Understanding Tears

Let’s get clued up on hamstring strains; why you may have one, what you can do to help and how to prevent a future injury.

WHAT ARE THE ?

The hamstrings are a group of three muscles; the biceps femoris, semimembranosus and semitendinosus. You can feel these muscles if you place your hands on your sitting bones where the muscles originate and slide your hands down the back of your . The main action of these muscles is to bend your , take your out behind you and to assist rotation of your knee, especially when performing accelerating and decelerating actions.

How does a hamstring strain/tear occur?

A strain/pull/tear is when the muscle fibres are overstretched. Injuries are frequently felt as a short sharp pain in the back of your whilst exercising. A hamstring strain will typically happen when just before your hits the ground. At this point, the hamstrings are working eccentrically to control the forward motion of the two lower leg bones, your tibia and fibula. Pain is often the most debilitating symptom affecting your ability to continue exercising and may cause a limp. Other symptoms include swelling, bruising, muscle spasm and reduced movement at your knee.

How long will it take to heal?

Strains can be categorised into 3 different grades. 1 being the mildest with a small number of fibres being torn to grade 3 being the most severe which can be a complete muscle rupture. The good news is muscles have a fantastic blood supply and should heal within 3-12 weeks depending on the degree of injury. However, the flexible fibres, which your muscles are made up of, are replaced with much more inflexible tough scar tissue, which is where physio’s come in. Specific rehabilitation such as specialist , strengthening, taping and soft tissue techniques can dramatically influence how muscle fibres are restructured reducing the amount of scar tissue speeding up the healing process helping you return to sport quicker. With any soft tissue injury, R.I.C.E (rest, ice, compression, elevation) should always be your first response.

What will a Physiotherapist do?

A physio will be able to perform a thorough assessment and educate you on why you sustained a hamstring strain in the first place. Common factors that can predispose you to hamstring strains are not warming up or cooling down properly, tight hamstrings or hip flexors, weak hamstrings or gluteal (butt) muscles, training at a high intensity without adequate training or altered biomechanics.

Who is particularly susceptible?

Runners often have short, weak hamstrings, tight hamstrings will restrict the length of your strides when running meaning you have to work harder to cover the same distance as you would with adequately lengthened hamstrings. Chronically tight hamstrings can cause not only hamstring strains but can contribute to back pain, knee pain and leg length discrepancies. So even if you have never stretched before it may be a good time to start stretching!

Prevention for “Pulling a hammy”

So to prevent yourself pulling a hammy make sure you warm up and cool down properly including effective stretching of not just your hamstrings but hip flexors, quadriceps and muscles, do sport specific strength and conditioning and avoid sudden increases in intensity of exercise. On your next visit why not ask your physio and find out how healthy your hamstrings are.

For more information or to make an appointment, you can BOOK ONLINE or call your local clinic.

What is a Rotator Cuff and have I torn it?

WHAT IS IT? The rotator cuff is a group of four small muscles that surround the shoulder joint. Their attach to the humerus, close to the joint line and act as a cuff that provides support and control to the shoulder. They also play a primary role in creating rotational movements of the shoulder.

Rotator cuff tears are common injuries and can occur in any of the four muscles, usually at their weakest point, which is the junction between the muscle and tendinous tissue. These tears are common in racket and throwing sports and are one of the leading causes of shoulder pain. The prevalence of rotator cuff tears increases as we age due to age related degenerative changes in the tissues.

What are the symptoms?

Many people have rotator cuff tears with no symptoms at all, and are unaware of the injury. However, for others, these tears can be very painful and lead to difficulty moving the shoulder, particularly with overhead activities. They may find their range of movement is restricted and the arm feels weak. They often experience pain that radiates down to the arm and pain at night, which can cause sleep disturbances. It is interesting to note that the size of a tear is not necessarily related to the amount of pain and dysfunction experienced, with small tears sometimes creating large problems and large tears going unnoticed.

What are the causes?

Movements that create a rapid twisting motion or overstretching of the shoulder often cause rotator cuff tears. The most common mechanism of injury is a fall onto an outstretched hand. These tears can be acute or chronic, developing over a period of time or related to degenerative changes, where tissue is damaged by everyday activities due to reduced strength and elasticity.

