Tag: Physio Parramatta

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. 

Wrist Sprains

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What is a wrist sprain? 

CUMBERLAND PHYSIOTHERAPY: Wrist sprains are a general term used to describe any injury to the wrist that doesn’t include a fracture. While this can indicate that they are not serious injuries, wrist sprains can be complicated injuries that require supervision and treatment to recover fully. 

The wrist refers to the area where the bones of the forearm, the radius and ulna, meet and join the bones of the hand. The wrist is able to twist on itself and allows the hand to move to face palm up (supination) or palm down (pronation). The hand is also able to move up and down (flexion/extension) and side to side (abduction/adduction). To allow such complicated movements, the joint surfaces of the wrist are held together by a series of ligaments. When a wrist is sprained, it is usually these ligaments that have been damaged. 

What are the symptoms?

The primary symptom of a sprained wrist is pain with movement of the joint or when taking load, such as when holding a heavy object. 

Ligament injuries are given a grading scale to indicate their severity, which can help to guide treatment. Grade I tears refers to a stretching or laxity of the ligament fibers and injuries of this grade usually heal with rest within 2-3 weeks. A grade II classification signifies that there has been a partial tear of the ligament fibers and will often need more time and treatment for recovery. Grade III tears refer to a full thickness rupture of a ligament and may require splinting or even surgery. 

The most common cause of a wrist sprain is a fall onto an outstretched hand. Ligament injuries can also happen gradually through over use, although this is less common. 

What is the treatment?

Your physiotherapist is able to help diagnosis a wrist sprain and can help to rule out a fracture. An X-ray might be required and your physiotherapist will perform special tests to help identify exactly which structure has been injured, giving the injury a grade, to help guide treatment. 

How can physio help?

The key to effective recovery for a wrist sprain is often in ensuring that the right treatment protocols are in place for your injury. Grade I sprains will recover best with gentle exercises and early strengthening while Grade II to III injuries may require splinting or even a surgical consult for repair. 

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

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

What to expect with Injury Healing

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CUMBERLAND PHYSIOTHERAPY: When injury strikes, the first thing that most of us want to know is ‘how long will this take to heal?’ Unfortunately, the answer to this can be complicated and requires at least a little understanding of how the different tissues of the body heal. Each of the tissues of the body, including muscles, tendons, ligaments and bone, heal at different speeds and each individual will have some variation on those times as a result of their individual health history and circumstances. 

Understanding the type of tissue injured and their different healing times is an important part of how your physiotherapist approaches treatment and setting goals for rehabilitation. On an individual level, a patient’s age, the location and severity of the injury and the way the injury was managed in the first 48 hours all affect the healing times of an injury. Unfortunately, as we age, injuries do tend to heal more slowly than when we are young. Any medical condition that reduces blood flow to an area, such as peripheral vascular disease, can also reduce the body’s ability to heal at its usual rate. 

There are some guidelines that can be followed when predicting how long an injury will take to heal based on the tissue type affected. Muscles are full of small capillaries, giving them a rich blood supply, and as such, they have a comparatively fast healing time with 2-4 weeks for minor tears. This time will be extended for larger tears and more complicated presentations. 

Ligaments and tendons have less access to blood supply and injury to these tissues generally take longer to heal. Larger or complete tears of all soft tissues, may not be able to heal themselves and in rare cases, surgery may be required for complete healing to occur. Similarly, cartilage, the flexible connective tissue that lines the surface of joints is avascular, which means it has little or no blood supply. To heal, nutrients are supplied to the cartilage from the joint fluid that surrounds and lubricates the joint.  

While the different tissues of the body all have different healing times, they do follow a similar process of healing with three main stages, the acute inflammatory phase, the proliferative stage and finally the remodelling stage. 

The inflammatory stage occurs immediately after an injury and is the body’s primary defence against injury. This stage is identifiable by heat, redness, swelling and pain around the injured area. During this phase, the body sends white blood cells to remove damaged tissue and reduce any further damage. This stage usually lasts for 3-5 days. 

The proliferation stage is the phase where the body starts to produce new cells. Swelling and pain subside and scar tissue is formed that eventually becomes new tissue. This stage usually occurs around days 7-14 following an injury. 

The final stage, known as the remodelling stage is when the body completes healing with the reorganization of scar tissue and the laying down of mature tissue. This stage usually occurs roughly two weeks after the initial injury is sustained. 

At each stage of the healing process, a different treatment approach is required and your physiotherapist can help to guide you through your recovery. Ask your physiotherapist to explain how your injury can be managed best and what to expect in your recovery process.

Focus on Carpal Tunnel Syndrome

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 What is Carpal Tunnel Syndrome?

