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Sciatica

Sciatica

Sciatica

 

WHO?

  • Persons with acute or chronic lower back pain and/or hip issues
  • Active persons with chronic muscular tightness
  • Elderly, with normal age related changes to the body
  • Desk workers & persons with chronic poor posture

 

WHAT?

Sciatica is a condition that refers to pain felt along the back of the thigh and lower leg, which normally originates from the lower back.  The pain generally occurs along the sciatic nerve itself, which is the largest nerve in the body, and runs from the lower part of the spine, travelling along the back of the leg into the outer portion of the calf. Pinching and compression causes irritation to the nerve resulting in the above distribution of pain. Occasionally patients may complain of pins and needles and/ or numbness in the lower back, back of the leg or outside of the calf.

WHEN & HOW?

Sciatic nerve irritation occurs when the nerve itself is pinched or compressed by the surrounding soft tissue or bony structures. Pressure on the nerve can be caused by joint inflammation, arthritic or bony growths, or a locked facet joint in the lower back. Chronic tightness in muscles such as the piriformis or hamstring muscles can also cause irritation to the nerve resulting in flair ups. This often happens in persons who sit a lot and/or those with poor posture which results in these muscles becoming overly tight, causing compression to the sciatic nerve as it passes through the muscle.

MANAGEMENT?

To manage sciatica your local Move Forward physiotherapist will assess the entire lower quadrant to determine any factors that may be contributing to your injury. This will include a detailed look at the soft tissue structures, such as the hamstrings, glutes and calves, as well as the lumbar spine and hips.  An individualized program and treatment plan will then be prescribed to help reduce irritation to the nerve 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
• Specific activity modifications, performed under physio supervision at our Hillarys Physiotherapy practise

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Shoulder Bursitis

Shoulder Bursitis

SHOULDER BURSITIS

WHO?

  • Sports with repetitive overhead activities
  • Gym goers
  • Elderly
  • Desk workers & persons with chronic poor posture

WHAT?

The bursa can be described as a fluid filled sac found between the bones that make up both the shoulder and the hip joint. There are several of these fluid filled sacs within the shoulder joint.  The role of the bursa is to help reduce friction between the structures within the joint allowing better and more fluid range of motion. Inflammation of the bursa is termed as bursitis and symptoms can typically include pain at the front and outside of the shoulder and upper arm, pain at the hand, pain at night when sleeping on the affected shoulder, and activities whereby the arm is lifted over shoulder height.

WHEN & HOW?

Bursitis can occur after an acute injury or trauma, or more commonly as a result of a chronic repetitive strain to the structures within the shoulder joint. Repetitive strain or injury to the structures within the shoulder joint causes an inflammatory effect and subsequent painful symptoms at the shoulder and arm.

Overuse or chronic bursitis is typically associated with shoulder impingement or tendonitis of the rotator cuff muscles. Impingement occurs when the soft tissue structures within the shoulder joint get “pinched” together resulting in inflammation and pain. When the bursa become irritated they tend to become inflamed and enlarged, resulting in less space within the shoulder joint and more chance of soft tissue structures impinging on one another. Physiotherapy aims to reduce the likelihood of impingement by addressing muscular imbalances and weakness around the shoulder, correcting posture, lengthening overactive and tight structures of the shoulder, and specific strengthening of the rotator cuff muscles.

MANAGEMENT?

To manage shoulder bursitis your local move forward physiotherapist will assess the shoulder and entire upper quadrant, including the neck, upper back and arm in order 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 shoulder joint and associated 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
• Specific 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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Shoulder Instability

Shoulder Instability

Shoulder Instability

WHO?

  • Throwers (baseball/ cricket etc.)
  • Swimmers
  • Acute injury (car accident/ footy collision)
  • Young persons (double jointed)

WHAT?

Shoulder instability is broad term that describes the condition whereby the connective tissue around the shoulder joint becomes lax, allowing greater range of motion at the shoulder than is normal.

The shoulder joint, or gleno-humeral joint, is a ball and socket joint, compromised of the head of the humerus sitting within a cup shaped socket, referred to as the acetabulum. Ligaments, tendons and the rotator cuff muscles are responsible for holding the humerus within the acetabulum. When these structures are injured, or are naturally looser, an excessive amount of movement can occur between the humerus and acetabulum.

This increase range can result in patients being able to sublux or even dislocate the shoulder joint. Pain is not necessarily always present but can be common at the joint itself or even referred down the arm and into the hand.

HOW AND WHEN?

Broadly, connective tissue laxity can occur due to an acute injury or trauma, chronic repetitive strain or simply occurs naturally since birth/ early childhood. In an acute incident such as a traumatic fall or collision the ligamentous and muscular tissue can be overstretched or even torn which results in this tissue become loose and less supportive to the joint. Similar chronic injuries such as repetitive throwing and over-head activities also cause the connective tissue to become looser over time. In some cases, however, a person may simply be born with more mobile joints and is often termed as being “double jointed.”

MANAGEMENT?

Management in all cases is fairly similar and straightforward. In order to allow greater support to the shoulder joints, the connective tissue and muscles must be strengthened, whilst movement patterns need to be assessed and activity modifications need to be put in place to prevent re-occurring injuries and damage to the connective tissue.

At any of our Move Forward Physiotherapy clinics an individualized program and treatment plan will be prescribed to help reduce the strain placed on your shoulder 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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Baker’s Cyst

Baker’s Cyst

BAKER’S CYST

WHO?

  • Cyclists/ runners
  • Older adults
  • Sports requiring lots of running/ turning/ jumping etc.

WHAT?

