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WHAT IS AN ANKLE SPRAIN?

15.05.20

WHAT IS AN ANKLE SPRAIN?

An ankle sprain is a stretch or tear in one or more of the lateral (outside) ligaments of the ankle. Ankle ligaments are slightly elastic bands of tissue that keep the ankle bones in place. Because the ankle is responsible for both weight-bearing and mobility, it is particularly susceptible to injury. The relatively small joint has to withstand large forces exerted when walking, running and jumping, especially if the surface is uneven. Most ankle sprains happen when the ankle twists or rolls suddenly, usually a rapid and uncontrolled movement. The most common injuries happen when the foot rolls onto the outside of the ankle, straining the outside ligaments of the ankle joint. Symptoms of a sprained ankle include; pain, tenderness and swelling, bruising, trouble moving the ankle, and sometimes an inability to put your full weight on the ankle.

HOW LONG DOES IT TAKE TO HEAL?

Most people recover completely from mild sprains within two to six weeks. More severe sprains can take up to six months before you can return to full activity, or sport. Once a significant sprain occurs, without good rehabilitation the joint may never be as strong as it was before the injury. It is not surprising therefore that many people have a history of repeated ankle sprains. With the correct rehabilitation however, you can help your ankle become even stronger than it was before the injury.

WHAT CAN BE DONE?

Tissue injury usually involves damage to small blood vessels that results in bleeding at the site of injury. This bleeding leads to inflammation, part of the natural healing process. However, the body tends to overreact to sudden traumatic injury and as a result excess inflammatory fluid accumulates which can result in ‘scar’ tissue production. Too much scar tissue may prevent normal function with reduced flexibility and increased risk of re-injury. It is important to get medical advice to gain a positive diagnosis and

ADVICE HANDOUT

Follow the PRICE guidelines immediately after injury and for at least 3 days afterwards before doing anything else. Your local physio therapist as well as most massage therapists can assist you with this: PROTECT - Protect the injured tissue from undue stress and avoid ALL movements in the same direction as when the injury occurred.  REST – Unload the joint (take the weight off it) as much as you can in the first 72 hours after injury. Try and avoid walking on the joint as much as possible. ICE – Ice is an amazing natural healer and a great short-term pain reducer. It is also believed to have a beneficial effect in reducing swelling and promoting healing. The optimal amount of time to apply ice is around 10-15 minutes in bony areas such as the ankle. It can be applied as often as desired to achieve pain relief, ideally every 1-2 hours. COMPRESSION - This is advised for the first 72 hours, but only while your foot isn’t elevated. The compression can be firm if it doesn’t cause pins and needles or any loss of feeling around the joint. ELEVATION - Reduces the flow of blood to the area which helps reduce swelling. Elevation is recommended in the first 72 hours after injury. However, remove any compression while your foot is elevated unless you are wearing just a light compression bandage. When following PRICE it is also important to avoid HARM, hence the saying: ‘Give PRICE and avoid HARM’. HARM is an acronym for Heat, Alcohol, Running, Massage. Following this acute management phase, your physical therapist will start some ‘hands-on’ treatment to mobilise and strengthen the joint. This phase of treatment is crucial to ensure you return to full function and prevent future injury. Adequate preparation for activity is key and weight-bearing should progress gently. Drastic changes in activity level and performing unpractised skills expose your ankle to re-injury. Gradually build up your fitness level. Your ankle, and the rest of your body, will thank you for it!   WHY IMMEDIATE TREATMENT IS IMPORTANT The success of injury healing can be boosted by appropriate, effective and timely action particularly in the early stages of an injury (ie. the first 72 hours). Any ‘soft-tissue’ is subject to injury including ligaments (which join bones to bones), tendons (which join muscles to bones) and to muscles themselves. The immediate reaction of the body to injury is similar irrespective of the soft tissue structure and is known as an inflammatory reaction. Injuries can be caused by overstretching, bruising or crushing. A strain describes overstretching of a muscle, while a sprain describes overstretching of a ligament or tendon. THE INFLAMMATORY REACTION Tissue injury usually involves damage to small blood vessels that results in bleeding at the site of injury. This bleeding leads to the four main signs of inflammation:
  1. Heat – chemicals released from the damaged tissue causes dilation of surrounding blood vessels to bring healing agents to the area. The result is more blood and therefore heat
  2. Redness – is due to the increase in blood to the area
  3. Pain – is caused by the chemicals released from the injured tissues as well as the increased tissue pressure from the fluid acting on nearby nerve endings
  4.  Swelling – is the result of this accumulation of extra fluid.
This inflammatory reaction is necessary as it is part of the natural healing process. However the body tends to overreact to sudden traumatic injury and as a result more inflammatory fluid accumulates than is necessary for healing. This fluid contains a protein that turns into replacement ‘scar’ tissue. If too much can form it may prevent the structure returning to normal function with reduced flexibility and increased risk of re-injury.

