Tag: Cumberland Physiotherapy

Femoroacetabular Impingement (FAI)

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What is it?

When the two surfaces of the hip joint move over each other, they usually move freely without any friction. If there is an alteration to either the socket part of the joint (the acetabulum) or the ball (the head of the femur), irritation may occur as the two surfaces move over each other. This is known as Femoroacetabular impingement (or FAI) a common disorder of the hip, characterised by pain and stiffness.

Femoroacetabular impingement can be classified as cam, pincer or mixed. A cam FAI occurs when the femoral head junction is flattened or a small bump is present. Pincer type of impingement occurs when the acetabular rim extends slightly, causing the femur to be impacted. Cam impingement is more common in men while pincer impingement is more common in women. However, most cases of FAI (about 85%) are mixed, meaning they both have cam and pincer types of impingement. 

What are the symptoms?

The most common symptom of FAI is pain located in the hip or groin when resting in certain positions or with specific movements. Some patients also report pain in the back, buttock or thigh. Other symptoms include stiffness, loss of movement range (particularly of the hip), locking, clicking or a feeling that the hip is about to give way.

Activities that cause the incongruous surfaces to move over each other repeatedly are naturally the main culprits for causing symptoms. These can include prolonged sitting, twisting, sitting with crossed legs, squatting and climbing stairs can all aggravate the pain caused by femoroacetabular impingement.

What are the causes?

There are many factors that may cause an individual to develop femoroacetabular impingement including; 

  • Hip dysplasia or malformation during infancy/childhood
  • Repetitive stress on the hip
  • A femoral neck fracture that did not heal properly (malunion)
  • Small bony growths around the joint called osteophytes.
  • Normal anatomical variation

How can physiotherapy help?

Femoroacetabular impingement is a complex condition and researchers are still determining the best possible treatment. It is thought that untreated FAI can lead to osteoarthritis of the hip down the track and there are both surgical and non-surgical options for treatment.  Conservative (non-surgical) management for FAI involves core stability training, strengthening exercises for the lower limb specifically the hip and postural balance exercises. This program aims to improve the hip’s neuromuscular function. A hydrotherapy program can also helpful as it reduces weight through the joint, making movements more comfortable. Lastly, a home exercise program is made for patients, so they can continue treatment at home. For many people, physiotherapy is enough to resolve their symptoms and prevent future problems, however others may require surgery.

With surgery, hip arthroscopy is the most common procedure for this disorder and is used to change the shape of the joint slightly so that there are no points of irritation with movement. After surgery, patients are usually referred to physiotherapy for rehabilitation. 

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. 

Patellofemoral Pain Syndrome

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What Is It?

The knees function as hinges, allowing your legs to swing forwards and backwards smoothly as you walk, kick and run. The kneecap, also known as the patella, sits at the front of the knee and has a variety of functions, including guiding the muscles that straighten the knee, protecting the knee joint and absorbing forces when the knee is bent. When something goes wrong and the kneecap doesn’t move up and down smoothly, the soft tissue between the kneecap and the knee can become irritated, causing pain in a predictable fashion. This is called patellofemoral pain syndrome (PFPS), sometimes also referred to as PFJ syndrome or runner’s knee.

Pain is usually felt on the inside of the kneecap when you put pressure on your knees by running, squatting, bending, using stairs, or hopping. Sitting for long periods of time or keeping your knees bent could also result in pain.

What Causes It?

The kneecap sits in a shallow groove at the front of the knee and usually moves up and down as the knee bends and straightens without too much trouble. The quadriceps muscles, located at the front of the thigh, contract and pull on the kneecap, which then attaches to the lower leg and act to straighten the knee. If one side of the quadriceps is stronger or tighter than the other, it can cause the kneecap to pull to one side and over time become irritated. 

The cause of muscle imbalance or weakness can be for many reasons. In general, the outer muscles of the thigh tend to be stronger and tighter than the inside muscles. If you have poor posture and hip position, this often causes the outer muscles to work harder and the inside muscles to become weaker. Lack of arch support in your feet or simply a physical abnormality of the knees can also cause this condition.

How Can Physiotherapy Help?

Diagnosing patella-femoral pain syndrome correctly is important because pain on the inside of the knee can also be caused by injury, dislocation, inflammation, arthritis and a variety of other less common diseases.

With that in mind, it is helpful to know that your physiotherapist can diagnosis PFPS and identify its likely causes.

Whether it is due to poor posture, a lack of arch support in your feet, or poor running technique, your physiotherapist will assess the problem and provide a specific treatment program to best approach your condition. PFP syndrome usually responds quite well to biomechanical analysis and correction of any muscular weakness and imbalance. Having the correct shoes and orthotics can also make a huge difference. There are some short-term treatments, such as patella taping, try needling, trigger point therapy and ultrasound, which may help alleviate symptoms quickly and keep you active while you address the other factors contributing to your pain.

In the rare case that your condition is not helped by physiotherapy, surgery is also considered as last resort. For more information, please feel free to ask 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 individual injury. 

Can Poor Balance Lead to Ankle Sprains?

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CUMBERLAND PHYSIOTHERAPY PARRAMATTA Ankle sprains are one of the most common sporting injuries and most people have experienced one at least once in their lifetime. While they are common, this doesn’t lessen their negative impacts. Surprisingly, having poor balance might be increasing your risk of ankle sprains. Here we discuss a few facts about balance and what you can do to reduce your risk of ankle injuries.

Why are ankles particularly vulnerable to injuries related to poor balance?

Our ankles have to support our entire body weight when standing on one foot. To provide us with agility as well as stability, our ankles have the ability to move from side to side as well as back and forwards. There is a complicated process constantly operating to keep your foot in the correct position while supporting all this weight, particularly with quick changes of direction, activities done on tiptoes, jumping and landing. 

