Tuesday, April 30, 2013

Mothers Day Massage Gift Vouchers Specials NOW Available!



If your Mum loves massage then a treat for her is just around the corner.

With Mother's Day fast approaching, PhysioWorks has just released our Massage Gift Voucher Specials available until Mothers Day 2013.

Buying a thoughtful and practical gift for her special day has become very difficult. A massage gift voucher is just the ticket for your Mum.

For more details, simply contact your nearest PhysioWorks clinic or click here.





Clayfield - Ph 3862 4544 - 789 Sandgate Road

Sandgate - Ph 3269 1122 - 18 Bowser Parade





What is Patellofemoral Pain Syndrome? What Causes It? How to Fix?


Patellofemoral pain (or kneecap pain) is one of the most common knee complaints of both the young active sportsperson and the elderly.

Patellofemoral pain syndrome is the medical term for pain felt behind your kneecap, where you patella (kneecap) articulates with your thigh bone (femur). This joint is known as your patellofemoral joint.

Patellofemoral pain syndrome, is mainly due to excessive patellofemoral joint pressure from poor kneecap alignment, which in time, affects the joint surface behind the kneecap (retropatellar joint).
patellofemoral pain

What Causes Patellofemoral Pain?

Your patella normally glides up and down through the femoral groove. As your knee is bent, pressure between your kneecap and the groove increases.

This retropatellar pressure is further increased if the patella does not ride normally through the groove, but “mistracks”, meaning it travels more to one side, making it rub against the femur.
patellofemoral pain

Repeated trauma causes an increase in your retropatellar joint forces, which can lead to kneecap pain, joint irritation and eventually degeneration of your patella joint surface.

The most common causes of patellar malalignment are an abnormal muscle imbalance and poor biomechanical control.

Aching kneecaps (patellofemoral pain) affect 25% of the population at some time in their lives but it is more common in athletes. The sports where patellofemoral pain syndrome is typically seen are those when running, jumping and landing or the squatting position is required.

Sports include running, tennis, netball, football, volleyball, basketball, skiing and other jumping sports.

Untreated patellofemoral joint pain can also predispose you to patellar tendonitis.

What Causes a Muscle Imbalance?

Your quadriceps (thigh) muscles attach to the patella and through it to the patella tendon, which attaches to the top of your shin.

If there is a muscle imbalance between the quadriceps muscles: vastus lateralis (VL), which pulls your patella up and outwards, and the vastus medialis oblique (VMO), which is the only quadriceps muscle that pulls your kneecap up and slightly in, then your patella will track laterally in the groove.

Common reasons for a weak vastus medialis oblique (VMO) include knee injury, post-surgery, swelling or disuse.

Longstanding tightness of your lateral knee structures (lateral retinaculum, VL, and ITB) will encourage your kneecap to drift sideways over time. Especially, if your VMO is also weak.

patellofemoral pain syndrome

Patellofemoral pain is more common during adolescence, because the long bones are growing faster than the muscles, tendons and ligaments, putting abnormal stresses on the joints. Active children who do not stretch the appropriate muscles are predisposed to patellar malalignment.

What Biomechanical Issues Cause Patellofemoral Pain?

Poor foot posture (eg flat feet) and weak hip control muscles can both allow your knee to abnormally twist and result in a lateral deviation of your patella.

When poor biomechanics are repeated with each step of your walking or running pattern that poor habit repeatedly traumatises your patellofemoral pain.

What are the Symptoms of Patellofemoral Pain Syndrome?

The onset of your kneecap pain is normally gradual rather than traumatic.

Patellofemoral pain symptoms are normally noticed during weightbearing or jarring activities that involve knee bending.

Stairs, squatting, kneeling, hopping, running or using stairs are commonly painful. As your patellofemoral pain syndrome progresses your knee will become painful while walking and then ultimately even at rest.

