Author: Cumberland Physiotherapy

CUMBERLAND PHYSIOTHERAPY PARRAMATTA: If you’ve ever started a new hobby and noticed your balance isn’t quite up to scratch, it can be quite a disturbing discovery. Balance is an important part of many activities and if your balance is not being challenged regularly, it’s easy for it deteriorate without you noticing.

What is balance? 

Keeping your balance refers to a state where your centre of gravity is maintained over your base of your support, preventing you from falling. Your body is always working hard to keep this equilibrium without you realising it. Balance is controlled by many systems that work together, including the visual, vestibular, proprioceptive and musculoskeletal systems.

What is proprioception? 

Proprioception refers to the awareness of your body’s position in space. The central nervous system gains sensory input from the muscles, skin and tendons and interprets the information, creating a sense of where your body is positioned. This is how you know your foot is flat and ready to take your weight when you step, without needing to look at it. You may not have heard of proprioception before, but it is vital to keep you from falling and can be improved.

How can I test my balance? 

Your physiotherapist is able to assess your balance more extensively, however here are a few quick tests you can do at home to see if your balance can be improved.

Stand with two feet together and close your eyes. 

Try again, this time standing on one foot. Close your eyes only once you have found a steady posture with your eyes open. 

To increase difficulty, stand on an uneven surface, like a pillow on the floor. 

Aim to balance for at least 30 seconds in each of these postures. If you can’t have a chat with your physiotherapist and see if your balance can be improved. They will be able to offer you some practical tips on how to reduce falls and injuries.

CUMBERLAND PHYSIOTHERAPY PARRAMATTA: Strains and sprains are words that are used almost interchangeably when describing injuries, however, they each have quite distinct meanings. The most straightforward explanation is that a “strain” refers to a tear in a muscle or tendon, while a “sprain” refers to a tear in ligament fibres. Here we briefly describe what that means and how we treat sprains and strains differently. 

Ligaments are fibrous tissues that connect and hold bones to other bones. These are very strong parts of your anatomy and, depending on the joint, provide large amounts of support and stability to the body. 

Some ligaments are so strong that sometimes a bone will break before the ligament will tear. When ligament fibres do tear, the nearby joint can feel unstable as it has lost some of its structural support. 

A torn ligament will usually become painful and swollen, it may appear red and also warm touch and occasionally there will be some bruising. The pain will be worse with movement or if the ligament is placed under more stress. Occasionally, if a ligament has torn all the way through, the pain will not be as severe as it is with a partial tear.

Your physiotherapist can grade the severity of a ligament sprain, which will help guide treatment and expected recovery times. Muscle strains are easy to confuse with ligament sprains, however, there are a few tell-tale differences. Following a muscle tear, it is more likely that you’ll feel weakness rather than instability. The pain will also be isolated over the muscle, rather than near a joint. 

An injury to a ligament will be tender over the site of the ligament and special tests can be done to test for any joint laxity. Treatment is also slightly different as sprains will need more support and will sometimes even need to be braced, whereas muscle strains will benefit from gentle movements earlier. In both cases, following the basic principles of rest, ice, compression and elevation is great advice in the early stages of any injury. Applying heat is not recommended until at least two days after the injury.

It is important to seek a professional opinion when recovering from both a strain and a sprain. It is very easy to re-injure an area while it is healing if undertaking strenuous activity too early and without correct rehabilitation. Speak to your physiotherapist for more information. 

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

CUMBERLAND PHYSIOTHERAPY PARRAMATTA:

1. Problems that seem to arise for “no reason” are usually a result of disuse or lack of movement. 

It’s common to want to know why pain has occurred; however, it’s not always easy to identify a cause. What you come to learn as a physiotherapist is that pain and tissue damage are just as likely to arise from disuse and inactivity as they are to develop from an accident. 

Our bodies are made to move and modern-day life simply doesn’t allow for enough movement. We certainly shouldn’t be sitting as much as we are as this allows our joints to stiffen, muscles to shorten and weaken, and nerves to become extra sensitive. 

There is also evidence that movement is essential for joint health, due to the movement of joint fluid that provides nutrients to the joint structures. The reason physiotherapists are always advocating for more movement is that we see the long-term effects of disuse on a daily basis. 

2. Bad habits are hard to break, but the best time to make a change is today. 

Small, gradual changes made today can have a big effect in the future. Some habits that should be formed early are incorporating as much exercise into your routine as possible. It’s harder to be fit and active in your 60s if you weren’t active in your 30s. 

