Month: July 2018

Where is your pain really coming from?

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

 

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

 

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

 

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

 

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

 

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

 

We also know that not understanding or being afraid of pain can make pain feel stronger. In rare cases, people who have pain in one hand can feel pain just by seeing their other hand moving in a mirror. There are many other fascinating aspects to pain, and understanding how it works is an important part of managing your symptoms. To understand how referred pain may be affecting you, chat to your physiotherapist who can help with any questions.

 

 

 

Patella Dislocation

What is it?

The knee joint is composed of the thigh bone, (femur) and leg bone (tibia) and a small floating bone at the front, commonly known as the kneecap (patella). The interaction between these bones allows for smooth movement of the knee as it bends and straightens.

During movement, the kneecap sits in a groove at the front of the knee and acts as a mechanical see-saw. This protects the knee joint and improves the efficiency of the muscles working to move it. When the patella moves out of this groove it is called a subluxation. If the patella moves far enough out of this groove it becomes a dislocation.

What are the symptoms?

The first time the patella dislocates is usually the most traumatic and painful. The knee may give way, and a visible lump can be noticed where the patella has dislocated. There will often be bruising, swelling and the knee may feel unstable. First time dislocations may also cause a heamarthrosis or bleeding within the knee joint. If there is damage to the ligaments of the knee, subsequent dislocations can happen more easily, and from everyday activities, causing the knee to give way suddenly.

What are the causes?

First time dislocations often occur due to a traumatic event. The most common cause of patellar dislocation is a non-contact injury to the knee with a twist of the leg (the thigh bone rotates internally on a fixed leg and foot). In addition, a direct blow to the side of the knee can also dislocate the patella.

If there is some instability of the joint, dislocations can occur more regularly and from smaller forces. Dislocations usually occur when the knee is bent and the kneecap slips back into place when the knee is straightened again. While the kneecap can be dislocated in both directions, it usually dislocates towards the outside of the knee.

Certain factors can make dislocation more likely, including overall hyper-flexibility, damage to the ligaments of the knee and muscular imbalance of the quadriceps. The structure and angle of the knee joint itself can also make dislocation more likely. This can be seen in the increased prevalence of dislocations for women as they have a slightly different angle of femur compared to the tibia than men. A traumatic dislocation can cause instability that can lead to future dislocations.

How can physiotherapy help?

An acute patellar dislocation should be treated like any traumatic injury and assessed by a medical professional to reduce pain and swelling, make an accurate diagnosis and check for fractures. While the kneecap may relocate itself quickly, ensuring that it is able to heal correctly to prevent further dislocations may require immobilization for up to six weeks.

Your physiotherapist will be able to identify any factors that may predispose you to further dislocations and provide you with a personalised treatment program to address any stiffness, weakness or instability surrounding the knee. Balance and proprioception (your sense of where your body is in space) are often reduced following an injury and your physiotherapist will help to rehabilitate these. Your therapist may provide you with education and advice regarding bracing or taping. In severe cases of instability, surgery may be recommended to stabilise the knee however this is usually not considered unless there has been a fracture or until a full rehabilitation with physiotherapy has been completed.

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

 

 

 

 

 

 

The Hidden Benefits Of Learning A New Skill

When thinking about getting fit and exercising more, our first thoughts are usually that we should join a gym or start jogging. While these are both worthwhile activities, studies show that if you dislike the activity you’re doing, the long-term benefits are usually not enough to keep you committed. There are a few things that are often overlooked when talking about exercising more, particularly the fact that you can often improve your life in more than one way if you find the right activity.

Finding the right activity can boost your confidence an increase your daily activity levels.

We all have different tastes in food and the same is true for exercise. Some of us chase the thrill of learning a new skill; others prefer the challenge of pushing their limits of endurance while others love being surrounded by nature. Exercise is good for everyone, but finding the right activity for you is going to make it much easier to make it a committed part of your lifestyle.

We are also more likely to enjoy doing activities that we are good at. Some people have great balance, while others have great eye hand coordination, others have great rhythm and someone who is an excellent dancer might be a terrible runner. Consider what you are personally good at and try to choose your activity based on this. Finding something that suits your routine is also an important component to making a new activity a part of your lifestyle.

Sometimes it is simply a lack of imagination that fails to get us off the couch. Jogging is not for everyone, but one of these sports might be. Here’s a quick list of less common activities that you may not have thought of trying; rock-climbing, volleyball, soccer, hula-hooping, slack-lining, golf, mountain biking, hiking, standup paddle boarding, roller skating, skateboarding, dancing, Pilates and yoga, just to name a few.

Learning new skills can be good for your brain.

Many people think that as they get older, learning new skills becomes too hard. The truth is, that with a bit of patience, you can surprise yourself with your ability to learn new things at any age. The brain is capable of incredible change and adaptation to new stimulus. Learning new things can be a great source of confidence and exercise has been shown to improve your brain function overall.

Many activities can help you meet new people and open you up to new communities.

