a full recovery.

Most patients will require physiotherapy, pain management, and psychological support—even if treatment is delivered promptly. While this is a very rare condition, public awareness is essential, as early intervention is crucial to prevent permanent damage.

None of the information in this article is a substitute for medical advice. Always consult a qualified health professional regarding your specific condition.

Meniscal injuries

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The knees take a lot of stress when doing medium- or high- impact activities such as running, jumping, hill-walking and playing field sports. The meniscus is commonly damaged during these activities, and can be a cause of significant pain and movement dysfunction if damaged.

What is the role of the meniscus?

The meniscus is a thin, fibrous cartilage lining the bones of the knee. Its main function is to absorb shock when performing weight-bearing activities such as walking, running or hopping.

The meniscus in the knee is c- shaped, and there is one on the outside (lateral) and one on the inside(medial) knee joint. The medial meniscus is more commonly damaged than the lateral meniscus, because of the fact that more weight is transferred through the medial knee joint in normal movement.

What causes meniscal damage?

Twisting forces most frequently damage the meniscus. For example, if a soccer player’s foot is planted on the ground and their body rotates around the knee, the meniscus will often be unable to withstand the pressure and will sustain a strain or a tear. This can be of varying degrees, to a few stretched fibres right up to a large tear involving multiple areas of the cartilage. A locking, clicking or clunking may be felt in the knee upon movement. Your physiotherapist will be able to perform clinical tests to check whether the meniscus is likely to have been damaged or not.

How can physiotherapy help?

Depending on the extent and location of the injury, many patients have excellent functional outcomes with physiotherapy management. This typically involves strengthening the muscles around the knee as well as increasing the range and training task-specific activities. Sometimes, a referral to an orthopaedic doctor can help to determine whether or not surgery may be appropriate. If you have any doubts, talkto your physiotherapist about your options.

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.

Four Tips For Reducing Knee Pain

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Knee pain comes in many forms with many different causes. While treatment for every person and condition will be different in each case, here are a few tips that may help to reduce knee pain throughout the day.

1. Choose supportive footwear

One of the biggest culprits for ongoing knee pain is wearing unsupportive or high-heeled shoes to work. High heels often lead to tight calves and altered gait patterns, while unsupportive shoes can allow rollingin of the ankles, which can, in turn, place extra stress on the knee joints. Having an assessment with your physiotherapist to see how your shoes might be affecting your knee pain is a worthwhile investment.

2. Adjust your sleeping position

While most of the time, our knees get a well-deserved rest during the nighttime hours, there are a few sleeping positions that can place additional stress on the knees. Lying on your side with bent knees can place tension on the outer thigh muscles and also the knee joint itself. Try to keep your knees straightened to at least 30 degrees and if you sleep on your side, place a pillow underneath the top knee to reduce stress on the joint. Alternatively, if you sleep on your back it may be helpful to place a pillow under your knees so that they rest in a slightly bent position, to unload the joint. Try experimenting with different pillow arrangements to see which combination works best for you.

3. Avoid sitting or resting too much

When knee pain strikes, your first instinct is probably to get off your feetand stop exercising. The truth is that our knees, like all our joints, are designed for movement and regular exercise helps to keep them healthy. If you are having pain with high impact activities such as running, try switching to swimming and cycling before stopping exercise altogether. Resting in a sitting position for prolonged periods can also place excess stress over the knee cap and knee joint. When sitting for long periods, try to stretch your legs out ahead of you and avoid crossing your legs.

4. Seek physiotherapy treatment

Many of us see putting up with pain as a sign of strength however, a small niggle that is easily treatable can turn into a larger problem over time. This may seem like an obvious point, yet the first step to recovery is often just seeking treatment.

Our physiotherapist is happy to discuss your condition with you and share their tips to help you stay pain-free.

The Hidden Benefits Of Learning A New Skill

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 When thinking about getting fit and exercising more, our first thoughts are usually that we should join a gym or start jogging. While these are both worthwhile activities, we know that if you dislike the activity you’re doing, the long-term benefits are usually not enough to keep you committed. There are a few things that are often overlooked when talking about exercising more, particularly the fact that you can often improve your life in more than one way if you find the right activity. 

Finding the right activity can boost your confidence an increase your daily activity levels.

We all have different tastes in food and the same is true for exercise. Some of us chase the thrill of learning a new skill; others prefer the challenge of pushing their limits of endurance while others love being surrounded by nature. Exercise is good for everyone, but finding the right activity for you is going to make it much easier to make it a committed part of your lifestyle. 

We are also more likely to enjoy doing activities that we are good at. Some people have great balance, while others have great eye hand coordination and someone who is an excellent dancer might be a terrible runner. Consider what you are personally good at and try to choose your activity based on this. Finding something that suits your routine is also an important component to making a new activity a part of your lifestyle.

Sometimes it is simply a lack of imagination that fails to get us off the couch. Jogging is not for everyone, but one of these sports might be. 

Here’s a quick list of less common activities that you may not have thought of trying; rock-climbing, volleyball, soccer, hula-hooping, slack-lining, golf, mountain biking, hiking, standup paddle boarding, roller skating, skateboarding, dancing, Pilates and yoga, just to name a few. 

Learning new skills can be good for your brain. 

Many people think that as they get older, learning new skills becomes too hard. The truth is, that with a bit of patience, you can surprise yourself with your ability to learn new things at any age. The brain is capable of incredible change and adaptation to new stimulus. Learning new things can be a great source of confidence and exercise has been shown to improve your brain function overall.

