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By Physio Team acute pain, Appointments & Fees, body parts, chronic pain, Exercises, feet, heel pain, Home exercises, Injury, Lockdown, lockdown wellbeing, muscles, online consultations, orthotics, pain, pain management, physical health, Physio, rehabilitation, Sporting, Sprain, tendon, Therapy , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

Disorders of the Achilles Tendon

Basic Anatomy

The Achilles tendon is the largest tendon in the human-body. It is a band of tissue that connects your calf muscles to your heel bone (calcaneus). This tendon primarily facilitates general mobility such as walking, running, climbing stairs, jumping, and standing on your tip toes, by helping to raise the heel off the ground.

 

 

Common Achilles Pathology

Achilles tendinitis and tendinosis are two common disorders and are typically classified as overuse injuries.

Achilles tendonitis involves inflammation of the Achilles tendon. Inflammation is the body’s natural response to injury or disease, and often causes swelling, pain, or irritation. This inflammation is typically short-lived. Over time, if this is left resolved, the condition may progress to degeneration of the tendon- Achilles tendinosis, in which case, the tendon loses its organized structure and is likely to develop microscopic tears.

There are two types of Achilles tendonitis and it is based on which part of the tendon is inflamed:

  • Insertional Achilles tendonitis affects the lower portion of your tendon where it attaches to your heel bone.
  • Non-insertional Achilles tendonitis involves fibres in the middle portion of the tendon and tends to affect younger people who are active.

In both non-insertional and insertional Achilles tendinitis, damaged tendon fibres may also calcify (harden) and often bone spurs (extra bone growth) develop with insertional Achilles tendinitis. Achilles tendonitis may also increase your risk of sustaining an Achilles tendon rupture (tear).

Causes

Typically referred to as “overuse” conditions, Achilles tendonitis and tendinosis are often caused by the sudden increase in repetitive activity involving the Achilles tendon. This can put too much stress on the tendon too quickly, that can then lead to micro-injury of the tendon fibres. Because of this ongoing stress on the Achilles, the body is not able to repair the injured tissue. The structure of this tendon is then modified, resulting in continued pain and other symptoms. The Achilles tendon also has poor blood supply that makes it more susceptible to injury and may make recovery from injury slow.

Common factors that may lead to the development of disorders of the Achilles tendon include:

  • Weak and/or tight calf muscles
  • Rapidly increasing the amount or intensity of exercise within a short span of time
  • Hill climbing or stair climbing exercises
  • Presence of bony spurs in the back of your heel
  • Changes in footwear – especially changing from wearing high-heeled shoes to flat shoes
  • Wearing poor fitting, inappropriate, or worn out shoes during sporting activities
  • Exercising without adequate warm-ups and stretching
  • A sudden sharp movement which causes the calf muscles to contract and the stress on the Achilles tendon to be increased. This can cause the tendon fibres to tear.
  • Excessive mobility
  • Poor feet positioning and biomechanics (excessive pronation and flattening of the arches of the foot)

 

Symptoms

Achilles tendon pain: Causes. when to see a doctor, and treatment

 

Common symptoms include:

  • Pain and stiffness along the Achilles tendon especially first thing in the morning
  • Pain along the tendon or back of the heel that worsens with activity
  • Severe pain the day after exercising
  • Visible thickening of the tendon
  • Tenderness to touch
  • Bone spur
  • Swelling that is present all the time and gets worse throughout the day with activity

If you have experienced a sudden “pop” in the back of your calf or heel, you may have torn your Achilles tendon. Please seek urgent medical attention if you think you may have torn your tendon.

Diagnosis

If Achilles tendonitis or tendinosis is suspected, please deter from any activity or exercise which causes the pain. It is advisable to see your doctor or physiotherapist as soon as possible so that an accurate diagnosis may be made and appropriate treatment recommended.

You will be asked about the nature and duration of your symptoms and the medical professional assessing you will have a look at your foot and ankle. Ultrasound scanning may be used to evaluate the damage to the tendon and/or surrounding structures.

An MRI may be recommended if symptoms persist. X-rays may also be taken to rule out other disorders which may cause symptoms like Achilles tendonitis and tendinosis.

