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By Physio Team Exercises, Injury, online consultations, Sporting, Therapy, Work Injury , , , , , ,

Concussion recovery

Managing Headaches After Concussion/Mild Traumatic Brain Injury | BrainLine

What is a concussion?

A concussion is a type of traumatic brain injury caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. Rapid movement causes brain tissue to change shape, which can stretch and damage brain cells. This damage also causes chemical and metabolic changes within the brain cells, making it more difficult for cells to function and communicate (concussionfoundation, 2020).

Have you or someone you know had a fall or blow to the head ? If so it’s important to get medically assessed! It is strongly advised that you discontinue any sporting activities, school or work until a trained medical professional has seen you and given you the green light.

Symptoms

The most common signs and symptoms of concussion are:

  • Feeling stunned or dazed
  • Confusion, e.g. a delay in answering questions
  • Headache
  • Nausea
  • Ringing in the ears
  • Dizziness
  • Tiredness
  • Balance disturbance – Gait, unsteadiness.
  • Vision disturbances (double or blurred vision or ‘seeing stars’)
  • Memory loss (amnesia) that improves within a few hours.

Medical care should be sought if symptoms worsen or if there are more serious symptoms such as:

  • Loss of consciousness, however brief
  • Repeated vomiting
  • Slurred speech
  • Confusion or disorientation
  • Convulsions or seizures
  • Memory loss, e.g. being unable to remember what happened before or after the concussion
  • Changes in mood or behavior, e.g. unusual irritability
  • Drowsiness or difficulty staying awake
  • A headache that gets worse and does not go away
  • Weakness, numbness, or lack of physical co-ordination.

Recovery times:

Recovery from concussion can take up to 6 months. For the majority, symptoms will improve most rapidly within the first 1-3 months. If symptoms are still present after 6 months, these will most likely resolve after one year (SouthernCross, 2018).

Did you know?

Every year, there are 35,000 head injuries in New Zealand (Feigin et al., 2013). Although head concussion is normally associated with sporting injury, almost 80% occur outside of sporting activity (Theadon, 2014).

Brainstorm Conference 2019

Is Physiotherapy routine or advised post head concussion?

A study conducted by Van der walt, 2019 extracted clinical service data from a concussion service provider in Dunedin; this was to determine how often their subjects received or were recommended medical input, including physiotherapy. Results show that of the 147 subjects, 80 subjects (54%) received or were advised neck physiotherapy management and 106 cases (72%) received or were advised vestibulo-ocular physiotherapy management. In 59 cases (40%) both neck and vestibulo-ocular physiotherapy were received or recommended.

The findings suggest that recovery post concussion very often requires specific physiotherapy as part of multidisciplinary care. The evidence for the effectiveness of cervico-vestibular rehabilitation post-concussion is very favorable (Schneider et al., 2014).

Vestibular Physiotherapy | The Independent Physiotherapy Service

To help get you back on track, your physiotherapist will complete a detailed history of your current complaint/s and medical history. Treatment provided may involve:

  • Cervical spine assessment and treatment, including: mobilizations, soft tissue treatment
  • Balance assessment and treatment
  • Home exercise plan
  • Acupuncture

References

concussionfoundation(2020).WHAT IS A CONCUSSION?. Available at: https://concussionfoundation.org/concussion-resources/what-is-concussion. Last accessed 27/08/2020

Southerncross(2018). Concussion – causes, symptoms, treatment. Available: https://www.southerncross.co.nz/group/medical-library/concussion-causes-symptoms-treatment. Last accessed 27/08/2020.

Feigin V, Theadom A, Barker-Collo S et al. Incidence of traumatic brain injury in New Zealand: A population-based study. The Lancet Neurology. 2013;12(1):53-64.​

Theadom, A., Parag, V., Dowell, T., McPherson, K., Starkey, N., Barker-Collo, S., and BIONIC Research Group. (2016). Persistent problems 1 year after mild traumatic brain injury: a longitudinal population study in New Zealand. Br J Gen Pract, 66(642), e16-e23.

Van der Walta ,K, Tyson,A, Kennedy, E. (2019). How often is neck and vestibulo-ocular physiotherapy treatment recommended in people with persistent post-concussion symptoms? A retrospective analysis. Musculoskeletal Science and Practice . 39 (130-135), 1-5.