RUN: Better, Faster, Longer, Stronger

26.08.19

RUN: Better, Faster, Longer, Stronger

Do you dream of being that runner where every step of every mile is 100% pain free? No aches, no twinges or niggles, no lingering soreness from yesterday’s session. You are not alone; research shows that as many as 79% of runners get injured at least once during the year. Stop. Think about that number for a moment; nearly 8 out of every 10 runners you see at your next race have been or will be injured sometime that year. Think of running pains in terms of a spectrum. At one end you have severe, full-blown injuries, we’ll name that the red zone, which includes stress fractures that require time off. The other end, where you're in top form, is the green zone. Mild, transient aches that bug you one day and disappear the next sit closer to the green end. Unfortunately, many runners get stuck in the middle, in the not-quite-injured but not-quite-healthy yellow zone. Your ability to stay in the green zone depends largely on how you react to that first stab of pain. Often a little rest now, or reduction in training mileage and intensity, with some treatment, can prevent a lot of time off later. Developing a proactive long-term injury-prevention strategy, such as strength training, stretching, regular massage and foam-rolling can help keep you in the ‘green.’ Physical therapy is a lot like homework, not all of us like having to do it, but if you don't do it, you’re sure to get in trouble at some stage!

What Causes Running Injuries?

There are a lot of theories as to what causes running injury but it seems the answer is fairly obvious: running! Research has stated that “running practice is a necessary cause for RRI (Running Related Injury) and, in fact, the only necessary cause.” With running being the key risk factor for running injuries what other factors influence risk? Historically a lot of emphasis was placed on intrinsic factors like leg length discrepancy, pronation (flat foot), high arches, genu valgus/varum (knock knee or bow legged) and extrinsic factors like ‘special’ running shoes being stability shoes or anti-pronation shoes, lack of stretching. However, recent studies have shown there is no one specific risk factor that has a direct cause-effect relationship with injury rate or injury prevention. Whilst warming up, compression garments, acupuncture and massage have some evidence in reducing injury rates it is all a little grey. Leaving you with a multifactorial buffet of probable contributing causes to running injuries. There is however one specific factor that has been proven, and that is training error. Estimates suggest that anywhere from 60 to as much as 80% of running injuries are due to training errors. Runners become injured when they exceed their tissues capacity to tolerate load. A combination of overloading with inadequate recovery time. Poorly perfused tissues, such as ligaments, tendons and cartilage, are particularly at risk because they adapt more slowly than muscles to increased mechanical load. Factors that affect how much training load a runner can tolerate before injury will also have a role. There are 2 key factors that appear to play a part in this – Body Mass Index (BMI > 25) and history of previous injury, especially in the last 12 months. While high BMI and previous injury may reduce the amount of running your body can manage, strength and conditioning is likely to increase it. There is a growing body of evidence supporting the use of strength training to reduce injury risk and improve performance. Training error and injury risk share a complex relationship - it may not be that total running mileage on its own is key but how quickly this increases, hill and speed training. The old saying of “too much, too soon” is probably quite accurate. Injury prevention is really a ‘mirror image’ of the causes of an injury. So, if you understand the primary reasons for getting injured then you are heading in the right direction to staying healthy this running season.   What are The Most Common Injuries to be Aware of? Body tissues such as muscles and tendons are continuously stressed and repaired on a daily basis, as a result of both 'normal' functional activities and sport. An overuse injury often occurs when a specific tissue fails to repair in the time available, begins to breakdown initially at microscopic level and then over time develops into a true injury. So, the first time you feel a soreness, a stiffness or a pain is not necessarily when it all began. The most common injury is ‘runners knee’ or patellofemoral pain syndrome and accounts for over 40% of running injuries. This is followed closely by plantar fasciitis, achilles tendinopathy and then ITB (iliotibial band syndrome), shin splints and hamstring strain. These injuries generally need complete rest or at least a reduction in training volume and intensity. Followed by physical therapy to promote tissue healing and mobility. Although these are overuse injuries there is frequently an underlying muscle weakness and/or flexibility issue that needs to be addressed with specific rehabilitation exercises. If you do pick up an injury (including 'tightness' 'irritation' or 'niggle') that you’re worried about then we can help, the sooner it’s treated the better.   And don’t forget to check out our Facebook page https://www.facebook.com/pottsvillephysiotherapy  

