Author: Cumberland Physiotherapy

 CUMBERLAND PHYSIOTHERAPY PARRAMATTA 

What are shin splints?

Shin splints, are a painful condition of the lower leg, also known as Medial Tibial Stress Syndrome, it is an overuse injury that causes pain along the inside of the tibia or shin bone. It is a common condition in runners, hikers and soldiers who march long distances.

What are the symptoms?

Shin splints are typified by persistent leg pain, usually the inside of the shin, halfway down the lower leg. The pain might be felt during exercise or directly after. Some people experience a dull ache over their shin that lasts for quite a while after exercise stops, while for others the pain may be sharp and fade quickly. The pain is often progressive, becoming worse with shorter distances. Eventually, shin splints can severely impact activity levels as the pain becomes too severe to continue exercising. 

Shin splints can be extremely painful and very disruptive to activity levels. As the pain usually starts gradually and progresses many people find themselves unable to continue training. Shin splints may also progress to stress fractures if not diagnosed early and managed effectively. 

How does it happen?

Shin splints are predominantly seen in runners who increase their distances quickly, often while training for an event. Activities that require repetitive weight-bearing of any kind, such as marching or high impact sports have also been shown to cause shin splints. Although the pathology of shin splints is unclear, studies have been able to identify certain risk factors that may predispose someone to shin splints. These include; 

·An abrupt increase in activity level

·Improper footwear and support

·Higher BMI 

·Training on hard or uneven surfaces 

·Tight calf muscles 

·Flat feet

·Increased external rotation range of the hips

·Females are more likely to develop shin splints than males.

·Prior history of shin splints

·Wearing or having worn orthotics

How can physiotherapy help?

The first step for your physiotherapist will be to address any contributing factors and help to adapt your training program to a level that is optimum for you. A period of relative rest may be recommended along with a targeted strengthening and stretching program for any tight or weak muscles. Switching to low-impact activities such as swimming, cycling and yoga may also help to maintain fitness during recovery. Your running technique will be analysed and any training errors may be corrected. When getting back into your training routine, it is usually recommended that distances are not increased by more than 10% per week as this allows the tissues of the body to react to the increased demands and adapt accordingly. 

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 Pregnancy brings with it many changes including physical, physiological and hormonal. As your baby and body grow, there are shifts to your centre of gravity, weight and even your joints become more flexible. All of these changes can bring with them new aches and pains along with many questions about how to protect your changing body and baby. 

Guidelines in this area are usually separated into two categories; what is safe for the baby and what is safe for the mother. Some general recommendations include avoiding activities that may increase your risk of falling, such as skiing or mountain biking. Any activity that raises your core body temperature are also not recommended. This can include high intensity exercise, hot yoga, and spas, saunas and hot baths.

Activities that are safe for the mother focus on protecting your body from injury during each stage of pregnancy. For example, it is recommended to avoid heavy lifting, and learning to activate and strengthen your pelvic floor. As your pregnancy progresses, the hormone relaxin acts on your joints and ligaments to help them become more flexible. This means that your joints are a little less stable than usual, slightly increasing your risk of sprains or strains during exercise.

How can physiotherapy help?

Physiotherapy is able to help you at every stage of your pregnancy with advice for pain management in labour and post-natal pelvic floor health. Finding the right physiotherapist with specialised training can be life changing for your long term pelvic floor health, helping to prevent incontinence. 

Your physiotherapist is also able to help you treat back and pelvic pain that commonly arise during pregnancy. This can help to prepare you for birth and help to prevent ongoing back pain following the birth as your body readjusts. 

This article is not intended to replace medical advice. Speak to your physiotherapist and medical practitioner for more information on how to stay fit, safe and healthy during your pregnancy.

CUMBERLAND PHYSIOTHERAPY PARRAMATTA Many people know the value that physiotherapy brings to their life and their physiotherapist has been with them through the highs and lows of injury and recovery throughout their life. However, for those who have never been to see a physiotherapist before, there can be a question mark over exactly what it is that physiotherapists do. 

What is it that physiotherapists do? 

The answer is tricky because physiotherapists do so much. We might be described as pain management experts, as we work to reduce the pain of our patients, from those who have suffered a new injury, to those who have had pain for several years. We first identify the cause of the pain and then provide manual therapy techniques, education and management strategies to help our patients understand, manage and reduce their pain. 

While pain is usually the first thing that brings patients to see a physiotherapist, this pain has often caused patients to give up activities that they love and can even be getting in the way of everyday tasks. By identifying the cause of your symptoms, we can help to get you back to full function. Physiotherapists are able to do this for people at all activity levels, including elite athletes and those dealing with serious disabilities. 