You can also experience kneecap pain when you are in sustained knee bend eg. sitting in a chair. A nickname for this condition is “theatre knee”. 

Patellofemoral Pain Syndrome Treatment

Researchers have confirmed that physiotherapy intervention is a very effective short and long-term solution for kneecap pain.

Approximately 90% of patello-femoral syndrome sufferers will be pain-free within six weeks of starting a physiotherapist guided rehabilitation program for patellofemoral pain syndrome.

For those who fail to respond, surgery may be required to repair associated injuries such as severely damaged or arthritic joint surfaces.

The aim of treatment is to reduce your pain and inflammation in the short-term and, then more importantly, correct the cause to prevent it returning in the long-term.

There is no specific time frame for when to progress from each stage to the next. Your injury rehabilitation will be determined by many factors during your physiotherapist’s clinical assessment.

You’ll find that in most cases, your physiotherapist will seamlessly progress between the rehabilitation phases as your clinical assessment and function improves. It is also important to note that each progression must be carefully monitored as attempting to progress too soon to the next level can lead to re-injury and the frustration of a delay in your recovery.

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Phase 1 - Injury Protection: Pain Relief & Anti-inflammatory Tips

As with most soft tissue injuries the initial treatment is - Rest, Ice and Protection.

(Active) Rest: In the early phase your best to avoid all activities that induce your kneecap pain.

Ice is a simple and effective modality to reduce your pain and swelling. Please apply for 20-30 minutes each 2 to 4 hours during the initial phase or when you notice that your injury is warm or hot.

Protection: Your physiotherapist will normally apply kinesiology supportive taping or similar to help relieve your pain and commence your patellofemoral joint realignment phase. The patellofemoral taping is normally immediately effective in providing you with pain relief.

Your physiotherapist will utilise a range of helpful tricks including pain relieving techniques, joint mobilisations, massage, strapping and acupuncture to assist you during this painful phase.

Anti-inflammatory medication and natural creams such as arnica may help reduce your pain and swelling. Most people can tolerate paracetamol as a pain reliever.

Phase 2: Regain Full Range of Passive Motion

Your kneecap and knee must be able to glide through its full normal range of motion. Your physiotherapist will assess your motion and apply the necessary techniques to normalise your range of motion. 

Phase 3: Restore Full Muscle Length

Your thigh, hamstring and calf muscles will require stretching is they are tight and are causing excessive tension or pressure on your kneecap.

It is important to regain normal muscle length to improve your lower limb biomechanics.

Phase 4: Normalise Quadriceps Muscle Balance

In order to prevent a recurrence, your quadriceps muscle balance and its control should be assessed by your physiotherapist. In most instances you will require a specific knee strengthening program.

Your physiotherapist will prescribe the best exercises for you.

Phase 5: Normalise Foot & Hip Biomechanics

Kneecap pain can occur from poor foot biomechanics (eg flat foot) or poor hip control.

In order to prevent a recurrence, your foot and hip control should be assessed by your physiotherapist. In some instances you may require a foot orthotic (shoe insert) or you may be a candidate for the Active Foot Posture Stabilisation program.

Other patient may require a hip stabilisation program

Your physiotherapist will happily discuss what you require.

Phase 6: Normalise Movement Patterns

Kneecap pain commonly occurs from poor habits, whether they be an abnormal gait, jumping, landing, running or squatting technique.

In order to prevent a recurrence, your walking pattern, jumping and landing technique, running style or squatting method should all be assessed and corrected as required.

Your physiotherapist will happily discuss what you specifically require.

Phase 7: Restore High Speed, Power, Proprioception and Agility

Most kneecap pain sufferers need to return to high speed or repetition activities, which place enormous forces on your knee. Your physiotherapist will guide you in your return to sport planning.

Balance and proprioception (the sense of the relative position of neighbouring parts of the body) are both known to be adversely affected by patellofemoral pain. To prevent a re-aggravation, both aspects need to be assessed and retrained.