CUMBERLAND PHYSIOTHERAPY PARRAMATTA: The carpal tunnel is a small space base of the hand. This tunnel is covered by a thick ligament and creates a small tunnel where various nerves, arteries and tendons pass through from the forearm into the hand. If anything causes this space to be reduced, these structures can become compressed and damaged, particularly the median nerve. This common condition is referred to as Carpal Tunnel Syndrome (CTS).

What are the symptoms?

The hallmark symptoms of carpal tunnel syndrome are pain, numbness and weakness in the hand, usually following a typical pattern over the thumb, index and middle finger. There can also be a reduction in grip strength and wasting of the thumb muscles. Symptoms are usually worse on waking or with repetitive hand movements. Patients might also report difficulty holding items, writing or doing up their buttons.

How does it happen?

Carpal tunnel syndrome can be caused by anything that reduces the space in the carpal tunnel, including arthritis, the growth of a cyst or compression from everyday activities. The median nerve is particularly vulnerable to compression and is of the most concern as prolonged compression can cause nerve damage and permanent weakness of the hands.

How is it treated?

There are a few different treatment options for CTS. Non-surgical treatment is often recommended first, which includes physiotherapy, wearing a splint, cortisone or plasma rich platelet injections to promote nerve healing. The effectiveness of physiotherapy will depend on the cause of your carpal tunnel. If the space of the tunnel has been reduced permanently, such as with arthritis, then surgery is likely to be the most effective treatment. Carpal tunnel surgery is an operation to widen and release the carpal tunnel allowing decompression. This is a common surgery but is not without its risks or complications and requires a period of time off work for recovery.

For non-surgical cases, altered biomechanics of the arm, the mobility of the median nerve and muscle tightness may all be contributing to symptoms. In this case, physiotherapy can be highly effective, along with a period of rest, splinting and a change in daily habits.

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

Focus on Thoracic Mobility

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CUMBERLAND PHYSIOTHERAPY: Almost everyone will experience lower back and neck pain at some point in their lives, even if just in the form of a slight neck twinge after sleeping in an odd position. Spinal pain of the thoracic region is much less common, however, you might be surprised to know how important this part of the body is when it comes to pain and injury.

What is it? 

The thoracic refers to the part of the spine that is surrounded by the rib cage. It consists of 12 vertebrae with small, thick discs that sit between each of them. The thoracic spine isn’t an area that you might associate much with movement, however, this area can account for a surprising amount of flexibility, particularly in rotation.

With joint attachments both between each side of the 12 vertebrae and a rib on either side, the thoracic spine has almost more individual joints than you can count. If each of these

joints is not regularly moved through their full range they can tighten up and lose flexibility. This stiffness can become quite significant over time.

Why is it important?

Many people may not even notice this lack of movement, primarily because the neck and lower back provide much more range and can easily compensate for any loss of thoracic flexibility to complete everyday tasks.

When there is no movement occurring in the thoracic region, this means that the structures of the joints in other regions are pushed closer to their limits of range, particularly during rotation. This results in more compression and stress on these joints and the structures surrounding them, such as nerves, blood vessels and muscles.

Thoracic stiffness can be a significant risk factor for neck and lower back pain. This can also reduce the mobility of the chest wall, which can result in less efficient breathing mechanics and, in extreme cases, even reduced exercise tolerance.

How can physiotherapy help?

Your physiotherapist is able to assess your thoracic mobility and help you with treatments to improve your range, both with manual therapy and home exercises. They may even help improve your thoracic flexibility as part of a treatment plan for neck and lower back pain.

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

What Is Chronic Ankle Instability

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 Chronic ankle instability, as the name implies, is a chronic condition of instability affecting the ankle and it’s surrounding structures. It usually develops after a severe ankle sprain. However, some people are born with less stable ankles; these individuals are generally extra flexible throughout their bodies. Approximately 20% of ankle sprains lead to chronic ankle instability due to the resulting changes in ligament support, strength, postural control, muscle reaction time and sensation. 

What are the symptoms?

As well as being more susceptible to ankle sprains, people with chronic ankle instability may notice they are extra cautious during high-intensity activities, if running on uneven surfaces or when changing directions quickly. They may experience a sense of weakness or frequent ‘giving way’ when weight-bearing.

What are the causes?

The primary causes of this condition are ligament laxity, decreased muscle strength of the muscles surrounding the ankle and reduced proprioception. 

Following an ankle sprain, ligaments can be stretched and slightly weaker; in severe cases, they have torn altogether, leaving the ankle structurally weaker. Without full rehabilitation, the surrounding muscles also become weaker, and studies have shown that balance and sensation of the ankle can also be reduced. This means that the ankle is more likely to be injured again, creating a vicious cycle leading to further instability.