In fact, physiotherapists have a role to play at practically every stage of life. We can assess infants to monitor their motor skills development and as they grow we help them deal with the pains and vulnerabilities of a growing body. Among other things, we can help to prevent injuries, improve pelvic floor dysfunction and work to prevent falls in the elderly. 

Not just exercises and massage. 

Physiotherapists offer a range of treatments, from self-management strategies, stretches, manual therapies, dry needling, exercises and massage. 

A huge part of recovering from pain and injury comes from understanding what is happening and how to best manage these issues. Rather than create a dependency on their therapist, we aim to empower our patients to improve their health independently as much as possible. 

A physiotherapist’s primary goal is to improve your quality of life and remove any barriers to full participation, whether these barriers are due to pain, weakness or stiffness. 

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

 CUMBERLAND PHYSIOTHERAPY PARRAMATTA There are many reasons to choose biking as a sport. Commuting to work can help you conveniently find time for exercise, save money on transport costs and is a great way to exercise if you suffer from shoulder pain, hip or knee arthritis. Unfortunately, biking injuries are common, but in many cases, preventable. Here are a few tips from us to help you prevent cycling injuries and improve your performance.

Don’t neglect your upper body strength and trunk stability.

While cycling is a sport that predominantly uses the lower legs, it can be a mistake to think that leg strength is the only factor that matters when it comes to biking performance. 

Increasing the strength, flexibility and balance of your upper body can actually reduce the amount of effort used to cycle and the efficiency of your pedalling. Focusing on your upper body fitness can both improve your riding stats and help to prevent the neck, back and shoulder pain that comes as a result of maintaining postures for extended periods.

Yoga and Pilates are great complementary activities to help build upper body strength and stability while also counteracting the effects of prolonged flexed postures of the bike. 

Don’t skimp on your helmet.

A good quality helmet can mean the difference between a sore head and a life-changing injury. Helmets become less effective with each hit, as they can lose their shock-absorbing capacity, even if they don’t appear to be damaged. If in doubt after a crash, choose to replace your helmet as it may save your life.

Address aches and pains early

Due to the repetitive nature of cycling, overuse injuries are common. Ensuring your bike is set up corrected to minimise stress on your body while riding and paying attention to small niggles can help to identify and resolve issues early so that they can recover quicker. 

Speak to your physiotherapist for more information on how to improve your performance and stay injury-free while biking.

CUMBERLAND PHYSIOTHERAPY PARRAMATTA: Can prolonged stress affect your pain and healing? There’s a strong suggestion that it can, particularly with chronic pain. If you suffer from ongoing pain you may even have noticed this relationship yourself. Many people know that their pain is worse when they are stressed but they don’t know why. 

Stress activates your sympathetic nervous system, this is the state where we move into ‘Fight, Flight or Freeze’ mode. this part of our nervous system is responsible for keeping us safe when we are in danger, however, it can be activated for prolonged periods in modern life and many of us lack skills to return control to our parasympathetic nervous system, which is responsible for helping us to rest and digest.

How would this affect pain?

During this state, muscles become tensed and ready for action, the nervous system is extra sensitive to stimulus, blood pressure is raised and we are more likely to notice and have negative thoughts. Tense muscles can become tired and painful or put extra stress on other structures, causing pain and irritation. Quite often when in a stressed state, our breathing becomes shallow and rapid, particularly when doing work of low exertion, such as while sitting in an office. 

Use your breathing to recover.

One way to help your body return control to the parasympathetic nervous system is to consciously change your breathing. One method is to hold your breath for as long as you can, once you relieve your breath your body senses that a threat has passed and can return to a relaxed state.

Another commonly used technique is box breathing. To do this, breathe in for four seconds, hold for four, breathe out for four, hold again for four and repeat. Do this for a few minutes until you start to feel more relaxed and calm.

Show your body that you are safe.

Other activities that can help your body to relax include yoga, going for a swim or having a shower, or doing some intense exercise where your heart rate is raised.

Speak to your physiotherapist for more information on this topic and tips to help you relax during the day. 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. 

CUMBERLAND PHYSIOTHERAPY PARRAMATTA:

What are they?

The ankle consists of three bones, the tibia, fibula and talus, all held together by thick fibrous ligaments. The bottom parts of the tibia and fibula join together and surround the talus in such a way that it is able to rock forwards and back while providing stability and restricting the side-to-side movements.