Other causes of rotator cuff tears include overuse, lifting or carrying heavy objects and repetitive overhead activities. Poor biomechanics can cause weakening of the shoulder’s tendons with insufficient blood supply to the rotator cuff over a long period of time. This can leave the tendon more susceptible to injury as is a significant contributing factor to the development of tears and the outcomes of recovery.

How can physiotherapy help?

The primary objectives of physiotherapy treatment are to reduce pain, increase range of motion and strength and improve shoulder function. Your physiotherapist will work with you to help set goals assist to reach them with a targeted rehabilitation program, manual therapy and education on how to achieve the most from your recovery.

While severe tears are often repaired surgically, research is increasingly showing that even in severe tears, a comprehensive rehabilitation program under a physiotherapist leads to similar outcomes to . For this reason, a conservative approach guided by a physiotherapist is often recommended to patients as the first option for treatment. The exact time frame of treatment and recovery will vary from person to person and is affected by a variety of factors including if surgical repair was chosen, the severity of the injury and function prior to injury.

For more information or to make an appointment, you can BOOK ONLINE or call your local clinic.

None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.

Facts about Osteoporosis

Osteoporosis is a condition characterised by very low bone mass or density. This is caused by the body either losing too much bone, not making enough or both. Osteoporotic bones become weak and fragile and can break from small forces that would normally be harmless.

In osteoporotic bones, as well as loss of bone density and mass, there may also be abnormal changes to the structure of the bone matrix, which further contributes to the bone weakness.

Osteoporosis is an extremely common bone disease and women are more affected than men. As it is a progressive disorder that worsens with age, while the disease process might begin earlier, the effects are usually only noticed and diagnosed in people who are 50 years and older.

What are the Signs and Symptoms?

Often called a silent disease, many people with osteoporosis will have no idea that they have the disease, as there are no obvious symptoms. In fact, sometimes the first sign that an individual has osteoporosis is when the first bone is broken. Along with fractures, which are the most serious signs of this disease, osteoporosis can cause the upper back to become excessively hunched (itself often a result of spinal wedge fractures) and there maybe widespread pain as bony tissue is increasingly unable to withstand normal forces.

Fractures are a serious problem, especially in the elderly population. Bone breaks due to osteoporosis occur most frequently in the wrist, spine or hip. When the spine is affected by osteoporosis, people may develop a hunched or stooped posture, which can itself lead to respiratory issues and places pressure on the internal organs. Osteoporosis can severely impact a person’s mobility and independence, which can have a huge impact on quality of life.

What Causes It?

As this is primarily a metabolic disorder, there are a variety of things that can cause osteoporosis if they either interfere with the body’s ability to either produce bone tissue or encourage excessive breakdown. This can be anything from gastrointestinal conditions that prevent absorption of calcium, lack of dietary calcium or low levels vitamin D, which is essential for absorption of calcium.

Certain medications may also cause bone loss especially if they are taken for a long time or in high doses. A good example is the long-term use of steroids. Although steroids are used to treat various conditions, it has been proven that steroids can cause bone loss and eventually, osteoporosis.

As bones respond to force and weight bearing by building more bone, having a sedentary lifestyle or doing activities with low impact can also lead to osteoporosis and this has been shown be an issue amongst professional swimmers and cyclists. How Can Physiotherapy Help?

Physiotherapy can help you to improve your overall bone health, avoid or recover from fractures. Physiotherapy exercises can direct you to safely increase your weight bearing, which can help build bone mass. Balance training is also an important factor as this can reduce the risk of falls. Your physiotherapist can also educate you on how to adjust your lifestyle, at home or at work, to protect your bones and improve your posture.

For more information or to make an appointment, you can BOOK ONLINE or call your local clinic.

None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual condition.

Have I torn my Achilles Tendon?

WHAT IS THE ACHILLES TENDON?

The Achilles tendon is a band of fibrous tissue located at the back of the . Its main role is to connect the calf muscles to the of the foot. This tendon is the largest tendon in the body and when it tightens, as the calf muscles contract, it pulls the heel allowing you to stand on tiptoe or to point your foot.

Achilles tendon tears commonly occur in athletes, however, this injury can affect anyone and surprisingly, a complete tear is actually more common than a partial tear. These tears are commonly located at the part of the tendon where there is poor blood flow approximately 6cm above its attachment to the heel. Since there is poor blood supply, this part of the tendon is both vulnerable to injury and slow to heal.

