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Peroneal subluxation aka “Snapping ankle”

Peroneal subluxation aka “Snapping ankle”

Peroneal Subluxation aka “Snapping Ankle”

WHO?

  • Athletes
  • Sports involving side stepping/ toe running
  • Volleyball/ basketball/ netball etc.
  • Sprinters/ runners

WHAT?

Peroneal subluxation or “snapping ankle” is the condition used to describe a snapping or clicking sensation that occurs on the outside of the ankle. This clicking sensation, that traditionally occurs around the lateral malleolus (the large bony bump on the outside of the ankle) can be associated with pain or discomfort, and is caused by excessive movement or misalignment of the tendons of the peroneal muscles as they pass behind the lateral malleolus. When these tendons flick over the bony prominence, on the outside of the ankle, it creates a clicking or snapping sensation.

HOW & WHEN?

The tendons of the peroneal (fibularis) longus and brevis muscles are traditionally the cause of the ankle clicking. These tendons are normally held in place by a sheath of connective tissue called a retinaculum. This protective sheath and/or the fibularis tendons generally become weaker following severe or chronic ankle sprains and injuries. The most common cause of injury is an excessive turning of the foot inwards (inversion sprain) whilst the knee is bent, which generally occurs during activities and sports requiring lots of side stepping. Over time this can lead to  instability at the ankle resulting in an increased chance of further ankle sprains and injuries which further weakens the retinaculum and tendons resulting in the clicking sensation. In severe cases the retinaculum holding the tendons can be ruptured which will require a combination of physiotherapy and further medical management.

MANAGEMENT?

To manage peroneal subluxation your local move forward physiotherapist will assess your whole lower limb including your hips and lower back to determine any factors that may be contributing to your injury. An individualized program and treatment plan will then be prescribed to help reduce the strain placed on your ankle muscles and tendons in order to best manage your injury and to prevent any ongoing long term pain. A number of techniques may be used throughout your rehabilitation, which may include;
• Deep tissue massage
• Dry needling
• Joint mobilisations
• Stretching exercises
• Strengthening exercises can be incorporated into a Pilates program at both our Quinns Physiotherapy and Jindalee Physiotherapy Move Forward practices.
• Heat and/or ice therapy
• Taping
• Activity modifications, performed under physio supervision at our Hillarys Physiotherapy, located just next to Whitfords Shopping centre within Healthy Life Gym.

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Tennis Elbow

Tennis Elbow

Tennis Elbow

WHO?

• Desk workers
• Musicians
• Sportsman eg. Tennis players!, badminton, water skiers etc.
• Gym junkies
• Manual laborers e.g carpenters, plasterers etc.

WHAT?

Tennis elbow, or lateral epicondylitis as it is known medically, is an overuse injury of the forearm muscles and tendon that attach to a bony bump on the outside of the elbow joint, known as the lateral epicondyle. Pain is most often felt at the elbow and forearm muscles but can also extend down into the hand and fingers. It is mostly commonly aggravated by exercises and activities requiring lots of grip strength and/or repetitive wrist and elbow movements.

WHEN? and HOW?

Tennis elbow is most commonly caused by overuse of the forearm extensor muscles. When these muscles are overstretched or have too much stress placed through them they begin to create micro tears within the common tendon that attaches these muscles to the elbow joint. These micro tears in the tendon create an inflammatory effect which results in pain and discomfort at the elbow and forearm. Pain is most often felt with gripping activities or exercises that require extension of the wrist joint because it is the muscles responsible for these actions that connect to the outside of the elbow. In some cases, patients will also have an underlying component of neck tightness or stiffness which can result in irritation of the nerve that supplies the area around the outside of the elbow joint and forearm.

MANAGEMENT?

To manage tennis elbow your local move forward physiotherapist will assess your elbow, shoulder and neck to determine any factors that may be contributing to your injury. An individualized program and treatment plan will then be prescribed to help reduce the strain on your forearm muscles and tendons in order to best manage your injury and to prevent any ongoing long term pain. A number of techniques may be used throughout your rehabilitation, which may include;
• Deep tissue massage
• Dry needling
• Joint mobilisations
• Stretching exercises
• Strengthening exercises can be incorporated into a Pilates program at both our Quinns Physiotherapy and Jindalee Physiotherapy Move Forward practices.
• Heat and/or ice
• Taping
• Activity modifications, performed under physio supervision at our Hillarys Physiotherapy, located just next to Whitfords Shopping center within Healthy Life Gym.

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Fat Pad Impingement

Fat Pad Impingement

WHO?
• Young athletes
• Runners
• Cyclists
• Soccer/ Footy players

WHAT?

Fat pad impingment syndrome is a common condition affecting the knee joint and may also be referred to as Hoffa’s Syndrome. The fat pad is a small, sensitive area of soft tissue, composed mailny of adipose tissue (hence the name), that is found just underneath the bottom half of your kneecap and patellar tendon. This fat pad helps to lubricate the knee joint, whilst also acting as a bit of a shock absorber.

WHEN?

Fat pad impingement can occur at any age but most often occurs in active teenagers and adults between the ages of 20-50. It usually occurs over time and is regularly seen in persons performing running activities or sports that require lots of kicking. It is also a condition seen in the elderly either as a result of trauma to the knee or gradual wear and tear from age and/or conditions such as OA.

HOW?

Irritation to the fat pad is usually as a result of activities that require repetitive extension (straightening) of the knee. Over-extension of the knee can also be caused by a traumatic injury or a fall onto the knee. When the knee is overly straightened this fat pad can get pinched between the knee cap and the bones of the knee joint (femur and tibia) resulting in impingement. Repeated pinching and impinging of the fat pad results in inflammation which causes pain and swelling to occur around the knee cap.

MANAGEMENT?

Treatment and management for fat pad impingement is often quite straightforward, with a focus on managing painful symptoms in the initial weeks before moving onto to an exercise modification and rehabilitation program to target long term relief. Your local move forward physiotherapist will assess your knee as well as your hips, low back and ankle to determine the underlying cause of your injury. Once assessed you will then be given an individualised treatment plan to manage your painful symptoms and prevent any further damage. A number of techniques may be used to do this including;
• Dry needling/ acupuncture
• Knee mobilisations
• Deep tissue massage
• Heat/ Ice therapy
• Hydrotherapy
• Pilates
• Stretching and strengthening exercises
• Activity/ exercise modifications at either our Pilates studies at Quinns Physiotherapy , or within Healthy life gym located by hillarys Physiotherapy

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