LCL Tears

What is the LCL?

The knee is one of the largest joints in the body and has only one plane of movement. This means it bends and straightens but does not twist (much) or move from side to side. To keep the knee from moving in other directions, the knee is supported by many strong ligaments, with two of these being found on either side of the knee. The inside ligament is the ‘Medial Collateral Ligament’ (MCL) and the outside one is the ‘Lateral Collateral Ligament’ (LCL). The primary role of the LCL is to prevent the lower leg from moving too far towards the midline in relation to the upper leg. Both the LCL and MCL are extremely strong ligaments and provide lots of support to the knee during movement however, they are still vulnerable to injury.

How do tears happen?

The LCL is injured less often than the MCL, however tears do still occur. The most common way the ligament is damaged is through a force causing the knee to move inwards in relation to the upper leg, or a twisting of the knee. This can be seen in sports that involve changing directions or with a direct force, such as a rugby tackle. This injury can also occur from a simple fall and as with all sporting injuries, it is not only athletes who can be affected, anyone can tear their LCL in the right circumstances.

What are the symptoms?

Following an injury to the LCL, common signs and symptoms are a ‘popping’ sound at the time of injury, immediate pain with weight bearing and swelling and a feeling instability. The severity of the injury will impact how much each of these symptoms are felt and LCL tears are classified as either Grade I, II or III, which helps to direct treatment. A grade I tear is where a few fibres of the ligament are stretched and damaged, a grade II is where this a partial rupture of the ligament with some instability of the knee and Grade III is a complete tear.

How are LCL tears diagnosed?

Your physiotherapist is able to perform clinical tests to evaluate if there is any instability of the knee from an LCL tear. An MRI can confirm this diagnosis and an X- raymay be required to rule out any associated fracture. It is possible for nerve damage to occur at the same time as an LCL Tear, which will result in weakness and loss of sensation in the lower leg. Severe injuries are more likely to involve injury to other parts of the knee and your physiotherapist will make a full evaluation of all your injuries on assessment. Most LCL tears are managed well with just physiotherapy and support of the joint, however severe tears and associated nerve damage may require surgery. Your physiotherapist and medical team will work together to help determine the best course of action for each individual injury.

How can physiotherapy help?

For tears that don’t require surgery, your therapist will advise you on how to best support and protect the injured joint. In the first 48 hours, RICE protocol (Rest, ice, compression, and elevation) is applied to reduce any pain, swelling, and inflammation. Following this period, you will be advised on how best to mobilise the joint whilst preventing any further damage. Return to sport will be dictated by healing times with a full recovery expected by 6-12 weeks. Following ligament damage, balance, strength, and proprioception are often impacted and your physiotherapist will develop a program to address this, which is an important part of preventing further injury. Tears that are repaired surgically will require a longer program of rehabilitation and close liaison with the medical team.

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.

Tips to Optimise Your Physiotherapy Sessions

Physiotherapy treatment can be life changing, helping you recover from traumatic injuries, chronic pain and get you on the road to your best performance levels. There are ways to make sure you are optimising the effects of your treatment time.

Here are a few tips from our team to help you get the most out of every session.

1. Ask your therapist questions about your condition

Understanding your condition and how to best manage it is one of the most important factors for a successful recovery. Effective therapists allow time for you to ask questions in a non-judgmental environment. There are no stupid questions, if you don’t understand what is happening in your own body it is harder to follow advice and stick to protocols. This can also help you to cope with pain and feel less helpless in your recovery.

2. Follow your therapist’s advice and do your exercises

Home exercises are a key part of your recovery, especially when treatment times are limited. Try to stick to your exercise program as seriously as you would a medicine schedule. It is also important to ensure that you are doing your exercises correctly at home. Don’t be afraid to double and triple check your technique before leaving your appointment.

Your therapist will also provide you with advice regarding activities to avoid, how to stretch, when to rest and how to avoid further injury. If you’re not sure about something, ask your therapist to write it down for you.

3. Track your progress

Nothing can be more disheartening than feeling like the appointments and exercises you’re diligently attending to are making no difference. As therapists, we make regular measurements to track your improvement and know that while your symptoms might be staying constant, you are actually moving more and increasing stress on your body as you recover. Set your own measurements to help you track your recovery. This can help you stick to treatment and feel more positive as you complete your recovery journey.

4. Set goals and work with your physiotherapist to meet these.

The goals of recovery are different for everyone. Some of us want to be able to reach peak performance, such as running a marathon. For others, just getting through the day with a little less pain would be a huge success. Know your own goals and take the time to discuss this with your therapist, who will guide your treatment to help you meet these milestones.

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

 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

 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

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.

Five Holiday Challenges from your Physio

With the approach of the silly season, many people begin to consider their New Year’s goals. Unfortunately, we all know what the success rates are for the average new years resolution – most goals have been abandoned by the first day back to work. 

