Physiotherapy

07November

Caring for Ankle Sprains

The ankle joint is formed by four bones (tibia, fibula, talus and calcaneus). The stability of the joint is maintained by ligaments. Ligaments assist in guiding the normal movements of the joint and avoiding excessive movements. When an ankle is sprained, (usually caused by excessive side way bending of the ankle, for example walking on uneven surface or standing on someone’s foot) a ligament can be over stretched. This can lead to fibers of ligament and small blood vessels been torn. Then there will be symptoms like internal bleeding within the tissue, swelling and pain.

When an ankle sprain takes place, you need to immediately and within 72 hours of injury, apply RICE for management.

·       Rest – Avoiding any painful movements

·       Ice – Wrapping a wet towel around ice, then applying it on injured area for 20 minutes and repeating this process every two hours. This will help to control the amount of internal bleeding and pain.

·       Compression – Using bandage to wrap around ankle and bottom half of the leg to minimize swelling

·       Elevation – Positioning the ankle up high, above the heart level to decrease swelling

Within 48 hours post sprained ankle, it is important to avoid heat, alcohol, running and massage. This will prevent increases of swelling and will improve the healing process.

The rehabilitation process for ankle sprain can be started early on. Your physiotherapist can assist in minimizing ankle pain and movement restriction. Therefore, you can return to work and sport quickly. This process will also promote the healing of the ligament and the normal function of muscle and nerve.

Your physiotherapist will assess your sprained ankle to see which ligament is affected, how severe is the sprain and whether there is the need for x-ray. In the early stage of rehabilitation, it is mainly focusing on decreasing swelling and pain to allow ease in walking. Physiotherapist will mobilize your ankle joint to improve the mobility and to minimize joint stiffness. This will help to make walking easier and to form healthy scar tissue on the ligament. The ligament then will recover quicker and stronger.

Your physiotherapist will teach you some simple exercises to promote the strengthening of calf and ankle muscles. This will supplement the injured ligament. Muscle reaction will need to be trained as well. When the ankle position changes, muscles needs to react quickly in order to prevent re-injury of the ligament. Complete recovery of the ligament depends on the severity of the sprain. It can be few weeks up to few months. It is important to remember that pain and swelling will settle much quicker than the recovery of the muscle and ligament strength. Therefore, returning to work or sport too early can slow down the overall healing process. Your physiotherapist can teach you the use of ankle taping or brace to support your ankle to avoid further irritation while allowing you to return to normal daily routines.

The following methods can help you to minimize the chance of spraining your ankle and to minimize the severity of injury:

·       Wearing suitable shoes or applying sports tapes to provide good support at the ankle joint

·       Avoiding activities on slippery or uneven surfaces, including low light/dark locations

·       Strengthening the calf muscle to protect your ligaments

·       Practice standing on one leg to improve your balance reaction

·       Always do warm up before activities

 

If you have any questions, please contact your physiotherapist.

By Terry Kung

Posted in Wellbeing, Physiotherapy, General

01March

Headaches

Headaches are one of the most common symptoms experienced by humans, and we all know how much of an interruption they can be to your day!  

Why some people frequently experience headaches, while others may never, is still unknown. Very occasionally headaches can be the result of a more serious disease however they are usually harmless.

The brain itself is insensitive to pain, whereas its covering membranes, larger blood vessels and other structures within the head and upper neck (e.g., eyes, ears, sinuses, skin, muscle and joints) are richly supplied by nerve fibres capable of transmitting the experience of pain. 

One common source triggering a headache is upper neck joint dysfunction.  This is where irritation in the upper neck from mechanical, chemical or inflammatory mechanisms triggers pain sensitive nerve fibres to send a ‘pain’ message to the brain.

Once the pain signals get to the brain, it needs to decide from where the pain signals arise. Since the nerves that supply the upper neck also supply the skin overlying the head, forehead, jaw line, back of the eyes and ears, the brain may decided that the signal is coming from the head, therefore you feel a headache rather than having neck pain. This is also known as a cervicogenic headache.

Although cervicogenic headaches can occur at any age, it is commonly seen in patients between the ages of twenty and sixty.

All our physiotherapists are well trained to treat upper neck joint dysfunction to ease your headache. Come and visit us to see how we can help you regain control of your headaches!

 

By Amy Baum 
- B.Phty (hons)

Posted in Wellbeing, Physiotherapy, General

01March

Ankle Sprains

A sprained ankle is one of the most common injuries presenting to physiotherapy clinics on a daily basis.

The lateral ligament complex (outside of the ankle) is frequently the injured structure, this consist of three ligaments; 1) Anterior talofibular ligament  2) Posterior talofibular ligament and the 3) Calcaneofibular ligament.

Ankle Sprain

These ligaments are overstretched or torn with an inversion mechanism (rolling the ankle in) as the outside of the joint is opened. The inside of the joint is compressed with this mechanism and can be a cause for ongoing medial ankle pain. 

Grades of Ligament sprains:

·Grade 1 -  up to 20% of the ligament tearing 

·Grade 2 - (partial tear) up to 50% ligament tearing

·Grade 3 - over 80% tearing of the ligament fibres.