If the ankle rolls excessively inwards or outwards, the ligaments on the outside of the ankle can be damaged and torn. Balance is an important part of keeping the ankle in the correct alignment and not twisting too far to either side during challenging activities.

A study of high school basketball players  by Timothy McGuine et al. in 2010 showed that students with poor balance were up to seven times more likely to sprain their ankle than students with good balance. Other studies have shown that balance training is an effective way of preventing falls in elderly populations. 

Balance can vary from one leg to the other. 

Most of us tend to favour one side of our body for all activities. This is more obvious in the upper body, with most of us identifying as either left or right handed. The same is also true for our lower body, with each of us favouring one leg over the other for balance activities. This can mean that one leg has better balance and strength than the other, leaving the other leg more vulnerable to injury. 

Reduced balance can mean your body has to work harder to perform activities, with muscles activating in a less coordinated way. Improving your balance can also improve your body’s efficiency of movement, which can, in turn, improve your overalls performance without actually improving your muscle strength. 

Balance can be trained rapidly. 

Balance is one of the most overlooked dimensions of physical health however, the good news is that it can be improved relatively quickly. Do a quick check to see if you can stand on each leg for two minutes with your eyes closed. If this is difficult you might find that improving your balance is a great next step in your training program.

Your physiotherapist is able to identify any deficits in your balance is and is able to develop a training program for you to improve your balance. Come and see us for an appointment to see how we can help. 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.  

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.

Physio Suggestions for a Healthier New Year

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CUMBERLAND PHYSIOTHERAPY PARRAMATTA: Our health is something that is easy to take for granted, and it’s not until we’ve experienced a real loss of ability or comfort that we fully appreciate our health. It’s a phrase we’ve all no doubt heard, but prevention really is the best medicine. The new year is often the time that we all begin to make changes to maintain our health and prevent future illnesses. Here are some tips to make sure the next year is the healthiest it can be.

  1. Prioritise movement

Exercise and movement are arguably the most important factors when it comes to your health. Even more so than diet, weight and smoking status, believe it or not! If you do anything for your health this year, try to fit in some extra movement and exercise in any form you can. 

 2. Plan to start your New Year’s resolutions at the end of January. 

New years resolutions are almost doomed to failure. One of the reasons for this is that they are made at a time when people aren’t undertaking their usual routine. New found enthusiasm quickly wanes when the reality of the usual grind sets back in. You may have more success if you plan to start once life is back to normal and specifically plan how your new goals can be integrated into your usual schedule.

 3. Focus on small and incremental changes that you do regularly.

While big goals are important to set, small goals are easier to reach and can help release dopamine, reinforcing your behaviour and keeping you on track with your long term goals. You can still aim for larger goals, but if you set smaller markers along the way, this will make the journey more achievable.

 4. Buy or optimise your health insurance.

Two common mistakes when it comes to health insurance are to either not have any, which can help to cover the cost of physiotherapy or to not use what you have. When it comes to physiotherapy coverage, more often than not, rather than a safety net that you can use when something happens, policies are designed as a payment plan to help you spread out the costs and if you don’t use your limits for one year they don’t roll over into the next year. 

 5. Seek treatment for minor symptoms before they develop into larger problems. 

Many conditions begin as a small niggle that is easy to ignore, and most people don’t seek treatment until it’s impossible to ignore. Unfortunately, in many cases, treatment also takes longer, the longer that an issue has been present. Seeking treatment early can help you avoid months of pain and dysfunction. 

Ask your physiotherapist for more tip on how to reach your goals this year, no matter how big or small they are. 

Strengthen to Lengthen- Does it work?

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CUMBERLAND PHYSIOTHERAPY PARRAMATTA: Improving flexibility by stretching is a core tenant of most exercise programs. We have all heard the adage to stretch and warm-up before exercise to help prevent injuries and there is no doubt that stretching can just feel amazing! It can be surprising to learn that sometimes, the answer to improving flexibility can actually come from strengthening muscles, not just stretching them. 

Why is this? 

The muscles of the body are primarily responsible for its movement. By contracting and shortening they move their attachments closer together or by relaxing they allow their attachment to move apart in a controlled manner. The stronger and more coordinated muscles are, the more efficiently muscles are able to move the body more precisely and against more resistance. 

This likely comes as no surprise, however what you may not realise is that muscles also play a large role in providing stability to the body, particularly around the more flexible joints such as the hip and shoulder. If needed, they will often prioritise their role as stabilisers over that of movers. 

What does that mean? 

If muscles are too weak to allow safe and controlled movement when needed, they might ‘tighten up’ to provide the stability necessary to keep your body upright. The less movement through range, the less blood flow muscles will be receiving, which can also lead to reduced muscle health and greater risk of injury. Increasing the strength of muscles can allow them to relax and move more freely, improving flexibility.

One of the reasons why strengthening to improve flexibility may seem counter intuitive is because many of have experienced muscle pain and stiffness after a strength workout, which can add to the perception that strengthening muscles shortens them. This pain and stiffness is usually short lived, reducing over 48 hours as muscle tissues return back to normal. 

Do any strengthening exercises work?

While improving strength and coordination may allow muscles to ‘relax’, there is one type of strengthening exercise that will actually physically lengthen muscles by creating new muscle cells. Eccentric exercises, or ‘controlled lengthening’ have been shown to have a very beneficial effects on muscle health, length and even improve tendon health. Having a targeted eccentric training program to strengthen muscles has been shown to improve flexibility and reduce injuries overall. 

Ask your physiotherapist for tips on training muscles to their optimal health to promote flexibility. Your physiotherapist is able to assess any muscles for weakness and reduced length, giving you a targeted program to improve function and reduce injuries. 

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.