One way to improve your health and start your year strong is to get started right away, rather than waiting for the new year to start. Here are five challenges from us to help you get the best start in the new year.

  • Set up a daily exercise challenge from home. 

Staying active doesn’t require a gym membership. You can maintain your fitness and develop strength with simple at-home workouts such as skipping rope for three rounds of two minutes, completing two sets of 10 push-ups and squats, holding a plank for 30 seconds to one minute (twice), and doing two sets of 10 burpees. 

  • Explore the outdoors

Engaging in outdoor activities can improve both physical and mental health. Aim to walk at least 20 minutes a day to increase your daily step count while enjoying fresh air and new scenery. If you prefer cycling, dust off your bike and hit the trails.

  • Improve your balance. 

Improving balance is an underrated way to boost overall fitness and prevent injuries. Start by standing on one leg for 30 seconds and gradually increase this time to two minutes. If this 

becomes easy, challenge yourself by closing your eyes while maintaining balance. It can be surprising how quickly you can make improvements to your balance and how many other benefits this can lead to. 

  • Have all of your health appointments ready to go

The post-holiday rush can make it difficult to schedule necessary health appointments. Take proactive steps now to secure appointments for the new year. Staying ahead ensures that your health remains a priority, even during busy periods.

  • Journal your gratitude and goals

The holidays are an ideal time to reflect on your achievements and set new goals. Journaling can help solidify these intentions. Write down three things you’re grateful for each day and three goals you want to focus on. Research suggests that habits can be formed in as little as 21 days, making this a great time to begin.

By implementing these steps now, you can create a healthier foundation before the New Year begins. Speak to our physio Matthew for more suggestions on how to make your holidays a healthy one this year. 

Achilles Tendon Tears

 What is it?

The Achilles tendon is a band of fibrous tissue located at the back of the ankle. Its main role is to connect the calf muscles to the heel of the foot. This tendon is the largest tendon in the body and when it tightens, as the calf muscles contract, it pulls the heel allowing you to stand on tiptoe or to point your foot. 

Achilles tendon tears commonly occur in athletes, however, this injury can affect anyone and surprisingly, a complete tear is actually more common than a partial tear.

These tears are commonly located at the part of the tendon where there is poor blood flow approximately 6cm above its attachment to the heel. Since there is poor blood supply, this part of the tendon is both vulnerable to injury and slow to heal. 

What are the Symptoms?

Primarily, an Achilles tendon tear will cause difficulty in activities such as walking, running and jumping. Other signs and symptoms of an Achilles tendon tear include:

  • A loud pop or snap is heard 
  • Sudden and severe pain at the back of the calf or ankle
  • Feeling of having been kicked in the calf
  • There is a gap between the tendon and the heel (about 2 inches above the heel)
  • Swelling and stiffness followed by weakness and bruising
  • Difficulty walking particularly during push off
  • Standing on tiptoe may be impossible

What Causes It?

Anyone can tear their Achilles tendon if the tendon is subject to excessive force or overstretching, however there are some factors that can increase your risk of injury. The most common activities that cause this injury are running and jumping.

The Achilles tendon can thin and weaken both as we age and also if it is not used. As a result of this weakening, it becomes prone to injury like tear or rupture with less force or stretching required before an injury occurs. A tear of the Achilles is often observed in people with pre-existing Achilles tendinitis. Other factors such as certain medications including antibiotics and steroids and some illnesses like diabetes and arthritis can also result in weakness of the tendon, increasing injury risk. Being obese is also a risk factor as excess weight puts additional strain on the tendon.

How Can Physiotherapy Help?

Treatment for Achilles tendon tear will depend on the patient’s age, how severe the injury is and the patient’s activity level. For young people especially athletes, they opt to have surgery while older people choose conservative treatments including physiotherapy.

Physiotherapy treatment for an Achilles tendon tear will involve exercises to strengthen the calf muscles and the Achilles tendon and exercises for stability. Many people are able to return to their normal activities within 4 to 6 months. Functional rehabilitation is also part of the program as it focuses on how you coordinate your body and how to move it. The aim of functional rehabilitation is to help you return to your highest level of performance.

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. 

Tips for Finding Your Perfect Exercise Match

 Exercise is such an essential part of mental and physical wellbeing, however many of us find it difficult to make time to stay active. 

Often, when we think of exercise we imagine jogging or the gym. Exercise can be anything that gets you moving, and the trick to reaping the long term benefits is to find an activity that you love and do often.

Exercise can offer more than just physical benefits, a new activity can be a way to join a new community, improve self-esteem and can even improve brain function. By learning new skills or movements, your brain is laying down new neural pathways, a process known as neuroplasticityPhysical exercise has also been shown to help to improve learning and memory, in some cases even having a slight protective effect against age-related dementia. Here are a few tips to help you find the right exercise for you. 