Many activities can help you meet new people and open you up to new communities. 

Even solo sports often have well connected communities of like-minded enthusiasts. Surfers have surf clubs, or often meet each other in the water, rock climbers are always looking for more people to take adventures with and people who wake up at 5am to do boot camp together become great friends. As we leave high school and university, it can be harder to create new social connections. Using exercise as a way to make new friends can have a significant impact on your overall wellbeing. In many activities, the communities are extremely supportive of beginners and you might be surprised at how friendly they are to newcomers. 

Your physiotherapist is able to give you great advice on which activities might suit your ability level and they can give you some tips to ensure you stay injury free when starting your new hobby.

De Quervain’s Tenosynovitis

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 De Quervain’s Tenosynovitis is a condition that causes pain and swelling on the thumb side of your wrist. It occurs when the tendons that move your thumb—the abductor pollicis longus (APL) and extensor pollicis brevis (EPB)—become irritated and inflamed as they pass through a small tunnel near the base of your thumb. This swelling can make it hard and painful to move your thumb and wrist, especially when you’re gripping something or twisting your wrist. If it’s not treated, the tendon sheath can thicken, making thumb movement even more difficult.

What are the symptoms?
The most common symptom is pain near the base of your thumb, often described as a dull ache or sharp pain on the side of your wrist. This pain might spread up your forearm and tends to worsen when you move your thumb or wrist, especially when gripping, pinching, or twisting. You might also notice swelling, a snapping feeling when you move your thumb, or even a bump where the tendons are inflamed. In some cases, moving your thumb becomes stiff or painful, and there is tenderness at the base of the thumb.

How does it happen?
This condition often results from overusing your thumb and wrist. Activities like golfing, playing musical instruments, fishing, carpentry, or even frequent texting can strain these tendons. New mothers are especially prone to it because of the repetitive motion of lifting their babies. Over time, constant gripping, twisting, or wringing motions can irritate the tendons and cause swelling. If this continues, scar tissue can develop, making movement even harder.

How can physiotherapy help?
Diagnosing De Quervain’s Tenosynovitis is usually straightforward. Your therapist will ask about your symptoms and perform a simple test called the Finkelstein test. In this test, you make a fist with your thumb tucked inside your fingers and then bend your wrist towards your little finger. If this causes sharp pain along the thumb side of your wrist, it’s a strong sign of De Quervain’s.

The primary goal of therapy is to reduce any pain and swelling of the tendons. This may include splinting the wrist to rest the tendons. Interventions to reduce inflammation, including ice or heat and the use of non-steroidal anti-inflammatory drugs (NSAIDs), may be recommended. Your physiotherapist will also address any musculoskeletal factors that might be contributing to tendon stress through poor biomechanics. Muscle stretches and strengthening exercises may also be prescribed.

If rest and splints aren’t able to reduce symptoms sufficiently, a corticosteroid or platelet-rich plasma (PRP) injection can help lower inflammation and ease pain. In very rare cases, surgery might be needed to release the tight tendon sheath and give the tendons more room to move. This is usually a simple outpatient procedure, and most people recover quickly.

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

Easy Ways to Stay Pain-Free While Travelling

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The holiday season is one of the busiest travel periods of the year, with many people taking to the skies, roads, and rails to visit loved ones or explore new destinations. While the excitement of travel is undeniable, the long hours spent sitting can lead to common complaints such as lower back pain, neck stiffness, and headaches. To ensure you arrive at your destination feeling refreshed and pain-free, here are some essential tips to reduce travel-related discomforts.

Lower Back

Lower back pain is a leading issue for travellers, especially those spending hours in cars or airplanes. Try these simple adjustments to stay comfortable:

  1. Adjust the seat angle. If possible, tilt the seat slightly down toward your feet rather than your hips. Ideally, your knees should be level with or slightly lower than your hips. Using a footrest can help achieve this alignment.
  2. Modify the seat back. To reduce strain on your lower back and pelvis, keep your seat upright rather than tilted backward. This upright position aligns your spine and pairs well with the previous tip.
  3. Raise the seat height. Elevating the entire seat can prevent excessive hip bending, making it easier to sit upright for extended periods.
  4. Use lumbar support. Many modern car seats come with built-in lumbar supports, but they may not suit your specific needs. A lumbar pillow or a rolled towel can better support the natural curve of your spine, easing pressure on your discs and muscles.

Neck

Once your lower back is supported, addressing neck discomfort becomes easier. Here are a few simple strategies:

  1. Use a travel pillow. For airplane travel, consider wearing the pillow backward or sideways to support your head and reduce neck strain during rest.
  2. Practice chin retractions. Every hour, perform 10 “chin tucks” by sitting tall and gently pressing your chin straight backward, lengthening the back of your neck. Avoid tucking your chin to your chest. This exercise helps relax tight postural muscles at the base of the skull.
  3. Incorporate gentle neck movements. Keeping your eyes forward, rotate your head side to side and tilt it gently to the left and right. These movements help release tension from holding a still posture for too long.

General Tips for Long Trips

To further minimize discomfort, on car journeys, take a 15-minute break every two hours to stretch your legs and walk around. On planes, follow the airline’s recommendations for preventing deep vein thrombosis, including frequent movement and stretching exercises.

These tips are general suggestions and may not work for everyone. If any of them cause discomfort, consult a physiotherapist for personalised advice. By staying mindful of your posture and incorporating movement into your travel routine, you can make holiday travel more enjoyable and pain-free.

Four Surprising Reasons Why Your Pain Is Not Improving

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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?

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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

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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

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 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.