Sport-related concussion: optimizing treatment through evidence-informed practice.J. Orthop. Sports Phys. Ther. 2016; 46: 613-616

By Physio Team Appointments & Fees, Exercises, Home exercises, Injury, online consultations, Physio, Pilates & Exercise Classes, post-op, pre-op, rehabilitation, Sprain, Studies, surgery, Therapy , , , , , , , , , ,

Rehab After Surgery- Let’s get you moving!

Sometimes surgery may be necessary to enhance your health and it can be stressful, both physically and emotionally. Our highly skilled physiotherapists will endeavor to actively work with your surgeon and yourself to make sure you are getting the best possible treatment towards regaining optimal function, movement, and strength both before and/or after surgery.

 

Elective Pre-Surgery Physiotherapy

Research has clearly illustrated the advantages of physiotherapy before elective orthopedic surgeries. We recommend pre-surgery physiotherapy to enable an enhanced healing and recovery process. Following a comprehensive assessment, you will be given a pre-surgery exercise program to keep up your strength, movement, and function, in addition to preparing you for your post-surgery programme.

 

Post-Surgery Physiotherapy

Physiotherapy after orthopedic surgery is essential for optimal recovery. Our skilled physiotherapists are experts at providing rehabilitation for patients after surgery and will undertake a comprehensive assessment after your surgery, which will involve ongoing evaluation of your function, mobility, and strength. As per the different stages of healing, your goals and progress, your physiotherapist will prescribe a personalized rehabilitation program. We will continue to keep close contact with your specialist as needed for the duration of your treatment.

 

Common surgeries requiring post-operative physio

Many surgeries, particularly those resulting from sporting injury, require physiotherapy treatment during the recovery phase.

These include, but are not limited to:

  • Knee reconstructions
  • Hip replacements
  • Shoulder surgery
  • Ankle, wrist, elbow operations
  • Spine, neck and back surgery
By Brian Exercises, Injury, online consultations, Physio, Sprain, Therapy

CONNECTING WITH OUR CLIENTS THROUGH TELEHEALTH

What is Telehealth?

 The Health Resources Services Administration defines telehealth as “the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration. Technologies include videoconferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications”.

Here at Physio Fusion, we will be conducting video consultations for existing and new clients. You will see the same, experienced staff as you would on site at either our New Windsor Branch. With the exception of the hands on aspects, we strive to continue to provide you with the same level of education, advice and exercise progression as you would receive in person.

Telehealth Benefits for Patients:

  • Better access to services for residents/ workers in remote areas (Al-Shorbaji 2013, Bourne et al 2017, Cooper & Allen 2017, Nelson et al 2017) found that this can improve access to care services for clients in isolated areas and virtual consults can address access barriers for patients living in rural locales.
  • More convenient access to services (people avoid the travel and scheduling challenges of attending face-to-face appointments and can access some services after-hours).
  • The ability for patients to ask quick questions without having to book a full consultation
  • Access to high-quality online resources, including videos and digital tools

Telehealth benefits for Physiotherapists:

  • Access to an untapped pool of clinical resources: (Hunt et al 2014): Virtual health programmes offer benefits to clinicians who are looking for increased flexibility in their working life (e.g. semi-retired clinicians or those seeking an improved work/life balance). If offered, this may enable healthcare providers to attract and retain a high-quality workforce, improve staff satisfaction, and access highly specialized resources to improve quality of care.

What is Physitrack and how does it work?

Physitrack is an exercise prescription platform that lets you prescribe home exercises to our clients. It is a program that you as a customer can download for free on your smartphone, tablet or open it with your computer. The videos show how you can perform an exercise correctly and clearly. There are also more than 90 standard exercise protocols and videos with clear explanations about specific complaints or conditions.

 

How does it work?

Together we determine which exercises are most suitable for you and add these to your program. You will then receive an email with the link to download the Physitrack / app and the link to the program online. Your personal login code is also stated in the same email. If you have downloaded the Physitrack or clicked on the link and enter your password, you can enter your preferences in the program, such as setting reminders. Then you can start with the exercises in a correct and clear manner and contribute to your own recovery!

The attached document is designed to help you prepare for your Telehealth call. PhysiApp_Telehealth_call

What will happen once my appointment is booked?

  • Your Physiotherapist will send an email with more details on how the consultation will take place.
  • Before your appointment you will receive another email from Physitrack with a link to where the consultation will take place.
  • Make sure that you have a working camera and microphone.
  • Make sure you’re using a modern browser, such as Chrome, Firefox, Safari or Microsoft Edge.
  • If you are using a mobile device for your consultation, you will be prompted to download Physitrack app Please do this and then click join as a guest.
  • We ask that you get online 10 minutes before your appointment and click on a link to join the consultation.
  • If you are using a computer, make sure your camera and microphone are available and enabled.
  • Please ensure that you have enough space in case you are required too perform exercises.