Don’t Let Yourself Be Sidelined by Tennis Injuries

01.02.19

Don’t Let Yourself Be Sidelined by Tennis Injuries

  Tennis is one of the most popular sports throughout the world, with approximately 75 million participants worldwide. It is a sport that you can play at every age and at every level. Children can start playing from the age of 4, using softer, slower balls and smaller rackets on modified courts to make the game easier and more fun, gradually progressing to regular rackets, balls and courts. Older players can start the sport at any age and can continue playing all their life. Whether you are looking for the competitive club league tennis or a more social game amongst friends, tennis is an excellent sport with loads of health benefits. Tennis is a fun and social (as well as competitive) way to add to your weekly activity goals.

Here are some amazing benefits of participating in regular activities like tennis:

1.    Increased brain power From alertness to tactical thinking, tennis enhances the neural connections in your brain. Kids who play tennis regularly get better grades at school. 2.    Better hand–eye coordination Playing tennis involves regular skills that all contribute to good hand–eye coordination. You can improve your agility, balance, coordination, reaction time and more. This can benefit you in injury prevention where improved balance and agility can help protect against rolling an ankle or tripping and falling often resulting in sprains or Colles fracture of the wrist or worse a hip fracture in older age. 3.    Reduced stress Tennis involves physical, mental, social and emotional challenges, which increase your capacity to deal with stress. Or simply running around smashing some balls may help you to blow off some stress too! 4.    Strong heart Compared with other sports, tennis players have the lowest incidence of cardiovascular disease. Playing just 3 hours a week will reduce your risk of heart disease by 56%. 5.    Higher fitness levels Playing tennis on a regular basis (2–3 times/week), either singles or doubles, meets the global exercise recommendations and leads to increased fitness levels. Tennis is an excellent interval training technique - running, stopping, burst of activity then rest between points or games (which elevates and then lowers heart rate repeatedly through a match) which is proven to be hugely beneficial in improving fitness levels and in cardiovascular conditioning too. The effect is not only seen in elite players but with recreational tennis too. 6.    Leaner body Tennis is an excellent and fun way to burn calories and lose weight. An hour of singles play can burn 580–870 calories. A lower body weight has immense benefits in preventing and managing cardiovascular diseases including diabetes, and a lighter frame will reduce loading on your back and joints reducing joint pain and possible arthritis in older age. 7.    Strong bones Playing tennis on a regular basis leads to stronger, healthier bones. This effect is strongest in those who play tennis from an early age, but even if you start playing tennis later in life you can benefit from the positive effect on your bones. This is applicable to both women and men combating the development of osteoporosis a.k.a. brittle bones with ageing. 8.    Strong leg muscles Playing tennis strengthens your leg muscles, which helps maintain your mobility and independence in old age.

The Secret is Staying Injury Free

But these health benefits won’t be very fruitful is you are sitting side-lined because of injuries and while some injuries are quick to repair, others can take a couple of weeks and others may be more stubborn, taking 6 weeks or more. What’s more frustrating, and unfortunately very common, is the risk of re-injury. One of the greatest risk factors for an ankle sprain or a muscle strain (tear) is having suffered from a previous sprain or strain. Nearly 2/3rds of tennis injuries are chronic overuse injuries, many of which are caused by poor technique, incorrect equipment use and lack of physical conditioning

Acute injuries, like an ankle sprain or calf strain, although sudden and unpredictable can also be prevented with adequate preparation and appropriate conditioning. Chat to one of our friendly staff for more information on how to prevent common tennis injuries and stay in the game longer!

10 top tips for Cyclists

03.08.18

10 top tips for Cyclists

 

Common injuries in Cyclists include knee, lower back, neck and shoulder

 
  1. Make sure your bike is suitable for the type of riding you are doing

  2. Make sure your body fits the bike

  3. Have a great pedalling technique

  4. Vary your riding from day to day

  5. Stretch and activate, slow build your effort as you start your ride

  6. Target sleep, stress, diet and alcohol

  7. Eat well especially during and after a ride of 2 hours or more

  8. Have a strong and consistent recovery routine

  9. The recovery ride – An easy one our ride at high cadence and low power is essential to good recovery after a hard day.