Achilles Tendonitis - Ankle - Conditions - Musculoskeletal - What We Treat - Physio.co.ukHow to Treat Achilles Tendinopathy with Physical Therapy - prohealthcareproducts.com

Treatment

Treatment will depend on the nature, severity, and length of the injury. Generally speaking, the longer the symptoms are present before treatment commences, the longer the timeframe until full recovery is attained.  Full recovery may take between three and nine months.

Initial treatment options in the early stages may include:

  • Rest – to avoid further injury to the area
  • Ice – to reduce inflammation
  • Elevation – to reduce swelling
  • Non-steroidal anti-inflammatory drugs to reduce pain and inflammation.

 How physiotherapy can help:

Physiotherapy typically focuses on two main areas: treatment and rehabilitation. Treatment may entail massage, shockwave therapy, acupuncture, gait re-education, and gentle stretching, whereas, rehabilitation predominantly entails strengthening of the Achilles and surrounding musculature.

Strengthening of the muscles surrounding the Achilles tendon facilitates healing in the tendon itself. Strengthening is attained through the utilization of specific exercises, that will be taught by your physiotherapist. It is common for the rehabilitation programme to take up to three months.

 

Exercises

 

 

By Physio Team Appointments & Fees, Exercises, Home exercises, Lockdown, online consultations, Physio, Pilates & Exercise Classes, Sporting, Studies, Therapy, Uncategorized , , , , , , ,

Stay safe, Stay fit

Our daily routine has been forced to change during the lockdown and it has never been more important to focus on your physical and mental health. The current situation we’re facing is strange, stressful, emotionally exhausting and there is no surprise that the motivation to keep fit has been a bit of a struggle. It is in these disquieting times that exercise can provide much-needed solace.

Research shows that being physically active helps lower cholesterol and blood pressure and can significantly reduce the risk of heart disease, stroke, and diabetes. Physical activity also maintains mass and bone density, reducing the risk of developing osteoporosis (loss of bone density), Sarcopenia (loss of muscle mass), and helps boost one’s immune system, as it flushes bacteria from the lungs and airways, increases white blood cell circulation and raises body temperature, all of which help the body fight infection.

How much Activity is Recommended?

Be active every day, in as many ways as possible. Aim for at least 2 ½ hours of moderate (or 1 ¼ hours of vigorous physical activity) spread throughout the week. The Ministry of Health outlines how much physical activity New Zealanders need to stay healthy https://www.health.govt.nz/your-health/healthy-living/food-activity-and-sleep/physical-activity/how-much-activity-recommended.

Create a Routine

Whether you are looking to maintain an exercise regime or just stay motivated from one day to the next, as your own four walls start to make you feel a bit stir crazy, many people find that it helps to have a set routine. It portions the day into bite-size chunks and allows you to feel a sense of accomplishment as you tick off the day’s tasks.

Few of us are lucky enough to have an exercise bike/treadmill at home. Fortunately, there are plenty of simple exercises that you can do around the house or with household objects that will work instead. If you do not have your own weights at home there are some surprising substitutes you can utilize instead i.e bags of rice or flour, a tin of beans and bottled water can be used, if you need something heavier you can always fill a carrier bag with a few items inside.

1. Squats

Directions:

Lie on the floor and rest on your back. Ensure that your knees are bent, and your feet are touching the floor.

Put your hands behind your head and then lift both your chest and your legs slightly but leave a gap between them.

Go back to the starting position and repeat.

2. Crunches

Crunches are another important exercise for your abs to strengthen your body core.

Directions:

Widen your feet parallel to your shoulder and extend your arms in front of you.

Bend your knees and your hips slightly and then do the traditional squat position.

Push up using your heels and repeat.

3. Stationary Lunge

Directions:

Stand up straight and put your right leg forwards and your left leg backward. It should look like you’re preparing to run.

Place your hands on your hips. Bend your right leg, leaving a little gap between the floor and the knee.

Then, switch your legs and do the same.

These bodyweight exercises are a great way to start your day and get the blood pumping in your body.

 

Safety during exercise outside

If you’re working from home, getting outside for physical activity will do wonders for your physical and mental health. Regular walking, running or cycling is a great way to stay active and healthy during lockdown, but it is important to keep your distance and stay more than two metres away from others. Plan your route when you’re thinking of heading out for a cycle/jog. If possible try to think of roads, neighborhoods, and parks that will be quieter and less congested. Follow the latest advice about whether you will also need to wear a mask.

