Tag: Parramatta Physio

Can Stress Affect my Pain?

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 A common fear for patients when discussing pain is the idea that their symptoms are ‘all in their head’ or that they won’t be believed either by friends, family, therapists or workplace. This fear can be worse when there appears to be no obvious cause for their pain or it has been present for a long time. 

What is pain?

Many of the models used in the past to explain pain lead us to believe that the intensity of pain will always be proportional to the severity of an injury. The experience of pain is always real and usually distressing. However, pain is a warning system used by our nervous system to alert us to danger, not a direct indicator of damage done. This is a subtle, yet important distinction meaning that the experience of pain can be influenced by many different factors and not exclusively tissue damage.

How can stress impact pain?

Part of the role of your nervous system is to sort through a huge amount of sensory input and interpret it in a meaningful way. When pain is considered to be a serious threat to the body, the intensity of the pain will be worse. 

This can happen in many situations, for example:

-The source of the pain is not well understood, leading to fear that the pain might be something very serious.

-The nervous system is in a state of hyper-arousal, such as when you are stressed or tired.

-The pain or injury could have a significant impact on your quality of life, career, relationships or hobbies.

-The injury occurred through a traumatic event such as a car accident.

What does this mean for my treatment?

Along with all our more traditional treatments, we also know that stress reduction strategies, mindfulness and addressing any emotional trauma associated with pain can all help to aid recovery and improve quality of life. Your physiotherapist is a great person to speak to about pain management strategies so you can get the most out of your life while dealing with long-term pain.

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.

Tibialis Posterior Tendinopathy

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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

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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

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 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

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 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?

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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.

Move More, Sit Less – 5 Tips from your Physio

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CUMBERLAND PHYSIOTHERAPY PARRAMATTA: More movement in your day can improve mental, physical health and even workplace productivity. Physiotherapists know that one of the most significant contributors to pain and injury is simply lack of physical activity. Getting more movement in your day doesn’t need to be about high-intensity exercise, all movement can be beneficial. Here are a few tips to help increase the amount of motion in your day. 

 

1. Try the Pomodoro Technique at work or when studying

 

The Pomodoro Technique, developed in the late 1980s, recommends breaking work into intervals, usually 25 minutes at a time interrupted by short rests. Studies’ have shown that by creating small time limits, you can focus more intently and the breaks can be useful motivators. 

 

Use these intervals as prompts for a short walk, some squats or stretches. Not only will you have made your day more productive, but you will also have added some movement to your day. 

 

2. Challenge a friend to match your steps

 

A little healthy competition is a great way to keep you motivated to move more. You can set daily, weekly and monthly targets and compare progress to keep you on track. You can use an app like ‘Habitica’ to help track and create movement habits in a game format. 

3. Park further away 

 

This is an oldie, but a goodie. If you can’t ride or walk to your daily destinations, try parking further away and using the opportunity to walk. Taking the stairs instead of the elevator and getting up and walking while taking phone calls are also great ways to increase your daily movement. 

 

4. Have a kettle boiling exercise routine.

 

The time spent waiting for the kettle to boil can feel like an eternity. Use this time to undertake a mini exercise routine. Try fitting in two sets of five squats, five lunges; five heel nurses or try to balance on each leg for two minutes. 

 

5. Stretch before bed

 

Gentle stretches before bed are a great way to relax and keep your joints mobile. Create a routine and make it part of our nightly ritual for better sleep and a healthier body. 

 

Our physiotherapists are happy to help you find strategies to create more movement throughout the day. Come and have a chat with us to see what might work for you.  

 

Can Poor Balance Lead to Ankle Sprains?

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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

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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. 

Three Essential Things to Ask Your Physio

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CUMBERLAND PHYSIOTHERAPY PARRAMATTA: A visit to the physio is never high on anyone’s wishlist. It usually means you’ve been the unfortunate victim of an injury or suffering from pain. While we love to treat our clients, we know that the most desirable outcome is that you no longer need us. Here are some questions that we suggest you ask any time you attend treatment to help you speed up your recovery. 

What can I do at home to optimise my recovery?

Physiotherapy treatment time is limited and often the most effective treatments are the exercises that you do at home. Your physiotherapist will give you a program to complete in your own time however, if you’re open to it they will certainly have more suggestions for you. You can also ask what kinds of lifestyle modifications will speed up recovery and how to improve your overall health. 

What can I do to prevent this from happening again?

Understanding the root causes of your injury or condition is crucial for preventing future recurrences. By discussing prevention strategies with your physiotherapist, you can gain valuable insights into lifestyle modifications, ergonomic adjustments, and preventive exercises tailored to your individual needs. Whether it’s addressing poor posture, modifying your workout routine, or implementing proper exercise techniques, proactive measures can help reduce the risk of re-injury and promote long-term well-being.

How long should my recovery take?

Recovery timelines can vary depending on the nature and severity of your condition, as well as individual factors such as age and overall health. By asking your physiotherapist about expected recovery timelines, you can set realistic expectations and track your progress along the way. While some injuries may heal relatively quickly with thorough rehabilitation, others may require more time and patience. Knowing what to expect can help you make adjustments that will incorporate those timelines and 

What are the signs that I am fully recovered?

Achieving full recovery means more than just the absence of symptoms; it entails restoring optimal function, mobility, and quality of life. Your body is very effective at compensating for joint stiffness and muscle weakness for long periods before you start to notice symptoms. Your physiotherapist can identify any areas of concern and make sure you’re well on your way to a pain-free future with less risk of injury. Often you can become pain-free by simply avoiding any activity that provokes pain, our goal is to make sure you can do everything you used to be able to do at full capacity. 

Your health and wellness are priceless commodities, a physiotherapist’s role is to empower you to stay strong and pain-free. Any questions that can aide your understanding of treatment are always welcome and can often have a very positive impact on your recovery.