What happens if internet is interrupted or my technology fails during the consultation?

If we can call you, we will attempt to continue and complete the consultation via face time.

Here’s how to book your first Telehealth Consultation with us

Save time and book your appointments online with Physio Fusion 24 hours a day, 7 days a week. You can book your appointments via phone or online

By Physio Team Exercises, Injury, online consultations, Physio, Sporting, Sprain, Therapy, Work Injury , , , , , , , ,

THE MYTH ABOUT FOOT PRONATION (FLAT FOOT)

Myth: Foot pronation(flat foot) is the enemy.

In the foot, pronation should occur naturally when we are fully weightbearing on the front leg. Pronation will appear as the foot rolling inward and the arch flattening.

What are the benefits?

  • Dissipates the force that the foot receives from the ground.
  • Allows the foot to become a stable and mobile adaptor to enhance movement opportunity throughout the body.
  • Loads the muscles of the extensor chain (calf, quads, glutes) to convert ground reaction forces into forward momentum so we can move efficiently and without compensation.

So why have I been told this is bad?

So as you are now aware, pronation is very normal and a critical movement to ensure we move and propel ourselves forward efficiently.

What you may have heard someone say to you is that you ‘overpronate’?

Firstly, overpronation is subjective and not as black and white as it is sometimes made out to be. Overpronation has been defined as: ‘a foot that rolls inward towards the medial (inner) arch excessively’.

What we must understand is that a pronation can only happen when the foot has a stable tripod on the ground. This means that the calcaneus (heel bone), 1st metatarsal (big toe knuckle) and 5th metatarsal (little toe knuckle) must all remain in contact with the ground when the foot rolls inwards and the arch flattens.

So, If you have been told you are ‘overpronated’ , it is most likely that your whole foot is ‘everting’ NOT ‘overpronating’.

What is Eversion?

Eversion can be defined as: ‘the process of turning inside-out’.

In pronation your heel must naturally ‘evert’ (sole of the heel will move away from the midline of the body) NOT your whole foot.

If your ‘whole foot’ everts (turns out) you will no longer have a stable foot tripod as the 5th metatarsal (little toe) will lose contact with the ground.

The key to ensuring this does not happen is to provide an environment for the bones of the midfoot (middle of the foot) and forefoot (toes) to experience the opposite motion to that of the heel. This will mean that the foot has an opportunity to truly pronate with a three points of contact on the ground.

So how can you help me do that?

  • At Physio fusion we can help guide you to bring your own body into alignment and create an environment in which the healing can begin.
  • Foot strengthening exercises.
  • Footwear advice.
  • Referral to other healthcare specialists for further assistance (e.g. podiatrists).
By Physio Team acute pain, Appointments & Fees, ergonomics, Exercises, feet, flat feet, foot, foot pain, heel pain, Home exercises, Lockdown, lockdown wellbeing, online consultations, orthotics, pain, pain management, physical health, Physio, plantar fasciitis, Therapy , , , , , , , , , , , , ,

Managing Your Heel Pain

 

Plantar fasciitis is a very common cause of heel pain. It is associated with inflammation of the thick web-like ligament (plantar fascia) which runs across the base of your heel to the front of your foot. The plantar fascia provides support to the arch of your foot and is a shock-absorber, helping you walk. Hence it is obvious that this ligament experiences a considerable amount of wear and tear in your day to life.

 

 

Symptoms

 

 

Plantar fasciitis is associated with inflammation of plantar fascia triggered by the development of small tears in the plantar fascia which leads to heel pain and other symptoms. This condition mostly develops gradually and worsens over time. You may notice some swelling, redness, and warmth in the affected region. You may experience more pain in the centre of your heel, which may radiate along the sole of your foot. The pain may be achy, sharp, dull, stabbing.  It is mostly experienced when initiating movement first thing in the morning or after a period of inactivity, and may ease after a period of mobility. You may have no resting as the plantar fascia is offloaded and relaxed. It generally impacts just one foot, but it may impact both feet.

 

Causes

The plantar fascia is a thick web-like ligament which supports the arch of your foot and absorbs shock when you walk. Excessive stress and tension on the plantar fascia may cause smalls tears. Repeated stretching and tearing may inflame and irritate the fascia, though the cause remains unclear in many cases of plantar fasciitis.