Take a Bit of You Time

Fill your own cup first…Being healthy is not just about maintaining an exercise regime and eating right, it is also about staying mentally healthy too. If you are in isolation with your family, it is easy to spend the day making sure they are happy and entertained, but don’t forget to take a bit of time for you. Do a quick meditation or yoga routine while the kids are watching TV or maybe just go into the garden and take a few deep breaths to relieve some stress!

During this time of uncertainty, something we can take control of is our health and well-being. So, whatever your situation, try to keep active, eat healthily, and stay hydrated.

Ngā mihi and stay safe

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

5 COMMON MISCONCEPTIONS ABOUT PHYSIOTHERAPISTS – PART 2

Myth 1: When you see a physiotherapist you just lie on the bed and get given an ice or heat pack.

At Physio Fusion we use an active approach to treatments. Physiotherapy will include manual hands-on therapy to facilitate tissue healing and tissue load tolerance alongside an exercise program individualized to your needs.

Myth 2: If I have elbow pain then the injury must be in my elbow.

The area of pain is not always the area that is the issue! It may be a result of a previous injury that was never fully rehabilitated. This is where we can help you out. Our assessment will consist of gathering information on your presenting complaint, any previous injuries or traumas (physical and emotional) and a medical history followed by an objective evaluation of your body. This allows us to get to the root cause of the pain and manage your symptoms most effectively.

Myth 3: I can’t do any of my normal activities while I attend physiotherapy.

Not true! Our Physiotherapists want to keep you as functional as possible whilst allowing your injury to heal. During the initial assessment your physiotherapist will determine what activities you can do and advise you on those that must be avoided. You will then be given clear and timely objectives to ensure you reach your goals to get you back doing what you love!

Myth 4: A scan will show me exactly what is wrong.

Sometimes it will, but sometimes it won’t. It’s no secret that our bodies change as we age, so even people without pain are likely to have an imperfect scan. Medical imaging can sometimes play an important role in the assessment and management of your musculoskeletal issue. When necessary, your physiotherapist will know what type of imaging to refer you for.

Myth 5: Is cracking my back/neck/knuckles bad for me?

There is no strong evidence to suggest that ‘cracking’ your joints causes degeneration, laxity or instability. The ‘cracking’ occurs when we move a joint to its end range. The audible sound happens because of ‘cavitation’ in the joint; this involves gas bubbles popping within the fluid surrounding the joint as pressures change.

But is it good to crack?

Self manipulation can be a helpful way to reduce the feeling of stiffness or tightness. If you are finding that you need to ‘crack your joints’ often it is good to know that there are many other more beneficial ways to provide greater long term relief.

Top tips:

  1. Ask your physiotherapist to provide you with some specific exercises to help you overcome the feeling of stiffness or tightness.
  2. Move regularly and avoid movements or positions that exacerbate your symptoms until you have been seen by your physiotherapist.

By Physio Team Exercises, Injury, Physio, Sporting, Therapy, Uncategorized, Work Injury , , , , ,

5 COMMON MISCONCEPTIONS ABOUT PHYSIOTHERAPISTS- PART 1

Myth 1: ‘’Physiotherapy is just massage’’

This is a common phrase people use to describe a physiotherapists role. It is true that as a profession we like to work ‘hands on’. This is because our profession is directly affiliated with the anatomy of our clients and by using touch we can more accurately assess, locate and treat any dysfunctional motions within your body. Our physiotherapists like to use massage as it is a great way reduce pain and improve bodily function but their skill set is much more extensive than this.

Did you know?

There are well over 20 different treatment approaches commonly used by physiotherapists.  These may include, but are not limited to:

  • Exercise prescription.
  • Joint mobilization.
  • Joint manipulation.
  • Instrument mobilization.
  • Muscle energy techniques (improves muscle and joint function).
  • Neurodynamics (mobilization of the nervous system).
  • Taping.
  • Dry needling.
  • Acupuncture.

Myth 2: Always sit up straight! Slouching is bad.

In fact, forcing yourself to adhere to the traditional ‘good posture’ (back straight and shoulders back) may be putting unnecessary tension on your body. That isn’t to say being upright is bad either, but in life we must always find a balance. To reduce stress on your body whilst seated, ensure your back is supported and your feet firmly on the ground. To prevent and reduce the likelihood of back pain we must look to vary our posture frequently throughout the day and ensure we take short breaks to stretch, stand and walk.