Depending on what your sport or lifestyle entails, a speed, agility, proprioception and power program will be customised to prepare you for light sport-specific training.

Phase 8: Return to Sport

If you play sport, and depending on the demands of your chosen sport, you may require specific sport-specific exercises and a progressed training regime to enable a safe and injury-free return to your chosen sport.

Your physiotherapist will discuss your goals, time frames and training schedules with you to optimise you for a complete and safe return to sport. The perfect outcome will have you performing at full speed, power, agility and function with the added knowledge that a through rehabilitation program has minimised your chance of future injury.

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Helpful Products

Patellofemoral Brace

An effective patellofemoral brace can be useful as an alternative to kneecap taping.

patellofemoral pain brace

More information or to purchase online: http://bit.ly/ZZPzbY

ITB Roller

Excellent for stretching your tight thigh structures: ITB, quadriceps and hamstrings.

kneecap pain

More information or to purchase online: http://bit.ly/112y8Km

More Advice

For more advice, please consult your knee physiotherapist.

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Patellofemoral Pain Syndrome Treatment Options


 
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FAQs about Patellofemoral Pain Syndrome



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Contact PhysioWorks or Book Online

Monday, April 29, 2013

What is Flexall 454?


Flexall 454 is a Pain Relieving Gel

Flexall 454 provides you with powerful pain relief from this unique Mentholated Aloe Vera Gel formula enriched with Vitamin E.

Flexall 454 contains 7% Menthol as the active agent. 

Simply massage Flexall 454 on to your sore muscles for lasting effects.

Flexall 454 provides temporary, penetrating relief for painful muscles and joints.

Treat your sore muscles and arthritic joints with the same pain relieving Flexall 454 gel that has been endorsed by leading professional US athletic trainers and used by the world's top athletes.

Flexall 454 assists with temporary pain relief from:
  • arthritis pain, 
  • bursitis, 
  • tendonitis, 
  • backache, 
  • muscular tension, 
  • strains and sprains, 
  • bruises and cramps.
The Aloe Vera and Vitamin E help to soothe your skin after the product has been rubbed in.

Flexall 454 is easy to apply and greaseless.

How to use Flexall 454

Apply generously to your painful muscles and joints then gently massage until the Flexall 454 disappears. 

Repeat as necessary for temporary relief of minor arthritis pain, simple backache, bursitis, tendonitis, muscle sprains and strains, bruises, and cramps. 

Use before and after activity. When treating an injured area or joint, make sure to completely coat the entire area.

Flexall 454 Testimonials

"Absolutely Amazing!"  M Calvert, Bracken Ridge QLD

"Flexall is a miracle. All my friends now use it." E Anderson, Sandgate QLD



More info about Flexall 454


(TGA registered product - 49227)

Sunday, April 28, 2013

Trochanteric Bursitis... What is it? How is it Diagnosed? What's the best treatment?



The most common form of hip bursitis is trochanteric bursitis.

trochanteric bursitis
 
Trochanteric bursitis is inflammation of the bursa (a small, cushioning sac located where tendons pass over areas of bone around the joints), which lies over the prominent bone on the side of your hip (femur).

The superficial trochanteric bursa is located over the greater trochanter. This is the most commonly inflamed bursa. A deep trochanteric bursa lies deeper and can become inflamed in more severe cases.

What is a Bursitis?

What are Trochanteric Bursitis Symptoms?

One or more of the following symptoms may be experienced:
  • Pain and swelling occurring over the side of the hip
  • Referred pain that travels down the outside thigh and may continue down to the knee
  • Pain when sleeping on your side; especially the affected hip
  • Pain upon getting up from a deep chair or after prolonged sitting (eg. in a car)
  • Pain when climbing stairs
  • Pain in sitting with the legs crossed
  • Increased pain when walking, cycling or standing for long periods of time

What Causes Trochanteric Bursitis?