Even solo sports often have well connected communities of like-minded enthusiasts. Surfers have surf clubs, or often meet each other in the water, rock climbers are always looking for more people to take adventures with and people who wake up at 5am to do boot camp together become great friends. As we leave high school and university, it can be harder to create new social connections. Using exercise as a way to make new friends can have a significant impact on your overall wellbeing. In many activities, the communities are extremely supportive of beginners and you might be surprised at how friendly they are to newcomers.

Your physiotherapist is able to give you great advice on which activities might suit your ability level and they can give you some tips to ensure you stay injury free when starting your new hobby.

 

 

 

 

 

 

Femoroacetabular Impingement (FAI)

What is it?

When the two surfaces of the hip joint move over each other, they usually move freely without any friction. If there is an alteration to either the socket part of the joint (the acetabulum) or the ball (the head of the femur), irritation may occur as the two surfaces move over each other. This is known as Femoroacetabular impingement, a common disorder of the hip, characterized by pain and stiffness.

Femoroacetabular impingement can be classified as cam, pincer or mixed. A cam FAI occurs when the femoral head junction is flattened or a small bump is present. Pincer type of impingement occurs when the acetabular rim extends slightly, causing the femur to be impacted. Cam impingement is more common in men while pincer impingement is more common in women. However, most cases of FAI (about 85%) are mixed, meaning they both have cam and pincer types of impingement. 

What are the symptoms?

The most common symptom of FAI is pain located in the hip or groin when resting in certain positions of with specific movements. Some patients also report pain in the back, buttock or thigh. Other symptoms include stiffness, loss of movement range (particularly of the hip), locking, clicking or a feeling that the hip is about to give way.

Activities that cause the incongruous surfaces to move over each other repeatedly are naturally the main culprits for causing symptoms. These can include prolonged sitting, twisting, sitting with crossed legs, squatting and climbing stairs can all aggravate the pain caused by femoroacetabular impingement. 

What are the causes?

There are many factors that may cause an individual to develop femoroacetabular impingement including;

• Hip dysplasia or malformation during infancy/childhood
• Repetitive stress on the hip
• A femoral neck fracture that did not heal properly (malunion)
• Small bony growths around the joint called osteophytes.
• Normal anatomical variation

How can physiotherapy help? 

Femoroacetabular impingement is a complex condition and researchers are still determining the best possible treatment. It is thought that untreated FAI can lead to osteoarthritis of the hip down the track and there are both surgical and non-surgical options for treatment. Conservative (non- surgical) management for FAI involves core stability training, strengthening exercises for the lower limb specifically the hip and postural balance exercises. This program aims to improve the hip’s neuromuscular function. A hydrotherapy program can also helpful as it reduces weight through the joint, making movements more comfortable. Lastly, a home exercise program is made for patients, so they can continue treatment at home. For many people, physiotherapy is enough to resolve their symptoms and prevent future problems, however other may require surgery.

With surgery, hip arthroscopy is the most common procedure for this disorder and is used to change the shape of the joint slightly so that there are no points of irritation with movement. After surgery, patients are usually referred to physiotherapy for rehabilitation. 

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

 

 

What does a physiotherapist actually do?

What does a physiotherapist do?

Many people know the value that physiotherapy brings to their life and some have even been visiting their physiotherapist since childhood. However, for those who have never been to see a physiotherapist before, there can be a question mark over exactly what it is that physiotherapists do. In fact, this is one of the most common questions physiotherapists are asked.

What is it that physiotherapists do?

The answer is tricky, because physiotherapists do so much. Primarily, we might be described as pain management experts, as we work to reduce the pain of our patients, from those who have suffered a new injury, to those who have had pain for several years. We first identify the cause of the pain and then provide manual therapy techniques, education and management strategies to help our patient understand, manage and reduce their pain.

While pain is usually the first thing that brings patients to see a physiotherapist, this pain has often caused patients to give up activities that they love and can even be getting in the way of everyday tasks. Many of us reduce our activity levels to reduce pain without even realising it. Physiotherapists are able to identify which areas you are struggling in and why this is occurring. By identifying the cause of your symptoms, we can help to get you back to full function. Physiotherapists are able to do this for everyone including elite athletes and those dealing with serious disabilities.

In fact, physiotherapists have a role to play at practically every stage of life. We can assess infants to monitor their motor skills development and as they grow we help them deal with the pains and vulnerabilities of a growing body. Among other things, we can help improve the function of athletes, assist in preventing injuries, help those with pelvic floor dysfunction and work to prevent falls in the elderly.

 

Not just exercises and massage.

Physiotherapists offer a range of treatments, from targeted stretches, manual therapies, dry needling, exercises and massage. Physiotherapists are also committed educators and take our role as such seriously.

A huge part of recovering from pain and injury comes from understanding what is happening and how to best manage these issues. Rather than create a dependency on their therapist, we aim to empower our patients to improve their health independently as much as possible. 

Physiotherapists aim, to improve your quality of life and remove any barriers to full participation, whether these barriers are due to pain, weakness or stiffness.