Author: Cumberland Physiotherapy

What is Trochanteric Bursitis?

 

A bursa is a small jelly-like sac of fluid that sits between bone and soft tissue; there are many of them located around the body and their function is to reduce friction between two structures. When a bursa is irritated through excessive or abnormal stress, it can become inflamed.

 

The greater trochanter is the bony prominence you can feel on the side of your hip. This part of the thigh bone sticks out because this is where many muscles attach. There are two bursae near the trochanter, namely the gluteus medius bursa and the trochanteric bursa. Both can become irritated and inflamed and are covered under the umbrella term of “trochanteric bursitis”.

 

What are the symptoms?

 

This condition usually starts with pain on the outside of the hip, which can radiate to the knee and/or the back of the thigh. It is often made worse by repetitive movements such as cycling, walking, getting into and out of cars, and walking up or down stairs.

 

Certain people are more at risk of developing trochanteric bursitis; for example, it is shown that women are affected more often than men and those involved in repetitive sports such as running and speed walking have also been shown to have higher occurrences of the condition. Previous hip injuries such as falls onto the side of the hip, bumping into furniture, or lying on the same side every night in bed without turning can predispose to trochanteric bursitis. Structural issues such as spinal arthritis, scoliosis or a leg length discrepancy can be considered as risk factors for this condition too.

 

So, how is trochanteric bursitis treated?

 

There are a number of ways in which this condition can be managed. Firstly, patients should try conservative treatment; i.e. physiotherapy and activity modification. Those partaking in repetitive activities such as running

 

or cycling may require a period of relative rest and strengthening exercises of major muscle groups may be prescribed. Soft tissue release or massage by a qualified therapist can help by alleviating tightness and tension around the trochanteric bursa.

 

When conservative treatment doesn’t seem to work, medical management may include corticosteroid injections or the use of anti-inflammatory drugs, either of which may be prescribed at the discretion of a medical doctor.

Although trochanteric bursitis can be a relatively straightforward condition to treat, as always, prevention is better than the cure. Planning an appropriate exercise regime that incorporates graduated strength and conditioning exercises is key in order to maintain healthy tissues and prevent painful conditions such as trochanteric bursitis. Speak to Matthew for more information.

 

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

Health and wellness are terms that are often used interchangeably and both are important in physiotherapy. While the terms are similar, they do have slightly different meanings.

 

Health refers to the state of wellbeing in physical, mental and social terms, rather than just the absence of disease. Wellness, however, encompasses the ability of a person to experience personal growth in emotional, physical, psychological, spiritual, social and intellectual terms. Both are important factors in maintaining a high quality of life.

 

Unfortunately, most healthcare systems cater primarily towards cure rather than prevention. An active lifestyle is one of the most effective ways of preventing the development of chronic diseases later in life, as well as being key when managing pre-existing conditions. Physiotherapists are well positioned to help you to develop and maintain an active lifestyle.

 

It is widely accepted that chronic, or non-communicable, diseases (NCDs) are the leading cause of death and disability in the modern world. The four most common of these are diabetes, cardiovascular disease, cancer, and chronic respiratory conditions. They have a common theme: each is associated, at least in part, with individual lifestyle choices and behavioural patterns. Person-dependent factors including diet, exercise, alcohol and tobacco use play a role in the development of these chronic diseases.

 

For example, current guidelines suggest that healthy adults should undertake 30 minutes of moderate intensity exercise five days per week, in order to maintain ideal body weight and physical fitness. People who have pre-existing conditions such as diabetes need specifically tailored advice, which their physiotherapist can provide.

Goal setting can also be a useful tool in the development of health and wellness. Physiotherapists can help you to set and achieve SMART goals; i.e. objectives that are specific, measurable, achievable, realistic and timely.

 

Little by little, you too can work towards the ultimate goal of total wellness and health! Speak to Matthew about how you can improve your health and wellness.

The knees take a lot of impact 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 exactly is this mysterious meniscus, and why is it so important?

 

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.

 

Can I recover from a meniscal injury?

 

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, talk to your physiotherapist about your options.

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

Started a new exercise regime lately and noticed your balance isn’t quite up to scratch? Chances are, you need to dial things back a little and return to the basics. Balance is an important part of fitness and improving your balance can dramatically improve your performance.

What is balance?

Balance is a state in which weight is evenly distributed in order to prevent falling. Balance has major parts:

• Sight
• Vestibular system (the inner ear)
• Proprioception

 

Change any one of these three variables and you’ll challenge your balance in different ways.

 

What is proprioception?

Proprioception refers to the awareness of a person about their body’s position in space. The origin of the word is derived from Latin, and it translates as “one’s own perception”. The central nervous system gains sensory input from receptors in the skin known as mechanoreceptors. This information is processed by the brain, and helps to translate data sent from the body in the form of vibrations, pressure, motion and joint position. Proprioception helps to maintain stability.