What are the Symptoms?

Primarily, an Achilles tendon tear will cause difficulty in activities such as walking, running and jumping. Other signs and symptoms of an Achilles tendon tear include:

A loud pop or snap is heard Sudden and severe pain at the back of the calf or ankle Feeling of having been kicked in the calf There is a gap between the tendon and the heel (about 2 inches above the heel) Swelling and stiffness followed by weakness and bruising Difficulty walking particularly during push off Standing on tiptoe may be impossible

What Causes It?

Anyone can tear their Achilles tendon if the tendon is subject to excessive force or overstretching, however there are some factors that can increase your risk of injury. The most common activities that cause this injury are running and jumping.

The Achilles tendon can thin and weaken both as we age and also if it is not used. As a result of this weakening, it becomes prone to injury like tear or rupture with less force or stretching required before an injury occurs. A tear of the Achilles is often observed in people with pre-existing Achilles tendiopathy. Other factors such as certain medications including antibiotics and steroids and some illnesses like diabetes and can also result in weakness of the tendon, increasing injury risk. Being obese is also a risk factor as excess weight puts additional strain on the tendon.

How Can Physiotherapy Help?

Treatment for Achilles tendon tear will depend on the patient’s age, how severe the injury is and the patient’s activity level. For young people especially athletes, they opt to have surgery while older people choose conservative treatments including physiotherapy.

Physiotherapy treatment for an Achilles tendon tear will involve exercises to strengthen the calf muscles and the Achilles tendon and exercises for stability. Many people are able to return to their normal activities within 4 to 6 months. Functional rehabilitation is also part of the program as it focuses on how you coordinate your body and how to move it. The aim of functional rehabilitation is to help you return to your highest level of performance.

None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.

For more information or to make an appointment, you can BOOK ONLINE or call your local clinic.

Understanding Joint Stiffness

While pain and stiffness often go together, joint stiffness can occur on it’s own. Joint stiffness can limit your ability to perform usual tasks, for example turning your neck to check behind you while driving.

Stiffness can also be a warning sign that part of the body is vulnerable to future injury. There are many different causes of stiffness and we will explore a few of the reasons why you might not be feeling as flexible as normal.

1. Disuse and lack of movement.

Our bodies are made to move. When we are not regularly moving them through their full range, they can begin to feel ‘tight’. This can be caused by a combination of the capsule that surrounds the joint tightening up and the muscles that surround the joint shortening and losing flexibility. Stiff and tight muscles can cause you to feel as though your joints are stiff, even if it is only the muscle length that is restricting the movement. Joint mobilisations, manipulation and muscle stretches/massage can have a significant effect in improving the symptoms.

The most important way to maintain full movement is to regularly move joints through their full range, which also helps to keep muscles and joints healthy. Your physiotherapist can advise you on how to best approach this with a targeted set of exercises.

2. Osteoarthritis (OA):

OA is a degenerative disease, characterised by a breakdown of joint surface cartilage and the growth of bony osteophytes around areas of stress. While OA is increasingly common as we age, it is thought that the primary cause is abnormal load and stress to joint surfaces and not simply aging itself. As the joint space between two joint surfaces become uneven, joints affected by OA can feel stiff or even ‘blocked’. A person with OA will usually feel stiff for around 15-20 minutes after being still. Physiotherapy programs to strengthen the muscles surrounding the joints, so as to help absorb weight-bearing forces, has been shown to have positive results on OA symptoms. 3. Inflammatory Related Stiffness.

The inflammatory process is characterised by swelling and pain around a specific area. Usually this is a response to damage by the body. As an area swells, this will allow less space for movement and a sensation of stiffness, as anyone who has had sprained an ankle can attest to. Acute will cause swelling that increases over 24-48 hours and subsides gradually. Autoimmune disorders can cause the body to mistakenly have an inflammatory reaction where there has been no injury, with resulting pain and stiffness. and ankylosing spondylitis are two examples of such disorders.

Stiffness caused by inflammatory disorders is characterized by feeling of stiffness after rest, particularly in the morning that can take longer than 30 minutes to subside. Inflammatory disorders unrelated to injuries are complex in cause and require collaboration with medical teams for best treatment outcomes. Acute injuries are best managed by following RICE protocols (Rest, Ice, Compression, Elevation).

