Tag: Parramatta Physiotherapy

Where is Your Pain Really Coming From?

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CUMBERLAND PHYSIOTHERAPY PARRAMATTA: Have you ever been to see a physiotherapist for pain in one part of your body and when they treated you, they focused on a completely different area? While this can be a strange experience, it can be even more puzzling when the treatment actually works. So what is going on, shouldn’t pain be treated where it is being felt?

When pain is felt at a different location from where the pain is being caused, this is called ‘referred pain’ and is actually more common than you think. Exactly why this happens is a little complicated, and in fact, we don’t yet understand everything about the way that pain is processed. 

Pain is usually felt when something causes damage to the body, sending an electrical impulse to the brain. The brain receives this information and process it to make sense of which part of the body the signal is coming from and what kind of pain it is. When the brain thinks that the pain is coming from a different area than where the damage or signal is actually coming from, this creates the phenomenon of referred pain.

Sometimes referred pain is easy to explain, such as when a nerve becomes injured or irritated, causing the pain to be felt along the length of the nerve. This often feels like a sharp, burning pain that runs in a strip, along the skin. Other examples of referred pain are more difficult to explain and in some cases seem to defy explanation. Perhaps you have heard about the strange phenomenon of phantom pain where amputees continue to feel pain as though it was in the place where their limbs used to be. 

Muscular trigger points can also cause referred pain. The mechanism behind this is a bit trickier to understand, but is thought to be explained by tight bands of muscle tissues that cause pain to be felt in predictable patterns around the body. 

Adding to this, we know that other tissues of the body can cause pain to be felt in a different location, including discs of the spine and internal organs. Many times the internal organs can refer pain in peculiar patterns and this can actually lead to serious illnesses being mistaken for muscular aches and pains. Kidney pain can be felt in the lower back and tragically, some people fail to recognize that they are having a heart attack because they feel pain in their neck and arm, not in their chest. 

We also know that not understanding or being afraid of pain can make pain feel stronger. In rare cases, people who have pain in one hand can feel pain just by seeing their other hand moving in a mirror. There are many other fascinating aspects to pain, and understanding how it works is an important part of managing your symptoms.  

To understand how referred pain may be affecting you, chat to your physiotherapist who can help with any questions. None of the information in this newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your individual condition.

Spinal Stenosis

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CUMBERLAND PHYSIOTHERAPY PARRAMATTA: What is spinal stenosis? 

The spinal cord, nerves and arteries are housed by the spine, which acts as a hard electrical casing to support and protect these vulnerable structures. The spine has a hollow column that allows the spinal cord to run from the brain to the rest of the body. At each spinal segment, nerves exit the spine and supply the tissues of the body. There is also an intricate network of small veins and arteries that provide blood to the spinal cord and vertebrae, providing them with the nutrients needed to operate. 

Spinal stenosis is characterised by a narrowing of the spaces that house the spinal cord, nerves and blood supply. A variety of factors can cause spinal stenosis, however overwhelmingly it is caused by degenerative changes to the spine as we age. Many people over the age of 60 will have spinal stenosis; however, not all will have pain. Clinically, spinal stenosis is used to describe the painful symptoms of this condition rather than just the narrowing itself.

What are the symptoms? 

Pain with walking or standing that radiates into the hips, thighs and even feet is the hallmark of spinal stenosis. Usually, this pain will be reduced with rest and forward movements of the spine. Spinal stenosis is a progressive condition and symptoms will gradually increase over time. The pain is often described as a deep radiating ache and can be associated with fatigue, heaviness, weakness and numbness. It can affect just one leg, however more often will be felt in both legs.  There will often be associated back pain; however, leg pain is usually the most severe complaint. 

How can physiotherapy help?

There are many conditions that need to be excluded before a diagnosis can be made. Your physiotherapist is able to conduct a thorough examination and accurately diagnose this condition. In some cases, imaging may be requested. As mentioned earlier, many people have stenotic spinal changes without symptoms. Surgery to decompress the restricted nerves and stabilise the spine are used in very severe cases.  

For mild to moderate cases of spinal stenosis, physiotherapy can be extremely beneficial.  Your physiotherapist can help you manage your pain through hands-on techniques and by providing a targeted exercise program based on biomechanical assessment. They are also able to help you to understand and manage your day in a way that helps to reduce flare-ups and maintain muscle strength.

If surgery is the right choice 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 newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your condition.  

Move More, Sit Less – 5 Tips from your Physio

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CUMBERLAND PHYSIOTHERAPY PARRAMATTA: More movement in your day can improve mental, physical health and even workplace productivity. Physiotherapists know that one of the most significant contributors to pain and injury is simply lack of physical activity. Getting more movement in your day doesn’t need to be about high-intensity exercise, all movement can be beneficial. Here are a few tips to help increase the amount of motion in your day. 

 

1. Try the Pomodoro Technique at work or when studying

 

The Pomodoro Technique, developed in the late 1980s, recommends breaking work into intervals, usually 25 minutes at a time interrupted by short rests. Studies’ have shown that by creating small time limits, you can focus more intently and the breaks can be useful motivators. 

 

Use these intervals as prompts for a short walk, some squats or stretches. Not only will you have made your day more productive, but you will also have added some movement to your day. 

 

2. Challenge a friend to match your steps

 

A little healthy competition is a great way to keep you motivated to move more. You can set daily, weekly and monthly targets and compare progress to keep you on track. You can use an app like ‘Habitica’ to help track and create movement habits in a game format. 

3. Park further away 

 

This is an oldie, but a goodie. If you can’t ride or walk to your daily destinations, try parking further away and using the opportunity to walk. Taking the stairs instead of the elevator and getting up and walking while taking phone calls are also great ways to increase your daily movement. 

 

4. Have a kettle boiling exercise routine.

 

The time spent waiting for the kettle to boil can feel like an eternity. Use this time to undertake a mini exercise routine. Try fitting in two sets of five squats, five lunges; five heel nurses or try to balance on each leg for two minutes. 

 

5. Stretch before bed

 

Gentle stretches before bed are a great way to relax and keep your joints mobile. Create a routine and make it part of our nightly ritual for better sleep and a healthier body. 

 

Our physiotherapists are happy to help you find strategies to create more movement throughout the day. Come and have a chat with us to see what might work for you.  

 

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.