 

Key factors which may increase your risk of developing this condition include:

  • Foot mechanics: Having flat feet or very high arches or adopting abnormal gait patterns may have an impact of the way your weight is dispersed when you are standing/running/walking and lead to excessive stress on the plantar fascia
  • Obesity: Extra weight increases the tension on the plantar fascia
  • Exercises: Certain exercises such as long-distance running/walking and dancing may put more stress on your heel and plantar fascia
  • Age and Gender: Plantar fasciitis is more often noted in women than men, and is most common in the 40-to-60-year age group.
  • Occupation: which require prolonged periods of walking and standing especially on hard surfaces
  • Sudden and rapid change in activity levels
  • Footwear: Wearing high heels and/or poor fitting shoes that do not provide sufficient arch support cushioning
  • Muscle tightness: particularly of your lower limbs

 

 

Diagnosis

The diagnosis of this condition may be determined by your medical and occupational history, the nature, length and severity of your signs and symptoms, and the existence of localized tenderness in your heel. You may be referred on for imaging such as X-rays, ultrasounds or MRIs to aid the diagnosis and to possibly rule out other causes for your symptoms (fractures, arthritis, heel spurs etc).

 

Management

Initial management of this condition is focused on the reduction of pain and inflammation:

  • Resting is vital
  • Ice application
  • Taking anti-inflammatory medications
  • Wearing appropriate and supportive footwear with arch supports and shock absorbing orthotics
  • Getting your foot and ankle taped for sufficient support and alignment
  • Physiotherapy (involving a graduated rehabilitation program of stretching/strengthening exercises)

If you still do not notice any improvement in your symptoms, your doctor may recommend corticosteroid therapy. Corticosteroid medication is injected into the impacted region with the purpose of treating the inflammation directly hence, relieving your pain. Using a splint at night to avoid the Achilles tendon and plantar fascia from tightening while you sleep may also be recommended at this time. A surgical intervention is seldom recommended and is only usually opted for where the pain is severe and all other treatment has failed. Please discuss your management options with your doctors.

 

Prevention

Here are some helpful tips to prevent the development of plantar fasciitis and decrease the risk of reaggravating your symptoms:

  • Ensure you make warm ups and cool downs as part of your exercise regimes
  • Undertake exercises to strengthen your lower limb muscles
  • Regularly stretch your Achilles, calf and intrinsic foot muscles to increase their flexibility
  • Gradually increase your activity and exercise levels
  • Maintain a healthy body-weight
  • Wear appropriate and supportive footwear (use orthotics for support if needed)
  • Take regular rest breaks if standing and or walking for prolonged periods of time at work
By Physio Team Appointments & Fees, body parts, elbow pain, ergonomics, Exercises, golfers elbow, good posture, hand and wrist pain, Home exercises, Injury, ligaments, Lockdown, medial elbow pain, online consultations, pain management, physical health, Physio, posture, rehabilitation , , , , , , , , , , , , ,

Medial Elbow Pain Explained

Medial elbow pain is also known as medial epicondylitis or golfer’s elbow. It is typically associated with pain on the inside (medial side) of your elbow and can spread into your forearm and wrist. This pain is the result of overloading and damage to the tendons that flex your wrist towards your palm.

 

Causes

This condition is triggered by damage to tendons and muscles which control your fingers and wrist. This damage is associated with excessive or repeated stresses- particularly repetitive and forceful finger and wrist movements, incorrect lifting, hitting and throwing techniques, lack of warmups and/or poor muscle conditioning.

Key risk factors for developing medial elbow pain may include smoking, obesity, being of in age bracket of 40 years old and over and undertaking repetitive activity with your arms for at least two hours daily. High risk occupations may include chefs, office desk workers, plumbers, construction workers, painters, butchers and assembly line workers. Those who partake in sports such as golf, racket sports, rowing, weight lifting and baseball are also at a higher risk.

 

Symptoms

Symptoms may be triggered suddenly due to a traumatic incident or may gradually develop over time and include but are not limited to:

  • Tenderness and pain is typically felt on the inner side of your elbow (particularly on the bony knob), and may refer along the inner side of your forearm and down to your wrist and fingers. It often worsens with certain movements. For example, bending your wrist towards your palm against resistance, or when squeezing a rubber ball.
  • You may feel stiffness in your elbow, and making a fist may hurt
  • You may experience weakness in your forearm, wrist and hand
  • You may experience tingling and numbness that can radiate into one or more fingers — typically to your ring and little fingers.