How can I test and improve my proprioception?

1. Stand with two feet together.
2. Close your eyes.
3. Count how long you can maintain your balance for.
4. Try again, this time standing on one foot. Close your eyes only once you have found a steady posture with your eyes open.
5. To increase difficulty, stand on an uneven surface, like a pillow on the floor. Start by standing with two feet together; stand on one foot if this becomes too easy.

 

While this isn’t a definitive test, if there is a significant difference in your balance when your eyes are open to when your eyes are close, or from the right side to the left side, your proprioception might be a little diminished.

 

Speak to your physiotherapist for more practical tips on how to reduce injury incidence by improving your balance and proprioception.

As the warmer summer months beckon and time spent outdoors starts to increase, it’s the perfect excuse to de-clutter your surroundings, be it at home or at work. A clean environment helps to maintain a clear head, and the act of cleaning can be therapeutic in itself. Vigorous cleaning can burn up to 90 calories per fifteen minutes; that’s up to 360 calories per hour!

Vacuum cleaning, sweeping and mopping the floor raise the heart rate and can be incorporated into a cardiovascular workout. Lifting and moving heavy objects such as furniture can be incorporated into your strength training, while cleaning windows, hanging curtains and washing walls all have a stretching component. However, with vigorous cleaning comes the risk of over-exertion; necks and backs are particularly at risk of injury.

Make sure to maintain good alignment while doing all of these exercises in order to minimize your chances of injury.

Step-ups:

These are a great low-impact exercise to activate the gluteal muscles and core, and can be done while vacuuming the staircase. Keep your knees no further forward than your toes, and bend from the hips as you push up onto the standing leg by squeezing your backside muscles.

Squat twists:

Keep your knees bent and core engaged while you use your oblique muscles to rotate your body from the waist while mopping the floor.

Single-leg standing obliques: while washing the windows, engage the lateral abdominal muscles to pull the arms down to the side of the body as you balance on one leg.

Lunges:

Keep your back straight and front knee above your ankle while lunge walking as you sweep the floor. Try to lunge as low as possible while keeping a good technique.

Running is a great way to stay in shape, manage stress and increase your overall wellbeing, however it’s not without it’s drawbacks. While being a low risk activity, there are a few injuries that commonly affect runners. As running is a repetitive impact activity, most running injuries develop slowly and can be difficult to treat. Here are three of the most common conditions faced by runners.

 

1. Runner’s Knee:

Runners knee is a persistent pain on the inside of the knee caused by the dysfunctional movement of the kneecap during movement. The kneecap ideally sits in the centre of the knee and glides smoothly up and down as the knee bends and straightens, in a process described as tracking. If something causes the kneecap to track abnormally, the surface underneath can become worn, irritated and painful. The pain might be small to start with, however left untreated, runner’s knee can make running too painful to continue.

 

2. Shin Splints:

 

Shin splints is a common condition characterised by a recurring pain at the inside of the shin. While the cause of this condition is not always clear, it is usually due to repeated stress where the calf muscles attach to the tibia (shin bone). Why this becomes painful is likely due to a combination of factors that can be identified by your physiotherapist to help you get back on track as soon as possible.

 

3. Achilles Tendonitis:

 

The Achilles tendon is the thick tendon at the back of the ankle that attaches to the calf muscles. The amount of force that this tendon can absorb is impressive and is vital in providing the propulsive force needed for running. If the stresses placed on the tendon exceed its strength, the tendon begins to breakdown and become painful.

If you’ve just taken up running, you probably think that getting started is simple – you just run as far as you can and then run further the next time. Like most things, the reality is a little more complicated. Here are some tips to make the most of your running program and avoid injury.

• Don’t overdo it.

Rest is actually a big part of a training program. Your body needs time to recover and rebuild muscle. Not giving yourself adequate time to rest leads to greater risk of injury and you won’t improve as quickly as you might think. Aim to run three times a week.

• Don’t forget strength training.

Even if you’re trying to improve endurance, surprisingly, increasing strength can make a big difference. Particularly if you focus on specific muscles that may be weaker on one side of the body. This is also an important part of injury prevention. Your physiotherapists can help you to identify any weak muscles and develop a strengthening program.

• Your shoes and running surface matter.

Running on hard or uneven surfaces leads to a greater risk of injury than running on grass, which allows for a more natural distribution of forces through your foot. Having shoes that fit your foot properly and also provide necessary support is an essential part of your injury prevention plan.

• Listen to your body.

As you improve and push your abilities forward there will be many aches and pains. Most will only last for a day or two and DOMS (delayed onset muscle soreness) is a normal if not annoying part of getting stronger. However, if pain feels more serious, lasts for more than 48 hours or is preventing you from running speak to a professional as soon as possible. Running injuries do happen and can take a while to resolve. Early treatment is the best option for good outcomes.