Baker’s cyst is a condition whereby there is swelling at the back of the knee joint that accumulates within the joint space and bursa. It may also be referred to as a popliteal cyst, in reference to its location at the back of the knee, which is medically known as the popliteal fossa. The fluid-filled cyst can result in pain or discomfort at the back of the knee with during normal day to day activities that may increase with activity or overuse of the knee. Patients often complain of a feeling of “fullness” at the back of the knee, particularly with activities that require the knee to be in and fully flexed or extended position.

WHEN ?

A Baker’s cyst typically occurs as a result of both chronic degenerative changes to the knee or acute injuries to the knee joint, such as meniscal tears and strains. Patients can experience a range of symptoms, in minor cases there may be no pain and no palpable lump at the back of the knee. In more severe cases patients may be able to feel a large lump, and suffer significant pain or tightness at the back of the knee joint. This sensation of fullness or tightness can sometimes even extend further down the leg into the calf.

HOW?

As a result of chronic degenerative changes to the structures within the knee, such as knee OA, wear and tear occurs over time. This leads to irritation of the structures within the joint capsule, thus resulting in swelling. Similarly, following an acute injury, such as a fall or meniscal tear, the knee will undergo an acute inflammatory response which results in inflammation within in the knee joint. In both the chronic or acute scenario, there is an accumulation of inflammation and swelling within the joint capsule and/ or the bursa, resulting in a Baker’s cyst.

MANAGEMENT?

Treatment and management of a Baker’s cyst normally requires any underlying causes to be addressed. Although in some cases a cyst may develop for no reason and require no treatment either.  Your physiotherapist at our Move Forward Kinross Physiotherapy clinic will assess the whole lower limb, as well as the hip and low back in order to determine the exact cause of your knee pain. Following this assessment, you will be provided with a detailed outline of your own individualized treatment management plan. Your treatment may include a combination of the following;
• Rest
• Ice/ Heat
• Brace/ off-load taping
• Soft tissue massage
• Mobilizations
• Dry needling
• Stretching & strengthening exercises, which can be performed within the gym located at Move Forward Hillarys Physiotherapy
• Activity and exercise modifications to improve lower limb mechanics and posture, which can be performed within our pilates studio at Move Forward Quinns Physiotherapy or Jindalee Physiotherapy

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DE QUERVAINS TENDONITIS

DE QUERVAINS TENDONITIS

DE QUERVAINS TENDONITIS

WHO?

Sportsman requiring excessive wrist movements
• Golfers, rowing, racquet sports……

Office/ computer workers

Manual workers;
• Carpenters, painters, brickie….

 

WHAT?

De Quervains tendonitis is an overuse condition that affects the tendons of the forearm, found running along the outside of the thumb. The two main tendons affected are the extensor pollicis brevis (EPB) and the abductor pollicis longus (APL). With overuse of the thumb and/or wrist, these tendons can get inflamed, resulting in pain and swelling, over the thumb, back of the wrist and even the forearm.

 

WHEN and HOW?

De Quervains normally occurs overtime as a result of overuse of the thumb and or wrist. Repetitive movements at the thumb and wrist, in activities such as painting, golf, ten-pin bowling, working on the computer or even knitting, results in strain on both the EPB and APL tendons. Generally patients will develop this pain overtime when they have a sudden increase in activities such as the ones listed above. In some cases however, De Quervains can occur very suddenly as a result of direct trauma to the thumb or wrist, such as with a fall or forceful movement of the thumb or wrist. With either an overuse or sudden traumatic injury, the APL and EPB tendons undergo micro tears resulting in an inflammatory response and thus painful symptoms at the thumb and wrist.

 

MANAGEMENT?

Treatment and management of De Quervains tendonitis is normally quite straightforward. Your physiotherapist at our Move Forward kinross Physiotherapy clinic will assess the wrist and thumb, as well as the forearm, arm and neck to determine the exact cause of the condition. Once assessed, they will provide you with an individualized treatment management plan to assist in your recovery. Your treatment will include a combination of the following;
• Rest
• Ice/ Heat
• Brace/ off-load taping
• Soft tissue massage
• Mobilizations
• Dry needling
• Stretching & strengthening exercises can be performed within the gym located at Move Forward hillarys Physiotherapy
• Activity and exercise modifications
• Postural and workplace advice and exercise done within our pilates studio at Move Forward Quinns Physiotherapy

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Rotator Cuff Injury

Rotator Cuff Injury

WHO?

Sports People

Adult or Elderly

WHAT?

The rotator cuff is a group of four muscles (supraspinatus, infraspinatus, subscapularis and teres minor) which stabilise the shoulder joint. They also play a crucial role in controlling the multidirectional movement of the humeral head (of the upper arm) inside the glenoid (of the shoulder blade).

WHEN?

A rotator cuff injury may be caused by acute trauma (such as a fall on an outstretched arm or directly onto the shoulder) or an acute injury (lifting a weighted object up-to or from an overhead height). A rotator cuff injury may also be caused by repetitive use (such as working overhead, repetitive lifting, throwing or racquet use in sports) or simply due to age related degeneration.

HOW?

Rotator cuff injuries may include tears (partial or full thickness), impingement or tendinitis. When a rotator cuff injury occurs inflammation arises in the surrounding area, causing pain and loss of active range.

MANAGEMENT?

Your Move Forward Physiotherapist with assess your shoulder to determine the nature and degree of your injury. They may also decide to send you for an ultrasound scan to confirm this and, depending on the degree of damage, may refer you to a shoulder specialist as surgery may be required.

Conservative management may include:

Soft tissue massage

Manual therapies to improve range of motion

Assisted -> active shoulder exercises

Static -> active strengthening exercises

Functional rehabilitation

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