The ligaments holding the tibia and fibula together are large and thick (referred to as a syndesmosis) while a normal ankle sprain is a tear of the ligaments closer to the foot, a syndesmosis tear is called a “high” ankle sprain. 

How do they happen?

A high ankle sprain can occur when you twist inwards while your foot is planted on the ground. The foot is typically pushed back and rotated outwards, putting excess pressure on the ligaments that the lower leg bones together. This force can cause the syndesmosis to tear resulting in a gapping of the two bones, which can lead to significant instability of the ankle. This can happen from every-day activities such as a fall, but most commonly while playing sports that involve running and jumping. This is also a common injury for downhill skiers. Patients are often unable to walk on their toes after this injury.

What is the difference between a high and a low ankle sprain?

High ankle sprains are much rarer than lower ankle sprains, accounting for only 1-11% of all ankle injuries. It can be very difficult to tell the two injuries apart. To complicate things, a fracture of the ankle will also have similar symptoms. Your physiotherapist will have a set of physical tests they can perform if they suspect a high ankle sprain. Ultimately imaging may be required to confirm the diagnosis. 

Why does correct diagnosis matter?

High ankle sprains can take up to two times longer to heal than normal ankle sprains and require more immediate attention. Syndesmosis tears that are left untreated can result in chronic instability and pain, making them vulnerable to further injury in the future.

What is the treatment?

Severe and unstable tears may require surgery and most syndesmosis tears will need to be put into a supportive boot for 4-6 weeks. Following this period a rehabilitation program of strengthening, mobilisation, balance, control and agility will need to be commenced before your ankle will be at its pre-injury function. 

Other medical interventions may be recommended in some cases and have been shown to have good results, when accompanied by 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

What are they?

The hamstrings are a large group of muscles, located at the back of the thigh. Their job is to bend the knee, move the hip backwards and stabilise the leg. The muscles can be injured at any point but are most vulnerable where the tendon and muscle fibres join together. This is a common injury for players of all sports that involve running, but particularly those that involve quick movements and kicking. 

What are the causes?

As the hamstrings cross two large joints, they need to perform complicated movements, often activating suddenly and with great force. They are often stretched during a fall, large kick or sudden take-off. Factors that increase the chance of a tear, include poor flexibility and neural mobility. Other factors that contribute to hamstring injuries are muscle imbalances, abnormal lower limb biomechanics, fatigue, and inadequate warm-up. It seems, however, the biggest predictor of a future hamstring tear is a previous hamstring injury.

What are the symptoms?

The most common symptom of a torn hamstring is a sharp pain at the back of the thigh, often immediately after intense activity. There may also be swelling, bruising, difficulty walking and pain with knee movements. The symptoms of a hamstring tear are similar to many other conditions, as the lower back often refers pain to the back of the thigh, mimicking a hamstring tear. 

Your physiotherapist can confirm that the pain is due to a torn hamstring and tell you how bad the tear is. Although not usually required, diagnosis can be confirmed by having an MRI or real-time ultrasound scan.

How can physiotherapy help?

Once a diagnosis has been made, the first step is to follow the R.I.C.E protocol (Rest, Ice, Compression, Elevation). During the first 48 hours, you should apply ice for 20 minutes every hour to reduce swelling and bruising. Consultation with your physio will include advice about your recovery, and when it is appropriate to return to sport. Your physiotherapist has many techniques that can promote healing and reduce scar tissue formation, which may include ultrasound, deep tissue therapy, laser, TENS and dry needling.

They will also prescribe an exercise program to return strength, flexibility and control to the muscle, getting you back to your sport quickly and safely. Due to the high chance of recurrence, rehabilitation is very important and usually takes 6-12 weeks. If the muscle is completely torn, surgery may be required before rehabilitation can start. Your physiotherapist will work with you to help you set goals to get you back to your favourite activities as soon as 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.

Seeing a physiotherapist is an important investment in healing and recovery from injury. Here are a few tips to help get the best outcomes from your treatment time.

Know what your goals are and ask questions.

If you are clear on what you hope to achieve through physiotherapy, this can help you and your therapist to work together to target treatment towards these goals.

Understanding your condition also plays an important part in recovery, it means that you can make better choices to protect and allow your body to heal, plus you will know better how to prevent future injuries. Before each treatment, it can help to take a few moments to prepare some questions and consider what your short and long-term goals might be. 

Do your exercises.