How can physiotherapy help?

Physiotherapy treatment for chronic ankle instability focuses on improving strength, control and balance with a variety of techniques. This approach can significantly improve ankle stability and reduce the risk of future sprains. Physiotherapists can help patients to regain confidence and get back to their best performance. 

In some cases, orthotic braces for support can be used. However, this can lead to dependence and further loss of strength and control if used unnecessarily. In cases of extreme ligament laxity or if physiotherapy fails, surgery to repair the damaged ligaments is considered. This is usually combined with a full physiotherapy rehabilitation program for greatest success.

If you don’t feel 100% confident with your ankle, come and have a chat with one of our physiotherapists to see if we can help improve your ankle stability. 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

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 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.

Surprising Skills That Improve With Age

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 Many of us associate ageing with a decline of skills and quality of life. However, the truth is not as black and white as this. While certain skills and functions do tend to suffer as we age, surprisingly there are many abilities that actually improve as we grow older. 

Some studies have shown that happiness is U-shaped, proving that the mid-life crisis is real, with the ages between 40-60 holding the highest amount of stress and responsibility for adults. It seems that happiness increases steadily after this period, with the average 80 year old reporting themselves to be as happy as the average 20 year old. 

There is also evidence that your beliefs about ageing can act as a self-fulfilling prophecy. If you are positive about ageing, then your experience will be more positive than if you have negative beliefs about it. 

It’s not only good news about your mental health though. Studies have also shown that while your short-term memory might decline, other skills such as creativity can actually increase. One of the biggest reasons for a decline in skill and function is the disuse that comes with retirement from work. Keeping active and mentally stimulated can be enough to keep your skills up to speed. 

It has also been shown that confidence grows in both genders as we age. Making decisions becomes  easier as we know ourselves better and have a wealth of experience to draw on when a tricky situation arises. 

Certain physical skills such as strength and agility might decline, however it seems that other aspects of physical ability might increase, including endurance. There are many triathletes who are in their 70s, 80s, and unbelievably even in their 90s. In the absence of any serious disability, it might be the case that age is an excuse rather than an actual hindrance to being active. 

Verbal ability and vocabulary are also skills that improve as we age, which may explain why crosswords are so popular with the elderly. Making the most of your abilities at every age is important, so try not to let age be a barrier to trying new things and keeping active. 

Physiotherapists are dedicated to helping people stay active at any age and can help you with achieving your goals. Speak to your physiotherapist for more information.

Frozen Shoulder

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 What is frozen shoulder?

Frozen Shoulder (also known as Adhesive Capsulitis) is a condition that affects the shoulder joint with no apparent (idiopathic) cause. It is characterised by severe pain and stiffness of the shoulder. The shoulder capsule thickens due to lack of synovial fluid, which leads to tightness and stiffness. Frozen shoulder occurs most frequently between the ages of 40-60 years old and affects more women than men. 

How does it happen?

The cause of Frozen Shoulder is still unknown, however some risk factors have been identified that increase your chances of developing the condition including diabetes mellitus, stroke, shoulder injuries and immobilisation.

The hallmark sign of Frozen Shoulder is being unable to move your shoulder even with the help of other people. This is particularly noticeable when moving the arm away from the body. Physicians may ask you to undergo investigations such as X-ray and MRI, however frozen shoulder doesn’t tend to show up on imaging. 

What are the symptoms?

Frozen Shoulder has three stages:

1. Freezing (Painful stage) – lasts from six weeks to nine months; patient has a slow onset of pain (usually pain at rest), and the shoulder starts to experience limitation of motion

2. Frozen (Adhesive stage) – lasts from four to six months; pain begins to diminish (the shoulder is still usually painful with movement), of the shoulder getting stiffer, and activities of daily living are affected).

3. Thawing (Recovery stage) – last six months to two years; shoulder’s normal range of motion is slowly returning to normal

How can physiotherapy help?

Though Frozen Shoulder is a self-limiting condition, an important part of physiotherapy management is the prevention of related neck and shoulder issues secondary to the original problem. As you can imagine, frozen shoulder can be extremely debilitating and many adaptations occur in the surrounding musculature. Physiotherapy also acts to reduce pain throughout phases one and two, while restoring joint movement as the joint moves through the painful phase. This is done through a variety of treatments, including heat, stretching, joint mobilisation, range of motion exercises to improve shoulder’s motion and resistance exercise to strengthen, you will also be given a home exercise program. Recovery time varies with every patient. If you’re working hard to regain your normal shoulder function, you’ll be rewarded with a faster recovery.

Medical management includes medications and corticosteroids, joint manipulation while under anaesthetic and/or surgery, however at this point nothing has come close to providing a consistent and simple cure.

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.