Diagnosis

This condition is typically diagnosed based on your medical and occupation history and a physical exam by your doctor or physiotherapist. To evaluate stiffness, strength and pain, your clinician may apply pressure to the impacted region and get you to move your elbow, wrist and fingers in various ways. You may also be referred on for imaging such as X-rays and Ultrasounds to aid diagnosis.

Management

A mix of non-surgical treatment options are effective for the majority of medial elbow pain cases, and self-resolves over time. You should rest your elbow and painful activities should be avoided. But it is very vital to maintain gentle movements of the forearm, elbow, and wrist through its range of motion.

Potential treatment options include:

  • Ice
  • Rest
  • Physiotherapy and acupuncture
  • Anti-inflammatory medications as recommended by your doctor or pharmacist
  • The use of a wrist and forearm brace or splint to support and rest your forearm

As your initial elbow pain lessens, your muscles around the elbow, forearm and wrist should be safely strengthened and stretched under guidance of a physiotherapist. Your physiotherapist will advise you on particular exercises, give you appropriate symptom management advice and take you through a personalised graduated rehabilitation program. If you continue to experience pain after 6-8 weeks of treatment, your physiotherapist can refer you back to your doctors, to consider administration of a cortisone injection into the elbow to help reduce pain and inflammation, and further referral onto see a specialist to seek guidance on other treatment options.

Prevention

Having a good comprehension of risk of injury and being conscious of your everyday activities may aid in the prevention of medial elbow pain. You should:

  • Adopt appropriate technique and form when undertaking repetitive activities or sporting motions
  • Keep up with adequate wrist, forearm, and shoulder muscle strength
  • Undertake gentle wrist and forearm stretches pre and post activities
  • Adopt appropriate posture and body mechanics when lifting heavy objects to reduce joint strain- especially if doing so repetitively
By Physio Team acute pain, Appointments & Fees, body parts, chronic pain, ergonomics, Exercises, good posture, hand and wrist pain, Home exercises, Injury, Lockdown, lockdown wellbeing, muscles, online consultations, pain, pain management, physical health, Physio, posture, rehabilitation, repetitive stress injury, RSI, sitting posture, Sprain, tendon, Therapy, wellbeing, Work Injury , , , , , , , , , , , , , , , , , , , , , , , , , ,

Repetitive Strain Injury (RSI) Explained

 

RSI is typically defined as an overuse disorder- a gradual build-up of overload to nerves, tendons, and muscles arising from repetitive movements or activities. Repetitive use of the same motions leads to inflammation and damage to these soft tissues. This disorder mostly affects the upper limb- particularly the elbows, hands and wrists.

 

Causes

Possible causes of RSI include but are not limited to:

  • Undertaking the same and repetitive movements and stressing the same muscle groups
  • Working in cold environments
  • Assuming a sustained and/or awkward posture for prolonged periods of time
  • Undertaking a particular activity for prolonged periods of time with no rest-breaks
  • Frequent and prolonged use of vibrating equipment
  • Adopting poor postures from working at inappropriately designed workstations
  • Undertaking a motion which involves carrying and/or lifting heavy items

 

 

Symptoms

RSI leads to a gradual development of a broad variety of symptoms, which range from mild to severe in severity. RSI particularly affects the muscles and joints of your wrists, hands, elbows, forearms, shoulders, neck. Having said this, RSI can affect other areas of the body as well.

Common symptoms may include:

  • Pain
  • Tingling
  • Cramping
  • Increased sensitivity to heat and cold
  • Tenderness
  • Fatigue
  • Loss of strength
  • Throbbing
  • Soreness
  • Achiness
  • Stiffness
  • Struggling with typical activities of daily living, such as gripping and twisting motions, carrying light weights, writing, kitchen prepping, dressing, personal cares etc

You may develop these symptoms when you undertake a task repetitively for a period of time, and can settle when you stop. Symptoms may settle over a few hours or over the course of a few days. However, if left untreated or is poorly managed, a minor RSI may gradually progress to a nasty chronic injury.