Being active now is arguably one of the most important things you can do to ensure you have a comfortable and healthy later life. Other changes that are best to make today are improvements to your posture and balance as these both will tend to deteriorate over time.

3. Pain is affected by so much more than just tissue damage. 

Your beliefs and attitudes about pain can have a huge impact on how you experience pain. Being fearful and anxious will amplify pain. The worst-case scenario is actually very unlikely and seeking the treatment of a physiotherapist can help to ensure the best outcomes possible.

CUMBERLAND PHYSIOTHERAPY PARRAMATTA:

WHAT IS IT?

The AC (acromio-clavicular) joint is a thick fibrous joint that connects the top of the shoulder blade to the outer end of the collarbone. The joint is required to be strong and supportive and is the primary way in which weight-bearing forces are transferred from the upper limb to the rest of the skeleton. The joint is connected by three strong ligaments, the Acromioclavicular, Corococlavicular and Corocoacromial ligaments.

HOW DOES THIS INJURY OCCUR?

The primary mechanism that will cause this joint and its ligaments to be injured is a force that separates the shoulder away from the collarbone, usually in a downwards direction. This can occur from a fall into the ground where the top of the shoulder hits the ground first, a rugby tackle or a fall onto an outstretched hand. As with all injuries, there are many variations in severity and a grading system has been developed to classify AC joint injuries.

WHAT ARE THE SYMPTOMS?

After an AC joint injury, there is usually immediate pain on the top of the shoulder, swelling and bruising. There is often loss of movement of the shoulder and pain from putting weight through the arm or carrying heavy objects. In severe cases, there is a visible lump on top of the shoulder, known as a ‘step deformity’, which is where an obvious height difference can be seen between the top of the shoulder and the collar bone. There is frequently pain felt when reaching across the body, as when putting on a seatbelt.

To confirm the diagnosis, your physiotherapist can perform some clinical tests and an X-ray can help to grade the severity of the injury. The classification that would be given to you by your physiotherapist or doctor help to determine the optimal course of action for each injury based on current research and available techniques.

There are different classification systems, some use four grades and the other six. Injuries with a smaller number of ligament fibres being torn are given a lower grade classification, going upwards as further damage is incurred. Injuries classified as higher grades will require surgical repair.

HOW CAN PHYSIOTHERAPY HELP?

The role of physiotherapy, in this case, is to ensure the joint is supported and given a chance to heal naturally while maintaining the strength and normal movement of the shoulder girdle. This is done initially by providing support to the joint. You may need to have your arm supported in a sling or brace for some of this time and your physiotherapist can show you some taping techniques to add support.

Most AC joint sprains take six weeks to fully heal, although many patients report shoulder problems in future years. For this reason, a comprehensive rehabilitation program is very important. More severe sprains are often treated with surgery to stabilise the joint and treat any possible fractures. Surgical repair will also require a proper rehabilitation program.

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

CUMBERLAND PHYSIOTHERAPY PARRAMATTA: 

Our muscles play an important role in the movement of our body. Without our muscles, we wouldn’t be able to bend our elbow or straighten our leg. As our muscles are soft and designed for flexibility, they are also prone to injury and if you have ever had a muscle tear, you know that they can be surprisingly painful. 

In the period following a muscle tear, there are a few mistakes we see people make, that can actually make their injury worse and delay healing times. Here are a few of the most common mistakes we see. 

1. Stretching 

After a muscle tear, the damaged fibres slowly begin to heal and reattach to each other. This process can be quite fragile and during the early stages, aggressive stretching of recovering tissue can impair healing or even lead to more tearing. While gentle stretching a few days after the injury can have a positive effect, you should check with your physiotherapist to ensure you’re not stretching too far and causing further damage.

2. Applying H.A.R.M.

Most of us are aware of the acronym R.I.C.E (rest, apply ice, compress the area and elevate) as the recommended treatment in the early stages of an acute injury. The acronym H.A.R.M is less well known and is used to remember the things you shouldn’t do after an injury. This stands for applying heat, drinking alcohol, running or massage. All of these activities can increase swelling, pain and increase the damage of the injury in the first 48-72 hours. 

 3. Failing to see a physiotherapist 

The diagnosis of a muscle tear might seem straightforward, however, there might be more going on than you realize. Many conditions can mimic a muscle tear, or you may have suffered a tear due to an underlying weakness or pathology. Having a physiotherapist confirm your muscle tear or identify another condition is vital to ensuring you recover fully. 

Your physiotherapist is also able to identify any factors that could lead to further injury and is able to help restore your tissue to its previous level. 