Speak to your physiotherapist for more information regarding a specific condition.

For more information or to make an appointment, you can BOOK ONLINE or call your local clinic.

Use it or Lose it! Many 2017 Private Health Insurance extras benefits run out 31 Dec

Can you believe we are little over a month until the end of the 2017?

While we rush around shopping, socialising and organising, you might forget that extras benefits on many Private Health Insurance policies run out on 31 December.

So, if you don’t USE IT, you’ll LOSE IT!

3 ways to get the most from your Private Health Insurance Extras 1. Understand how your extras works

Each fund and policy is different but if you are paying for extras you might have services covered such as Physiotherapy, Podiatry, Massage or Myotherapy. Each fund will usually have a limit as to how much can be claimed per year for that service. This limit does not rollover but rather resets at the end of the year. For example: if the limit for Physiotherapy is $1000 per person, per year, if you don’t use that amount, this will still be $1000 the next year, it does not add up to $2000.

2. Check your policy

Every fund is different, so it’s a good idea to find out from your insurer what extras your policy entitles you to, when it runs out and how much benefit you have left. You can give your insurer a call or check this out online. Who knows, you might find out that Massage, Myotherapy or Pilates is included and you’d forgotten! That would be a nice way to ease your way into the silly season.

3. Get those niggles checked

If you’ve been struggling with pain, mobility or soreness and it’s not getting any better, it’s time to get it checked. With some injuries, the longer you put off treatment, the longer your recovery will be. Amid the busyness of the tail-end of the year, make a head start on your new years resolutions and make your health and body a priority. Why wait until the new year!

“Don’t put off till tomorrow what you can do today” Thomas Jefferson.

To make an appointment call your local clinic or Book Online.

When will my injury heal?

When injury strikes, the first thing that most of us want to know is ‘how long will this take to heal?’

Unfortunately, the answer to this can be complicated and requires at least a little understanding of how the different tissues of the body heal. Each of the tissues of the body, including muscles, tendons, ligaments and bone, heal at different speeds and each individual will have some variation on those times as a result of their individual health history and circumstances.

Understanding the type of tissue injured and their different healing times is an important part of how your physiotherapist approaches treatment and setting goals for rehabilitation.

On an individual level, a patient’s age, the location and severity of the injury and the way the injury was managed in the first 48 hours all affect the healing times of an injury. Unfortunately, as we age, injuries do tend to heal more slowly than when we are young. Any medical condition that reduces blood flow to an area, such as peripheral vascular disease, can also reduce the body’s ability to heal at its usual rate.

There are some guidelines that can be followed when predicting how long an injury will take to heal based on the tissue type affected: Muscles

Muscles are full of small capillaries, giving them a rich blood supply, and as such, they have a comparatively fast healing time with 2-4 weeks for minor tears. This time will be extended for larger tears and more complicated presentations.

Ligaments and tendons

Ligaments and tendons have less access to blood supply and tears to these tissues generally take longer to heal. Larger or complete tears of all soft tissues, may not be able to heal themselves and in rare cases, surgery may be required for complete healing to occur. Similarly, cartilage, the flexible connective tissue that lines the surface of joints is avascular, which means it has little or no blood supply. To heal, nutrients are supplied to the cartilage from the joint fluid that surrounds and lubricates the joint.

While the different tissues of the body all have different healing times, they do follow a similar process of healing with three main stages:

The acute inflammatory phase The proliferative stage The remodeling stage

The inflammatory stage: occurs immediately after an injury and is the body’s primary defense against injury. This stage is identifiable by heat, redness, swelling and pain around the injured area. During this phase the body sends white blood cells to remove damaged tissue and reduce any further damage. This stage usually lasts for 3-5 days.

The proliferation stage: is the phase where the body starts to produce new cells. Swelling and pain subsides and scar tissue is formed that eventually becomes new tissue. This stage usually occurs around days 7-14 following an injury.

The remodeling stage: is when the body completes healing with the reorganization of scar tissue and the laying down of mature tissue. This stage usually occurs roughly two weeks after the initial injury is sustained.

At each stage of the healing process a different treatment approach is required and your physiotherapist can help to guide you through your recovery.

Ask your physiotherapist to explain how your injury can be managed best and what to expect in your recovery process.

To book an appointment, contact your local clinic or Book Online.