 

Diagnosis

 

If you experience mild discomfort whilst completing particular activities at home or at your job, it is a good idea to see your GP or physiotherapist to talk about RSI. But an RSI is not always simple to diagnose as there is no particular clinical test for it. Your GP will enquire about your medical history, occupation and work environment, and other activities to attempt to identify any repetitive motions you undertake that may be the cause of your symptoms. A physical examination will be undertaken, where they will assess your movement, check for pain, inflammation, sensation, tenderness, strength and reflexes in the impacted body part. RSI may be triggered by specific health disorders like bursitis, carpal tunnel, tigger finger, ganglion cyst, or tendonitis (inflammation in your tendons). Your GP can refer you on further diagnostic tests such as X-rays, Ultrasounds, blood tests, MRIs, nerve conduction tests etc, to determine if these underlying disorders may be the cause of your symptoms. You may be also be referred onto a physiotherapist and acupuncturist for conservative treatment and management for mild-moderate issues. If symptoms persist, you will then be referred onto a specialist.

 

Management

Initial treatment options for the management of RSI symptoms is conservative. This includes:

  • Rest, Ice, Compression, and Elevation (RICE principles)
  • Taking regular breaks between tasks and looking after your posture
  • Undertaking your activities and movements with appropriate form and posture
  • Intake of Nonsteroidal anti-inflammatory drugs (NSAIDs), both oral and topical as prescribed by the GP
  • Use of cold and heat to the impacted area
  • Administration of steroid injections into inflamed joints and tendons
  • Tailored exercise prescription from physiotherapists to correct posture and strengthen and stretch affected muscles
  • Acupuncture
  • Stress reduction and relaxation training
  • Use of splints and braces to help protect and rest the affected muscles and tendons

Ergonomically appropriate adjustments to your workstation and work environment may be recommended by your physio and GP- for example resetting your desk and chair if you’re working at computer, and alterations to your equipment and activities/motions to lessen the strain and stress on your muscles and joints. Surgery may be necessary in some cases.

 

Prevention

Minimizing repetitive actions particularly if they involve the use of heavy machinery or vibration. Improving your working posture and work-environment as well a taking regular breaks. Employers often undertake risk-assessments when you join a company to determine that the work area is ergonomically fit, comfortable and appropriate for you. You may be able to request for an assessment if you have not had one or are having issues with your work environment

By Physio Team Appointments & Fees, body parts, bone weaking, bones, Exercises, falls, Home exercises, Injury, Lockdown, lockdown wellbeing, muscles, older adult, online consultations, osteoporosis, pain, pain management, Physio, posture, rehabilitation, Therapy, weak bones, wellbeing , , , , , , , , , , , , , , , , , , , , , , ,

Osteoporosis

 

Osteoporosis is a condition which results in weak and brittle bones- to such degree that a fall or even mild stresses like coughing or bending over may result in a fracture. Bones are living tissues which are continually being broken down and replaced. However, your bones become osteoporotic when the formation of new bone does not keep up with the loss of old bone. This condition typically develops over time without any pain or other major symptoms, and is generally not diagnosed until you have sustained a fracture. The hip, pelvis, upper arm, spine and wrists are the most common structures affected by osteoporosis- related fractures.

 

 

How do you know if you have Osteoporosis?

 

Because there are no obvious early warning signs and symptoms, it is difficult to pre-diagnose osteoporosis. You may be unaware that you have this condition perhaps till you have one of the following:

  • Sustained a fracture from an incident more easily than you should have- like a simple fall or a bump
  • A decrease in the height of your spinal vertebrae over time
  • Change in posture – stooping or bending forwards
  • Back pain, due to a fractured or collapsed vertebra

Please see your doctor if you experience the following:

  • If you are over the age of 50 and have sustained a fracture
  • Sustained a spine, wrist, or hip for the first time
  • Sustained a fracture more easily than you should have (a simple fall or after a slight bump)

 

Risk factors

Key factors which may increase your risk of developing osteoporosis include:

  • Females- particularly post-menopausal Caucasian and Asian women
  • Over the age of 50
  • Excessive consumption of caffeine or alcohol
  • Smoking
  • Having a smaller or petite body frame
  • Poor physical activity levels and leading a very sedentary lifestyle
  • Family history of osteoporosis
  • Having low levels of vitamin D and poor dietary calcium intake
  • Decreasing levels of testosterone with ageing in men
  • Estrogen deficiency in women (irregular periods, early (before turning 40) or post-menopausal, surgical removal of the ovaries)
  • Use of long-term medication such as thyroid and epilepsy medications, corticosteroids
  • Having medical conditions such as gastrointestinal diseases; endocrine diseases; rheumatoid arthritis; cancer; and blood disorders

 

 

How will you be diagnosed?

Your doctor will review your signs and symptoms, family and medical history. You may be referred on for a specialized X-ray or CT scan to evaluate the bone density to help diagnose osteoporosis. Your bone density will be classified by comparing it to the typical bone density for a person of equivalent gender, size, and age.