Speak to your physiotherapist for more practical tips on how to improve your running and prevent injuries.

Why are workplace injuries so common?

 

When we’re at work, we often find ourselves doing the same task for hours on end. The more specialised our job is, the more likely this is to be true. The human body is designed to move and perform a variety of tasks, and is unaccustomed to repetitive behaviours.

 

At work we also find ourselves faced with time constraints and tasks that need to be completed immediately. This can lead to lazy postures, lifting objects that are too heavy, or in a way that is rushed and unnecessary risk taking, just to get the job done.

 

Many injuries occur as a result of simple tasks done repeatedly over the course of several hours. Often these issues begin slowly and take many months to resolve. Here are a few tips to keep yourself pain free in the workplace.

 

When lifting:

 

Assess the risk. Do you need to ask for help or use an assistive device?

 

Use your legs to power the movement. Your legs are the strongest part of your body.

 

Never bend and twist. This is terrible for your back and a significant trigger for injuries. Instead, lift and step to turn before putting the object down.

 

When moving trolleys:

 

Push rather than pull. This is a much more efficient movement.

 

Try to push at waist height and keep forces as close to your body as possible.

 

 

When doing desk based activities:

 

Try not to use the same side of your body all the time. Practise using both left and right hands for taking phone calls and mouse work.

 

Be aware of your posture. Good posture isn’t about having a completely rigid and upright spine. It’s about being able to let your spine sit comfortably in its natural curves and be able to move in and out of this easily.

 

Stretch to counteract positions you find yourself in for long periods.

Have your workplace set up assessed and corrected by a professional.

 

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

Health care professionals seem to constantly be talking about posture. While many people take away the message that they should “stand up straighter” the truth about what good posture is and why you should aim to have it is a little more complicated.

 

One of the reasons why posture is so important is that the body has an ideal alignment for almost every joint that provides the most stability and efficiency for movement in that position.

 

This is particularly true for the spine, which has a large number of joints that work together to provide movement, stability and support for the body. The spine must also provide a stable base for the shoulder and head. When the spine is in its optimum position, this also allows for free movement of the nerves that supply the trunk, arms and legs.

 

While the human body is highly adaptable and will continue to function when a posture is not “ideal”, a lot of energy is wasted and undue stress is placed on the muscles, tendons and ligaments of the body. Over time this can cause pain, tightness and loss of flexibility.

 

While being able to find these optimum postures is important, it is also important to simply keep moving and not be stuck in the same position for long periods. No matter how ‘ideal’ a posture is, when joints are held in the same position for too long, this can be troublesome.

 

Working with a great base posture combined with regular movement and stretches can have a surprising impact on your overall wellbeing. Having good posture has been linked to higher self-esteem, improved concentration, and even better lung function.

 

Speak to your physiotherapist for practical tips on how to improve your posture throughout the day.

What is it?

 

Runners’ knee is a common disorder characterized by pain at the front of the knee during activities that require frequent and repetitive bending of the knee. The knee joint is composed of the thigh bone, (femur) and leg bone (tibia) and a small floating bone at the front, commonly known as the kneecap (patella). The interaction between these bones allows for smooth movement of the knee as it bends and straightens.

 

During movement, the kneecap sits in a groove at the front of the knee and acts as a mechanical see-saw.This protects the knee joint and improves the efficiency of the muscles working to move it.

If the kneecap does not move within its groove normally. This can cause irritation and pain of the underlying tissues, creating what is known as patello-femoral pain syndrome.

 

What causes it?

 

The quadriceps muscle straightens the knee and is made up of 4 individual muscles, all ofwhich share a common attachmentto the kneecap.The quadriceps worktogetheras a group, with some pulling to the left and others to the right as they straighten the knee. If one side of the quadriceps is over or under developed compared to the rest of the group, their pull on the patella changes, causing the patella to move out of place as it pulled along in its groove. Over time this can damage the bony surfaces underneath the kneecap, causing irritation and pain.

 

How can physiotherapy help?

 

After examination your physiotherapist can determine the cause of the pain. They may perform some muscle releases and advise you of specific stretches to perform. If there is a strengthimbalance, you will be given specific exercises aimedat strengthening the appropriate muscle to reducingany imbalance.

 

Muscular imbalance at the hips or lower back, or poor biomechanics of the lower limb and foot can contribute to the dysfunction in the quadriceps muscleand is an important part of any successful treatment.Your physiotherapist may suggest you change your footwear or add an orthotic to your shoe to improve the support ofyour foot and lower limb This may be a permanent or temporary change.

 

Other strategies your physiotherapist may try include patella strapping, dry needling, or trigger point therapy. Surgery isconsidered a last resort following a period of physiotherapy management.

 

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