The trochanteric bursa may be inflamed by a group of muscles or tendons rubbing over the bursa and causing friction against the thigh bone.

This injury can occur traumatically from a fall or a sport-related impact contusion.

It can also be a case of gradual onset via a repetitive trauma to the bursa from such activities as running (with poor muscles control or technique), walking into fatigue, or cycling, especially when the bicycle seat is too high.

It is also a secondary injury associated with chronic conditions such as:
  • Scoliosis - curvature of the spine
  • Unequal leg length
  • Weak hip muscles
  • Osteoarthritis (degenerative joint disease) of the hips or lower back
  • Calcium deposition in the gluteal tendons that run over the bursa
  • Rheumatoid arthritis.

How is Trochanteric Bursitis Diagnosed?

Your physiotherapist will provide you with an assessment of your medical history and a physical examination of your hip, pelvis and back. A hallmark sign is if you feel tenderness over the bursa or greater trochanter (hip bone) when pressure is applied.

Diagnosis can also be confirmed by medical imaging techniques that include ultrasound scan & MRI. 

Contact Physio Works or Book Online

What is Trochanteric Bursitis Treatment?

Ice

  • Bursitis is an inflammed bursa. Daily application of ice packs is highly recommended to reduce your pain and swelling.

Medications

  • NSAIDs or anti-inflammatory drugs (i.e. ibuprofen). Use of these medications should be discussed with your doctor. 

Corticosteroid Injections

  • Single injection of a corticosteroid with a local anaesthetic into the bursa may be required to stimulate your healing response. It is preferable to have this injection using ultrasound guidance. 

Trochanteric Bursitis Treatment

PHASE I - Pain Relief & Protection

Managing your pain. Pain is the main reason that you seek treatment for trochanteric bursitis. In truth, it was actually the final symptom that you developed and should be the first symptom to improve.

Managing your inflammation. Bursa inflammation it best eased via ice therapy and techniques or exercises that deload the inflammed structures.

Your physiotherapist will use an array of treatment tools to reduce your pain and inflammation. These include: ice, electrotherapy, acupuncture, deloading taping techniques, soft tissue massage and temporary use of a mobility aid (eg cane or crutch) to off-load the affected side.

PHASE II - Restoring Normal ROM, Strength

As your pain and inflammation settles, your physiotherapist will turn their attention to restoring your normal hip joint range of motion, muscle length and resting tension, muscle strength and endurance, proprioception, balance and gait (walking pattern).

Hip researchers have discovered the importance of your hip muscle recruitment patterns with a normal order of: deep, then intermediate and finally superficial muscle firing patterns in normal pain-free hips. Your physiotherapist will assess your muscle recruitment pattern and prescribe the best exercises for you specific to your needs.

PhysioWorks has developed a “Hip Core Stabilisation Program” to assist their patients to regain normal hip muscle control. Please ask your physio for their advice.

PHASE III - Restoring Full Function

The final stage of your rehabilitation is aimed at returning you to your desired activities. Everyone has different demands for their hips that will determine what specific treatment goals you need to achieve. For some it be simply to walk around the block. Others may wish to run a marathon.

Your physiotherapist will tailor your hip rehabilitation to help you achieve your own functional goals.

PHASE IV - Preventing a Recurrence

Trochanteric bursitis does have a tendency to return. The main reason it is thought to recur is due to insufficient rehabilitation.

In addition to your muscle control, your physiotherapist will assess you hip biomechanics and start correcting any defects. It may be as simple as providing your will core abdominal exercises or some foot orthotics to address any biomechanical faults in the legs or feet. Your physiotherapist will guide you.

Fine tuning your hip stability and function by addressing any deficits in core strength and balance, learning self-management techniques and achieving the ultimate goal of safely returning to your previous sporting or leisure activities!

Bursitis Surgery

Surgery is not a common path. However, in persistent cases, arthroscopic removal of the bursa; a bursectomy, can be performed.