Targeted home exercises are an essential part of your recovery as they help your body to support itself through healing and recovery. Strengthening weak muscles is one way to correct biomechanical imbalances and reduce excess stress on body structures, as well as helping tissues to strengthen as they recover.

Follow your therapist’s recommendations.

Throughout your recovery, your therapist will guide you as to which activities you should avoid and how much rest to take. Return to sport and activity should be gradual, so as not to stress the body too hard when it is still healing. 

Rest is just as important a part of recovery as strengthening. Following the advice given by your therapist can ensure that you don’t injure yourself again and get the most out of your body.

Be patient with your progress.

It can be frustrating waiting for your body to heal. Returning to sport too early or giving up on treatment are common errors that lead to further injury or impaired healing. Recovery takes time, a general rule is that the longer a condition has been present, the longer it will take to resolve. 

If there is a part of your condition or injury that you are struggling to understand, be sure to seek clarification with your physiotherapist. None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your condition.

 What is Ankylosing Spondylitis?

Ankylosing Spondylitis (AS) is a type of inflammatory, autoimmune arthritis that primarily affects the spine. It is characterised by intermittent pain and progressive stiffness due to the inflammation and eventual hardening of the ligaments that surround the spine. The classic early symptoms of Ankylosing Spondylitis are pain and stiffness of the sacroiliac joints, the large joints connecting the pelvic bones to the sacrum in the lower back. In the final stages of the disease, the entire spine can become fused and rigid, often in a flexed, forward posture.

As this is an inflammatory disorder, many other systems and joints are often also affected. A significant number of people with AS also suffer from irritable bowel syndrome and inflammation of the eye.

What causes it?

The cause of Ankylosing Spondylitis is not clear, however, there are markers and predisposing factors that may contribute to the development of the condition. Genetics, chronic stress and frequent gastrointestinal infections are among the predisposing factors. Men are affected more often than women and symptoms usually begin between the ages of 17 and 45 years.

What are the signs and symptoms?

Intermittent back pain and progressive stiffness are the two most common symptoms of Ankylosing Spondylitis. Other tendons and ligaments may be affected, including those in the hands, feet and ribs. Symptoms tend to be worse following periods of rest, particularly first thing in the morning and improve following periods of activity. It is common for people to experience “flare-ups” and “remissions” of symptoms. 

Some people with Ankylosing Spondylitis may experience mild discomfort in the spine from time to time, while others may experience severe and debilitating symptoms at frequent intervals with minimal time in remission from symptoms. Long term issues with AS include breathing difficulties due to thoracic and rib cage stiffness and severe spinal pain and immobility. Medical treatment focuses on reducing inflammation and slowing the disease process.

How can physiotherapy help?

Physiotherapy treatment aims to manage pain during flare-ups and maintain optimal posture as the disease progresses. Your physiotherapist will assess your spinal movement and posture as well as strength. If your hands, feet, hips or shoulders are affected, they will also provide you with specific exercises to help maintain mobility and strength in those joints. Many studies have proven the positive benefits of exercise for those with Ankylosing Spondylitis, such as improved rib cage expansion when breathing, and improved posture of the upper back and neck. 

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

 The benefits of keeping active may seem obvious, yet it can’t hurt to be reminded of the many ways exercise can improve your life. Here are a few of our favourite reasons to get moving. 

1. Exercise improves energy levels. 

Improving your fitness means your body is capable of achieving more for the same energy expenditure. While doing exercise can make you tired in the short term, regular improvements to your fitness will help you get more out of your body each day.

2. Exercise can help to reduce stress.

If you are stuck in a state of stress or panic, exercise can help you move out of it into a calmer and more relaxed state, improving your mood, concentration and sleep.

3. Exercise and hobbies can help you build connections and community. 

Making new friends as an adult can be surprisingly difficult and the importance of connection and community is being recognised more as being essential for overall wellbeing. Being part of a team, or club is a great way to build confidence, meet friends as well as keeping active. 

4. Exercise keeps your muscles, tendons, joints and bones healthy.

Our bodies are often compared to machinery or car parts. However, there are some crucial differences between our bodies and machines, including the fact that our bodies respond to exercise by becoming stronger and healthier, rather than being worn out. One of the best ways to prevent osteoporosis is through regular high impact activity, which stimulates bone growth. 

5. Exercise can help to reduce injuries.

Similar to the previous point, tissues that are used regularly are stronger, more elastic and are less likely to tear or break when under stress. Regular exercise is the best way to keep your body in a healthy state and prevent injuries.

Finding the right exercise for you can be tricky, your physiotherapist can help you with suggestions based on your ability and skillset.