Grade 1 sprains generally recover with 1-2 weeks and respond well to physiotherapy. The patient can often weight bear immediately after the injury and there is often mild swelling which settles quickly. A grade 2 sprain or partial tear is a more severe injury characterised by inability to weight bear, moderate to severe swelling and more significant pain. These patients often require crutches to walk and may take up to six weeks to fully recover. A grade 3 rupture can take up to 3 months to rehabilitate and in some cases may require surgery to repair the ligament.

Initial treatment for ankle sprains should follow the RICE principle; rest,compression, ice and elevation. Ice buckets work well initially to reduce swelling. Once the patient is able to weight bear rehabilitation commences with active range of motion, calf strengthening, balance re-training and sports specific training. Most patients who sprain an ankle will be back to full functioning within six weeks, however, there is a small group of patients who will have ongoing pain and swelling which may require further investigations such as an MRI.

All MyCare Health Professional Physiotherapists have received extra training in the assessment and management of ankle sprains. We will perform an accurate assessment giving you a diagnosis with a rehabilitation program to follow so you are back on the sporting arena ASAP.  Our integrated team of Acupuncturists, Massage Therapists, Exercise Physiologists, Dietitian and Psychologist can further support your total care.

 

Solomon Cheng

Musculoskeletal & Principal Physiotherapist

Posted in Physiotherapy, General

01March

Identifying & Managing Sciatica

The sciatic nerve is the longest nerve in your body. It runs from pelvis through your buttock and hip area and down the back of each leg. It controls many of the muscles in your lower legs and provides feeling to your thighs, legs and feet.

Sciatica refers to pain that radiates along the path of the sciatic nerve, from your back into your buttock and leg. You may feel the discomfort almost anywhere along the nerve pathway, but it is most likely to follow a path from your lower back to buttock and the back of thigh and calf. The pain can vary widely, from a mild ache to a sharp, burning sensation or excruciating discomfort. Sometimes it may feel like an electric shock. Sciatic pain often starts gradually and intensifies over time. It may be worse when you cough or sneeze, and prolonged sitting or walking can also aggravate symptoms. Usually only one lower extremity is affected

Sciatica frequently occurs when a nerve root is compressed in your lower spine, mostly as a result of a herniated disc in the lower back. Disks are pads of cartilage that separate the vertebrae in your spine. They keep the spine flexible and act as shock absorbers to cushion the vertebrae when you move. As you grow older, the discs may start to deteriorate, becoming drier, flatter and more brittle. Eventually, the tough fibrous outer covering of the disc may develop tiny tears, causing the jelly-like substance in the disc’s centre to seep out. The herniated disc may then press on a nerve root, causing pain in your back, leg or both. Other conditions can also put pressure on the sciatic nerve, including, spondylolisthesis, trauma, sciatic nerve tumor and spinal tumors.

Mild sciatica usually goes away given a little time and patience. Call your doctor or physiotherapist if self-care measure fail to ease your symptoms or if your pain lasts longer than six weeks, and the pain is severe or becomes progressively worse.

Risk factors for sciatica are health problems, lifestyle choices and inherent qualities, such as age or race. They include:

  • Age – Age related changed in the spine are the most common cause of sciatica. You are likely to have some degeneration in the discs in your back by the age of 30. Most people, who develop herniated discs, are in their 30s and 40s.
  • Occupation – A job that requires you to twist your back, carry heavy loads or drive a motor vehicle for long periods makes you more prone to develop sciatica.
  • Physical activity – Although walking and jogging have been associated with an increased risk of sciatica, exercise in general has not. In fact, people who sit for prolonged periods or have a sedentary lifestyle are more likely to develop sciatica than active people are.
  • Genetic factors – Researchers have identified two genes that may predispose some people to disc problem.
  • Diabetes – This condition affects the way your body uses blood sugar and increases the risk of nerve damage.

For most people, sciatica responds well to self management. You will heal more quickly if you continue with your usual activities, but avoid what may have triggered the pain in the first place. Although resting for a day or two may provide some relief, prolonged bed rest is not a good idea. In the long run, inactivity will make your symptoms worse.

Other measures good for sciatica include using cold packs to reduce inflammation and relieve discomfort, applying hot pack and massaging to help relieve muscle spasm and stretching the lower back to feel better and may help relieve nerve root compression. Some over-the-counter medications can help to reduce pain and inflammation, but make sure you consult with the pharmacist or your doctor.

Physiotherapy and acupuncture play a vital role to help with relieving sciatica discomfort. Rehabilitation typically includes exercises to help correct your posture, strengthen the muscles supporting your back and improve your flexibility. The exercise physiologist can design a rehabilitation program to help prevent recurrent injuries. These treatment programs then should become part of your daily routine at home or at gym permanently.

When conservative managements do not alleviate your pain and the pain gets progressively worse, then surgery might be the last choice of management. Surgery is most often performed to remove a portion of a herniated disc that is pressing on a nerve. You may experience immediate results from disc surgery, but it does not stop degenerative changes and your pain may recur in time.

Preventing sciatica is not always possible. However, it is still very important to do so through exercising regularly, maintaining proper posture when you sit and stand, and using good body mechanics. Poor posture stresses the back, leading to fatigue and stress on joints and nerves. Before you lift something heavy, decide where you will place it and how you will get there. Bend at your knees, not your back, so that you legs do the lifting. Carry objects close to your body at about waist level. Don’t twist at your waist, but turn by stepping around.

If you have any further concerns, please contact us at Mycare Health Professionals.

 

By Terry Kung

B.Phty (UQ)

Posted in Physiotherapy