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How Can You Prevent Trochanteric Bursitis?

Muscle weakness or fatigue is a major cause of trochanteric bursitis. So addressing your strength and endurance is necessary to avoid a recurrence.

Wearing adequate footwear which supports any biomechanical imbalances in your feet is a key preventative measure.

Successful weight management, minimises excess stress on the hip joints which can alleviate pressure on the bursa. If you need advice regarding your weight-loss please discuss with your doctor or dietitian.

What Results Can You Expect for Trochanteric Bursitis?

While some people can respond quickly to physiotherapy treatment within a few weeks, more chronic cases where a tendinopathy exists in the gluteal muscle group under the bursa can require a few months to achieve recovery.

Trochanteric bursitis is successfully managed in the vast majority over a period of approximately six week. It is important to not stop your rehabilitation exercises as soon as you pain abates.

Excellent hip muscle control is your best rehabilitation and prevention strategy. Please follow the advice of your physiotherapist or doctor.

Physiotherapists at Physio Works can get your started on the right track to recovery! If you have any specific questions, please ask them.

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Common Trochanteric & Hip Bursitis Treatments


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FAQs about Trochanteric & Hip Bursitis



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Helpful Products for Trochanteric Bursitis

Bursitis - Trochanteric

Related Injuries


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Thursday, April 25, 2013

What is Degenerative Disc Disease?



degenerative disc disease
Your intervertebral discs are the shock-absorbing rings that sit between the bony vertebral bodies in your spine. They are made up of two main parts; the annulus and the nucleus.

The nucleus refers to the inner, jelly-like section of the disc which can change shape to adapt to different loads placed on the spine. This is very important for shock absorption between spinal segments, as well as ensuring there is enough room between each vertebrae for movement of the spine and for major nerves to pass in and out of the spinal canal.

The annulus is the outer component of the intervertebral disc, and is made up of dense fibrocartilage. This tough layer encases the fluid sac and plays a vital role in controlling the amount of movement the nucleus is allowed.
At birth, your intervertebral discs are made up of up to 80% water. As we age however, the discs “dry out” leading to poorer shock absorption ability and increased risk of small tears developing in the outer annulus layer. This is a normal part of the aging process and, in many cases, is not painful.

This degenerative process affecting your discs is known as degenerative disc disease.

Risk Factors for Degenerative Disc Disease

Although degenerative disc disease is a common part of ageing life, there are some factors which have been linked with higher incidence of disc degeneration. These often relate to increased forces travelling through the spine, and include:
  • Carrying excess body weight
  • Family history of early disc degeneration
  • Careers involving heavy manual labour or vibrations
  • Active lifestyle
  • Conditions affecting the biomechanics of the spine, such as osteoarthritis and scoliosis

Symptoms of Degenerative Disc Disease

Although degenerative disc disease can pass by unnoticed, an ageing disc can sometimes be very painful. It is thought that this pain originates from the inflammation and/or microinstability surrounding the affected discs, as well as the muscle spasm that occurs in the area as a natural response to the altered biomechanics of the spine.

The close relationship between your intervertebral discs and the spinal nerves also means that as the disc degenerates and the space between the vertebrae decreases, there is greater risk of irritation of nerves entering and leaving the spinal canal.

Common symptoms of degenerative disc disease include:
  • Lower back pain, which may travel into the buttocks, hips and legs
  • Pain that is aggravated by prolonged sitting or activities which load the intervertebral discs such as bending, lifting or twisting
  • Relief of pain by changing positions, standing up, lying down, or walking
  • Pins and needles or numbness down the leg may also occur when the spinal nerves around the affected disc become sensitive or irritated
It is important to note that the symptoms and amount of pain experienced varies from person to person, and is not indicative of the amount of degeneration or injury.

How is Degenerative Disc Disease Diagnosed?

Degenerative disc disease or narrowing of the disc space can be identified on MRI scans and X-rays.