 

 

How is Osteoporosis treated?

The treatment pathway chosen for the management of this condition is dependent on results of your bone density scan, gender, age, medical history and severity of the condition. Potential treatments for osteoporosis may include exercise, making positive lifestyle changes, vitamin and mineral supplements, and medications. Please consult your doctor for appropriate advice and treatment options.

 

 

How can Physiotherapy help?

 

Your physiotherapist will help you strengthen your bones and your muscles through a personalized and graduated rehabilitation program. Components of this rehabilitation program may include weightbearing aerobic exercises, resistance training using free weights/resistance bands/bodyweight resistance, and exercises to enhance posture, balance and body strength. Your physiotherapist will work with you to find activities that suit your needs and as per your physical activity level.

 

 

By Physio Team Appointments & Fees, Exercises, knee pain, ligament damage, ligaments, Lockdown, lockdown wellbeing, MCL knee pain, MCL ligament, medial knee pain, muscles, online consultations, pain management, physical health, Physio, Sprain, surgery, Therapy , , , , , , , , , , , , , , , , , , , , , ,

Managing your Medial Knee Pain: MCL injuries

What is it?

Although your knee has free movement going forwards and backwards, its’ sideward movements are restricted by the robust collateral ligaments on either sides of your knee. The medial collateral ligament (MCL) is situated on the inner part of your knee, but on the outside of your joint. The MCL connects the top of your shinbone (tibia) to the bottom of your femur (thighbone). It helps hold your bones together, provides stability and prevents your knee from bending sideways away from your body.

Injuries to the MCL are from the result of a direct blow to the outer part of your knee- and is most commonly seen in contact sports such as football and soccer. These injures may either over-stretch or cause a tear in the ligament. Whilst surgery may be needed in some severe cases, it is not always the go-to form of management.

Read on to know how physiotherapy can help manage your MCL related-knee pain.

 

 

Mechanism of Injury

Injury to the MCL typically occurs when a force drives the lower leg in a sideward direction away from your upper leg and body. Awkwardly landing from a height, twisting of your knee with your foot fixated to the ground, or from a direct blow to the outer part of your knee- most commonly seen in contact sports, are frequent causes of injury to the MCL.

 

 

Grading of MCL Injuries

MCL injuries are often graded using the system below:

Grade 1: Regarded as a minor injury- means that the MCL has been overstretched but not torn

Grade 2: Regarded as a moderate injury- means that there is a partial tear in MCL, and presents with some degree of instability in the knee

Grade 3: Regarded as a severe injury- means that the MCL has completely ruptured/torn, and presents with noticeable joint instability

 

Often 3 MCL injuries are associated with concurrent medial meniscus and ACL ligament damage, which may need surgical intervention. But, the good news is that most MCL injuries may be treated well with conservative physiotherapy management. It usually takes between 2-8 weeks for Grade 1 and 2 MCL injuries to heal, and a graduated rehabilitation programme is highly commended for prevention of future injury.

 

 

Signs and Symptoms

Because injury to the MCL may present with similar symptoms as with other knee injuries such as ACL damage, it is vital to have a medical professional such as your physiotherapist evaluate your injury.

Common symptoms of an MCL injury may include:

  • Tenderness and pain along in the inner part of your knee
  • Swelling in the knee
  • Experience catching and locking sensations in the knee joint
  • A ‘pop’ sound at the time of injury
  • Actual or feeling of giving way of the knee (often indicate grade 2 or 3 injury)

 

 

Diagnosis

Your physiotherapist will discuss your injury and its presenting symptoms, past medical history (including a history of any prior knee injuries) and will also undertake a thorough physical examination. During the physical examination, your physiotherapist will assess the structures of your injured knee and compare them to the non-injured side. The range of motion, strength and stability of your knee will be assessed. You may be referred on for imaging such as X-rays and Ultrasounds to help aid the diagnosis. For more severe MCL injuries, and if your symptoms do not resolve with conservative physiotherapy management, you may be referred onto a specialist who may consider referring you for an MRI to get a deeper look at your knee.

 

Management

The management options for MCL injuries will be dependent on the severity of the injury. In the initial stages of injury, management is focused on controlling swelling and pain, whilst allowing your body to initiate healing processes via inflammation. This is typically achieved through the P.O.L.I.C.E. principles (Protect, Optimal Loading, Ice, Compression and Elevation).