1. Do a quick personality assessment.

Are you a competitive person? Or do you prefer to focus on your personal improvement of technique? The type of activity that captures your attention and focus will be easier for you to commit to. Matching your activity to your personality will also mean that you meet people who have similar interests to you.

2. Work with your injuries.

Injuries that stop us from participating in an activity we love can be devastating. However, you can often find another activity that doesn’t aggravate your injury, either as a replacement or to maintain fitness while rehabilitating.

If you are struggling with hip or knee pain with impact sports such as running, switching to swimming or cycling are great options. If you like a little adrenaline, then mountain biking can be more of your style. Physiotherapists are able to advise you on which activities will be suitable for your particular condition.

Capitalise on your natural ability. 

Throwing and catching might not be your thing, but your balance might be exceptional. We all have natural abilities, finding a sport that challenges and develops areas that you find to be strengths is key to enjoying a hobby.

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. 

Shoulder Labral Tears

 What is it? 

A ring of flexible, fibrous connective tissue, known as the glenohumeral labrum, surrounds the shoulder joint. This labrum increases the stability of the shoulder while allowing for the required flexibility of one of the bodies’ most sophisticated joints. One well-known muscle of the arm, the biceps, has an attachment directly into the labrum and is a common site of injury. A tear of the labrum can occur in many locations, however the most common is at the point where the biceps tendon attaches to the labrum. Usually, this tear follows a typical pattern and is referred to as a superior labrum tear, anterior to posterior (SLAP tear). 

What causes it?

SLAP tears can be caused by trauma such as a fall onto an outstretched hand or a dislocated shoulder. Tears can also develop over time with repeated throwing actions or overhead activities as the labrum is weakened and eventually injured. Traumatic tears are more likely to be symptomatic than tears that develop slowly. 

What are the symptoms?

As mentioned, SLAP tears can occur suddenly, through trauma or develop slowly through repeated stress. Often if the injury develops over time, patients can be unaware they have sustained a tear and the injury doesn’t have a significant impact on their pain or function. Preexisting SLAP tears can however, place more tension on the long head of biceps tendon, leading to overuse disorders as a secondary complication. 

When the tear occurs through a sudden action or trauma, symptoms can be more marked. Sufferers often notice pain deep in the shoulder joint with overhead shoulder movements, a feeling of weakness, loss of power and/or accuracy with throwing activities. Some people may notice a popping or clicking sensation and occasionally the shoulder may give way. In severe tears, the shoulder might feel unstable and even be at increased risk of dislocation.

How can physiotherapy help?

Your physiotherapist is able to help diagnose a suspected SLAP tear and send you for further imaging if needed. SLAP tears are often graded by severity from I to IV as a way to guide treatment. Physiotherapy is usually recommended as a trial for all tears before considering surgical repair and in many cases can effectively help patients return to their previous activities, symptom-free.  

If physiotherapy is unsuccessful, surgical repair with a full rehabilitation program is recommended. Surgery will usually either repair the tear or reattach the biceps tendon to the humerus (tenodesis). Following surgery, a period of rest in a sling is required before rehabilitation can begin. 

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.

Physio Tips for Better Running

Distance running can be a surprisingly complicated sport. In this article, we offer some words of wisdom from our physiotherapists to help you get the most out of your training and avoid injuries. 

 Choose your shoes carefully:

Repeated stress from running long distances will show up any biomechanical flaws in your body relatively quickly. Choosing the wrong shoes can exacerbate an existing problem causing pain and injury. Your physiotherapist can guide you on what style of shoe will best suit you. 

Don’t neglect your upper body:

While running can appear to be a purely leg based activity, increasing the strength and mobility of your upper body can have a surprisingly large impact on your posture, running style, breathing and overall performance. 

Find time to train strength as well as endurance:

Your body is great at finding ways to compensate for weak muscles, however, over time this can lead to overuse injuries of tendons and muscles. Identifying any areas of weakness early and specifically strengthening these muscles can both improve your running and help keep you injury-free.

Pace your progress: 

Entering an event is a great way to set a specific goal and keep you motivated. While trying to increase distances and speed, it is easy to forget to include rest days as a part of your routine. Your body needs time to recover and restore itself, just as much as the active portions of your training program.

Increasing your speed and distances gradually also allows your body to adapt to new demands without breaking down. 

Enjoy your training and listen to your body:

Your body will guide you as to when you need to rest and when you can push a little further. Training will be more enjoyable when you are well-rested and pain-free. Most importantly, if you are able to enjoy your runs, this will help you maintain motivation over a longer period of time, so you can continue for many years to come.

Ask your physiotherapist for more tips on how to reach your running goals while staying injury-free. None of the information in this article is a replacement for proper medical advice. Always see a medical professional for assessment of your individual condition.