However as not all ageing discs are symptomatic. It is important to see your physiotherapist who can ask you questions and perform tests to determine the source of your back pain and treat it accordingly.

Treatment and Prognosis for Degenerative Disc Disease

Although your intervertebral discs will continue to age over time, it is highly likely that your back pain will actually decrease and your symptoms are often able to be managed successfully with conservative treatment. 

Your physiotherapist will be able to develop an individual program for you to achieve this so you can return to your normal day to day life as quickly as possible. 

It is important to note that just because you have degenerative disc disease present on CT scan or MRI, it doesn't mean it will be painful. In fact, when you were pain-free the day before you had your first symptoms, degenerative disc disease would have been present on scans!

Therefore the success in the treatment of degenerative disc disease is managing the disease and your associated findings rather than just the degeneration.

PHASE I - Pain Relief & Protection

Managing your pain is usually the main reason that you seek treatment for degenerative disc disease. In truth, it was actually the final symptom that you developed and should be the first symptom to improve.

Managing your inflammation. Inflammation is the main short-term reason for why you have suddenly developed degenerative disc symptoms. It best reduced via ice therapy and techniques or exercises that deload the inflammed structures.

Your physiotherapist will use an array of treatment tools to reduce your pain and inflammation. These include: ice, electrotherapy, acupuncture, deloading taping techniques, soft tissue massage and temporary use of a back brace.

Your doctor may recommend a course of non-steroidal anti-inflammatory drugs such as ibuprofen.

PHASE II - Restoring Normal ROM, Strength

As your pain and inflammation settles, your physiotherapist will turn their attention to restoring your normal joint alignment and range of motion, muscle length and resting tension, muscle strength and endurance.

Your physiotherapist will commence you on a lower abdominal and core stability program to facilitate your important muscles that dynamically control and stabilise your spine.

Researchers have discovered the importance of your back and abdominal core muscle recruitment patterns. A normal order of: deep, then intermediate and finally superficial muscle firing patterns is normally required for pain-free backs. Your physiotherapist will assess your muscle recruitment pattern and prescribe the best exercises for you specific to your needs.

Your physiotherapist may recommend a stretching program or a remedial massage to address your tight or shortened muscles. Please ask your physio for their advice.

PHASE III - Restoring Full Function

As your back’s dynamic control improves, your physiotherapist will turn their attention to restoring your normal pelvic and spine alignment and its range of motion during more stressful body positions and postures. They’ll also work on your outer core and leg muscle power.

Depending on your chosen work, sport or activities of daily living, your physiotherapist will aim to restore your function to safely allow you to return to your desired activities. Everyone has different demands for their body that will determine what specific treatment goals you need to achieve. For some it be simply to walk around the block. Others may wish to run a marathon.

Your physiotherapist will tailor your back rehabilitation to help you achieve your own functional goals.

PHASE IV - Preventing a Recurrence

Back pain does have a tendency to return. The main reason it is thought to recur is due to insufficient rehabilitation. In particular, poor compliance with deep abdominal and core muscle exercises. You should continue a version of these exercises routinely a few times per week. Your physiotherapist will assist you in identifying the best exercises for you to continue indefinitely.

In addition to your muscle control, your physiotherapist will assess your spine and pelvis biomechanics and correct any defects. It may be as simple as providing you with adjacent muscle exercises or some foot orthotics to address any biomechanical faults in the legs or feet.

General exercise is an important component to successfully preventing a recurrence. Your physiotherapist may recommend pilates, yoga, swimming, walking, hydrotherapy or a gym program to assist you in the long-term.

Fine tuning and maintenance of your back stability and function is best achieved by addressing any deficits and learning self-management techniques. Your physiotherapist will guide you.


Degenerative Disc Disease Treatment Options


FAQs about Degenerative Disc Disease


Helpful Products for Degenerative Disc Disease

Arthritis - Back

Related Injuries