Over the counter medication such as ibuprofen and paracetamol may be taken to reduce pain. Other stronger painkillers and NSAIDs may be prescribed by your doctor to help reduce swelling and inflammation as well.

After assessing your knee, your physiotherapist will frame a rehabilitation programme with exercises tailored to your needs. The purpose of physiotherapy is to help restore your knee’s range of motion, stability and strength, which in turn will then allow you to safely return to your usual day-to-day and sporting activities as soon as possible.

Management of most MCL injuries usually only involves knee bracing and physiotherapy treatment. However, in some cases, surgery may be recommended. Particularly if there is damage to more than one ligament or structure in your knee or if you continue to experience instability in spite of physiotherapy.

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Dealing with Rheumatoid Arthritis

Rheumatoid arthritis (RA), a chronic inflammatory condition associated with swelling, pain, fatigue, and joint deformity. Although there are no known cures for this condition at present, a combination of treatments are available to help manage your symptoms. RA is the 2nd most common form of arthritis after osteoarthritis and is known to affect 1–2% of New Zealand’s population.

 

 

Signs and Symptoms

RA may develop very quickly or gradually over time, with its signs and symptoms, as well as the severity varying from one person to another. This condition is associated with episodes of remission and flare ups, with or without apparent triggers.

Other symptoms may include

 

  • Swollen, tender joints- (often accompanied by warmth and redness)
  • Joint pain
  • Joint stiffness which worsens in the mornings and after a period of inactivity
  • Fever, loss of appetite weakness, and fatigue
  • Muscle pain
  • Changes to the skin and nails

In the early stages of RA, you may notice its impact on your smaller joints- especially in your toes and fingers. And as this condition develops, your symptoms typically branch out to the bigger joints- your shoulders, ankles, knees, wrists, hips and elbows. Symptoms are likely to affect your joints bilaterally. Over time, RA also causes joints to deform and shift out of place.

Because RA is a systemic condition, it is estimated that approximately 40% of the RA population may experience symptoms and signs other body systems than the joints. These may include:

  • Kidneys, lungs, heart
  • Skin, eyes, mouth
  • Bone marrow
  • Nerves and blood vessels

 

 

Causes and Risk Factors

Your immune system is designed to help protect your body from infection and disease. However, in RA, changes occur in your immune system that (for poorly understood reasons), causes it to mistakenly attack the healthy soft-tissues of joints resulting in pain, swelling and inflammation. Because of this ongoing process, over time damages to the lining of your joints and other soft-tissues may lead to bone erosion and joint deformity. It can also have an impact on your heart, lungs, nerves, eyes and skin.

One can get RA at any age, although it is more probable to develop in those in the age bracket of 25-50 years old. Though rare, under 16s may also develop Juvenile RA or Still’s disease.

Risk factors for the development of RA include:

  • Family history of RA
  • Age bracket of 25-50 years old
  • Smoking
  • Women are more likely to develop RA than men
  • Obesity

 

 

 

Diagnosis

 

At present there is no single test to confirm a clinical RA diagnosis. It is often difficult to differentiate this condition in its initial stages from other forms of connective tissue inflammation (fibromyalgia, lupus, gout etc.).

Your doctor will get your full medical history (as well as any familial history of RA), discuss your signs and symptoms, undertake a physical assessment- particularly of your joints, and refer you on for imaging and blood tests. X-rays may help evaluate RA progression in your joints over time, whilst MRI and ultrasound imaging may help evaluate the severity of RA in your body. The blood test will evaluate your level of anti-bodies and proteins (including the rheumatoid factor protein that is present in approximately eighty percent of the RA population), and markers of inflammation.

 

 

Management

At present, though there is no cure for RA, a range of treatments are available which may help slow its’ progression and reduce pain and inflammation, minimise and/or prevent joint damage and maximise joint movement.

A combination of prescribed medication as advised by your doctor and other treatment options as noted below are recommended:

  • Cease smoking if you are smoker
  • Physiotherapy will help improve and maintain your joint range of motion, increase your muscle strength, and decrease your pain. Additionally, your physiotherapist or occupational therapist will be able to teach you ways of using your body efficiently to reduce stress on your joints
  • Finding a balance between rest and activity
  • Use of heat and cold packs to help ease pain and inflammation
  • The use of splints or braces for joint support as needed
  • Hydrotherapy- exercising in water reduces the pressure on your joints, whilst the warmth of the water will relax your muscles and help lessen your pain.
  • Seeking regular medical advice and check-ups to monitor your RA symptoms and the progression of the condition
  • Adopting a healthy and active lifestyle