Myth 3: Physiotherapy sessions are painful

Physiotherapists aim to help you reduce pain and get you back to doing what you love! Whether your injury is acute or chronic our physios always ensure they work within your pain threshold to help you regain lost movement and function.

Myth 4: I need a referral to see a Physiotherapist’

We have got you covered!

Remember, physios are registered health care professionals. Physio Fusion is a registered ACC provider. This means that if you have had a recent injury (within one year), you can see us directly and we can help you lodge an injury claim directly with ACC. You do not need a referral for your doctor.


Myth 5: Lower back pain …. surgery is my only option

Around 70-90% of the total world population will experience lower back pain during the course of a life time. Symptoms can range from mild to severe and can either last for short or long periods or remain constant. Back pain can be very debilitating and when the pain does not resolve as soon as anticipated many fear that surgery may be the only option. In few cases surgery may be necessary, but for the majority there’s often nothing to fear, and with time and a gradual loading or exercise program, you can make a full recovery.

Did you know ?

Back pain is not always a sign of injury or damage. Each individuals back pain story will be different, and for many non-physical factors play a huge part in their story. These factors can be:

Psychological –

  • Stress.
  • Fear of movement.
  • Depression.

Health related –

  • Sleep deprivation.
  • Physical inactivity.
  • Smoking (nicotine decreases blood flow to your back).
  • Overweight.

Physio Fusions top recommendations for keeping back pain away:

  • Keep active – regular exercise nourishes joints, strengthens muscles, increases blood flow and improves your mood.
  • Sleep well.
  • Maintain a healthy weight by ensuring you maintain proper nutrition and diet.
  • Sit in a chair with good lower back support.
  • Quit smoking.
  • Ensure that when you lift or pick up objects you do so in a safe manner. This is something one of our physiotherapists can guide you with.

See a doctor urgently if you have the following symptoms:

  • Numbness in the groin or buttocks.
  • Loss of bladder or bowel control.
  • Redness or swelling on your back.
  • Difficulty walking.
  • Constant pain, especially at night.
  • Pain that is getting much worse, or spreading up your spine.
  • Numbness or pins and needles in both legs.
  • Feeling unwell with your back pain, such as a fever or significant sweating that wakes you from sleep.
By Physio Team Exercises, Physio, Studies , , , , , ,

EXERCISE AND MOOD

Exercise not only changes your body. It changes your mind, your attitude and your mood

We all have days where we plan to do our workouts and we know we should however when it’s time to put your shoes on and go… You simply just don’t want to go.

How many times have you said this to yourself?

  • I don’t feel like exercising
  • I’m too tired to exercise
  • I’ve lost my motivation to exercise
  • I’m not in the mood to exercise

What if we told you that exercise is not just about burning calories, regular exercise plays a vital role in cognitive function and mental acuity which helps support a positive outlook on life.

What we know about Exercise and Mood

Research has long supported the benefits of exercise, from weight control to reducing the risks of cardiovascular disease, type 2 diabetes, and even cancer. Regular exercise strengthens our muscles, bones, increases your flexibility and helps you stay fit and active for longer.

What can exercise do for my mood? Exercise can have an enormous impact on your mood. In fact, it is thought that exercise can be just as effective as anti-depressants in treating mild-to-moderate depression.

What we do know is:

  • Exercise can help treat people with depression who have partially responded to anti-depressants
  • both aerobic exercise (such as walking, cycling or running) and strength training (such as weight lifting) can help treat depression
  • Improved mood
  • Improved self-esteem
  • Reduced stress as well as an improved ability to cope with stress
  • Improved confidence in your physical abilities
  • Builds your coping and resilience
  • Can help distract from negative thoughts
  • Gives you a sense of accomplishment

Exercise and Depression

As mentioned previously, studies show that exercise can treat mild to moderate depression as effectively as antidepressant medication a recent study done by the Harvard T.H. Chan School of Public Health found that running for 15 minutes a day or walking for an hour reduces the risk of major depression by 26%. In addition to relieving depression symptoms, research also shows that maintaining an exercise schedule can prevent you from relapsing.