4. Returning to sport too early 

One of the most confusing things about muscle tears is that often they become less painful while the tissues are still not completely healed. Many people suffer another tear simply because they return to sport too early. While you may feel as though your tissues are back to full strength, the muscle fibres can still be healing and vulnerable to a tear. It is important to test your injury gradually, starting with gentle exercise and building up to high-intensity activities. 

Your physiotherapist is able to guide you with a full rehabilitation program. This can help to restore strength, flexibility and control to your damaged muscle, keeping you injury free for the future.

CUMBERLAND PHYSIOTHERAPY PARRAMATTA: A chest infection can leave you feeling terrible, and it’s not always just your chest and throat that are affected. There are many secondary symptoms that come with persistent coughs and sneezes, here are a few that your physiotherapist can help with.

PELVIC FLOOR WEAKNESS

Prolonged coughing can put additional pressure through your abdomen and pelvic floor, which can be a problem if you don’t have very good strength to start with. If sneezes and coughs are starting to leave you with a little leakage, know that this is very often treatable. Many physiotherapists specialise in pelvic floor control and strengthening. 

HEADACHES

Coughing and sneezing can raise your ICP, the pressure of blood on the cranial circulatory system. This can cause a throbbing feeling in your head when feeling unwell. Coughing elevates this pressure, resulting in increased feelings of heaviness and aching. You may also find that coughing and sneezing bring your head into a forward position, putting additional pressure on the muscles at the base of the skull, the most common culprits in causing headaches. 

BACK PAIN

Coughing and sneezing also put pressure on your lower back and ribs. If you already suffer from back pain, this might be obvious to you. Many people experience an episode of acute low back pain during or after a chest infection thanks to a sudden, awkward cough. Sneezes in particular create a sudden force on your body that can lead to strains and sprains of the ligaments and muscles around the spine. 

GENERAL ACHES AND PAINS

When your body is in a heightened immune state while fighting an infection, your entire body can feel stiff and achy. Any preexisting pains can be more painful, particularly neck and thoracic pain. 

This article is not intended to replace medical advice. Speak to your therapist for more information on how physiotherapy care might be able to help you.

 CUMBERLAND PHYSIOTHERAPY PARRAMATTA:

A visit to the physio is often at the front of your mind when you tear a muscle or wake up with a stiff neck, however, there are many other conditions that you might be surprised to hear physiotherapists can help with. Here are a few that you may not be aware of.

Respiratory Problems

Physiotherapists are one of the first ports of call to help clear a chest infection, particularly for the very young, elderly and those with chronic conditions such as cystic fibrosis. Your physiotherapist can assist with drainage, breathing cycles and physical percussion techniques to help you breathe easier. 

Vertigo

Benign Paroxysmal Positional Vertigo is a specific type of vertigo caused by loose microcrystals in the inner ear, resulting in dizziness when the head is turned in different positions. Your physiotherapist can give you exercises to relocate these crystals and regain your balance. Physiotherapists can also help with habituation exercises to help manage other types of vertigo and improve symptoms of dizziness. 

Neurological Conditions

Strokes, cerebral palsy, multiple sclerosis, spinal cord injuries and head injuries are all conditions that your physiotherapist has been trained to treat. In the private practice setting, they are particularly helpful at stretching the tight muscles affected and providing specially tailored strengthening exercises. 

Developmental Delays, balance and Incoordination

For some children, balance and coordination don’t come easily. Your physiotherapist can prescribe exercises to assist with improving balance and coordination for people of any age. 

This article is not intended to replace medical advice. Speak to your therapist for more information on how physiotherapy might be able to help you.

CUMBERLAND PHYSIOTHERAPY PARRAMATTA: 

The shoulder joint is surrounded by a ring of flexible connective tissue, known as a labrum. This labrum increases the stability of the shoulder while allowing the joint to stay flexible. The biceps muscle has an attachment directly into the labrum and this is often a point where injuries occur. 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). 

How do they happen?

SLAP tears can be caused by trauma such as a fall onto an outstretched hand or can develop over time through repeated stress. Repetitive overhead activities such as throwing or painting can gradually weaken the labrum over time and lead to a tear.

What are the symptoms?

Often if a SLAP tear develops over time, patients can be unaware they have sustained an injury at all and there is no significant impact on their pain or function. Preexisting SLAP tears can, however, place more tension on the long head of the biceps tendon, leading to overuse disorders as a secondary complication. 

When the tear occurs through a sudden action or trauma, symptoms can be more noticeable. Patients 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 feel 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 can help diagnose a SLAP tear and send you for further imaging if needed. SLAP tears are 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 then recommended. Surgery will 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 condition.