Exercise and Anxiety

Exercise is a natural and effective anti-anxiety treatment. It relieves tension and stress, boosts physical and mental energy, and enhances well-being through the release of endorphins. A systematic review by Aylett, E., Small, N. & Bower, 2018 assessed the use of exercise versus waiting list control groups in the treatment of anxiety and also the benefit of high intensity exercise vs low intensity exercise. The intervention was any aerobic exercise programme carried out for at least two weeks, and the comparison groups were either a waiting list control group or low intensity exercise (stretching/walking). This study concluded that higher intensity exercise have an advantage over lower intensity exercise in bringing about an improvement in anxiety scores. The study also confirmed that exercise represents an effective treatment and should be more available for referral from General Practice.

Exercise and Stress

Studies have found that stress contributes to 50% of all illnesses and that two-thirds of GP visits were for stress-related illnesses. Wang, C., Chan, C.H., Ho, R.T. et al. 2014 conducted a systematic review that assessed examining the effect of exercise on stress reduction or anxiety relief among healthy adult and found that exercise does in fact relieve anxiety and reduce stress. There is a great number of studies that have typically focused on aerobic exercises. There have been consistent findings that people report feeling calmer after a 20- to 30-minutes of aerobic exercise, and the calming effect can last for several hours after exercise.

Exercise and Enhancing Brain Function

Exercise also plays a vital role in improving brain function as it leads to increased blood flow and oxygen to the brain. Exercise can help generate new nerve cells and improve cognition, memory and learning. Regular exercises can even help to prevent Parkinson’s Disease, Stroke and Alzheimer’s Disease (Cotman & Engesser-Cesar, 2002). Brain-derived neurotrophic factor (BDNF) is important in brain function, neuronal transmission, and plasticity (Ferris, Williams & Shen, 2007). This process is known as neurogenesis or neuroplasticity. A study conducted by Ferris et al. (2007), studied BDNF to help confirm the relationship between exercise and brain function. Fifteen participants rode a bicycle for 30 minutes, one ride at moderate intensity. After exercise, BDNF values were increased and intensity dependent which supports the positive effect that exercise can have on brain function.

Are you maximizing your exercise routine? Are you unsure if the exercise you’re doing is right? Are you struggling with motivation to get moving again?

If you’re reading this and think any or all mentioned above sounds familiar, then we can definitely help you. Based on specializing in exercise progressions and exercising ourselves, we can help assess, adjust and progress your routine. Everyone’s needs are different so during our consultation with you, we ensure that we draw on the combination that will best serve you. We strive to ensure our clients are performing exercises correctly and efficiently, in order to maximize results.

So, what are you waiting for? Enquire with us to discuss how we can help you get started and achieve your goals!

If you are in a bad mood go for a walk. If you are still in a bad mood go for another walk.

References

Aylett, E., Small, N. & Bower, P. Exercise in the treatment of clinical anxiety in general practice – a systematic review and meta-analysis. BMC Health Serv Res 18, 559 (2018). https://doi.org/10.1186/s12913-018-3313-5

Wang, C., Chan, C.H., Ho, R.T. et al. Managing stress and anxiety through qigong exercise in healthy adults: a systematic review and meta-analysis of randomized controlled trials. BMC Complement Altern Med 14, 8 (2014). https://doi.org/10.1186/1472-6882-14-8

Cotman, C.W. & Engesser-Cesar, C. (2002). Exercise enhances and protects brain function. Exercise and Sport Sciences Reviews, 30 (2), 75-79.

Ferris, L.T., Williams, J.S., & Shen, C.L. (2007). The effect of acute exercise on serum brain-derived neurotrophic factor levels and cognitive function. Medicine and Science in Sports and Exercise, 39 (4), 728-734.

Hearing, C. M., Chang, W. C., Szuhany, K. L., Deckersbach, T., Nierenberg, A. A., & Sylvia, L. G. (2016). Physical Exercise for Treatment of Mood Disorders: A Critical Review. Current behavioral neuroscience reports, 3(4), 350–359. https://doi.org/10.1007/s40473-016-0089-y

Robertson, R., Robertson, A., Jepson, R., & Maxwell, M. (2012). Walking for depression or depressive symptoms: A systematic review and meta‐analysis. Mental Health and Physical Activity, 5( 1), 66– 75. https://doi.org/10.1016/j.mhpa.2012.03.002