  10. Massage

Achilles Tendon Injuries

30.07.18

Achilles Tendon Injury

A tendon is a band of tissue that connects muscle to bone. The Achilles tendon, connects leg muscles to the heel bone, allowing you to walk and run.   Achilles tendonopathy is a common injury among runners, but may also occur in people with pronated feet, high arches, tight calf muscles and those who wear inflexible running shoes. Overuse of the Achilles tendon at the back of the heel occurs in the case of dancers, runners and walkers who exert a lot of stress on the tendon during their activities. It is a very painful condition and if one continues to put pressure on the tendon, it may snap, often with a loud popping sound. The primary symptom of an Achilles tendon injury is pain to the back of the heel, which increases with exercise and lessens when exercise stops. Achilles tendonopathy also manifests itself with warmth, swelling and tenderness at the site. Range of motion may be limited. Achilles tendonopathy can lead to small tears in the tendon, making it susceptible to rupture, however rupture may also take place without any previous Achilles tendon problems. If any of these symptoms occur, it is best to rest and elevate the leg while icing it and of course, see us or doctor as early as possible. Achilles tendon ruptures are most often seen among middle-aged people who play a sport on weekends or in their spare time.

Symptoms of Achilles tendon rupture are:

 Sudden pain in the back of the ankle which feels like a kick or a stab. It may turn into a dull ache.  Swelling between the heel and the calf.  Difficulty walking or rising up on the toes.

 

A rupture may be treated surgically or non-surgically, depending on the extent of the damage and your condition.

  Until you can get professional help, the RICE formula should be applied:  Rest. This is important as walking may cause further problems.  Ice. Use an ice pack wrapped in a towel. Never apply directly to the skin and leave on for twenty minutes.  Compression. Bandage the foot to prevent further swelling.  Elevate the leg at or above the level of the heart to decrease swelling. For non-surgical intervention, we (or a doctor) will recommend a brace or special insoles for your shoes, as well as physiotherapy. We will work with you to manage your pain with ice and instruct you in stretching exercises for the calf muscles. We will also help you modify your training schedule to match your recovery and advise you on wearing proper shoes to prevent further injury.  

What is Clinical Pilates and why has it made such an Impact?

What is Clinical Pilates and why has it made such an Impact?

Clinical Pilates has been shown to reduce the onset, persistence and recurrence of pain by addressing the neuromuscular dysfunction it is associated with. Clinical Pilates is largely concerned with training local spinal and pelvic stabilising muscles to work efficiently throughout functional activity. It is particularly important in the rehabilitation of spinal pain amongst other motor control problems and is associated to what researcher’s term “specific stabilisation exercises” or “motor control exercise”. With the latest research emerging, evidence-based Physiotherapists have re-evaluated their management of low back pain with a shift towards this type of exercise rather than focus on strength and endurance, which is perhaps more appropriate in the advanced stages of rehabilitation. CLINICAL PILATES involves the following components which are particularly helpful to aid in the rehabilitation of low back pain:
  1. Teaches co-activation of Transversus Abdominis (TA), Pelvic Floor (PF) and Multifidus (MF) muscles
Research into muscle dysfunction in patients with LBP has identified motor control impairments in the deep muscles of the trunk. These muscles normally contract in anticipation of movement to increase stability of the spine and pelvis. This anticipatory function is lost in patients with LBP and not restored with the resolution of symptoms  therefore requiring specific retraining.
  1. Teaches correct muscle activation patterns
A focus on low load high repetition optimizes tonic recruitment of the Type 1 stability muscles. Researchers suggest a prolonged low intensity (submaximal) contraction is effective in retraining the stability function of TA and MF. Further research proposes that specific exercises to train the deep abdominal muscles address any motor control deficits and this stability can provide the basis for more skilful functional activities.
  1. Trains local and global stability systems
Functional spinal stability is dependent on the integration of local and global muscle systems . Clinical Pilates progresses from basic exercises which recruit stability muscles separately to more complicated exercises that involve the larger, more superficial global abdominal muscles. Researchers  suggest specific exercises which isolate the local muscles independently from contraction of the global muscles has proved to be the most beneficial way of targeting them in rehabilitation programs and ensuring that the correct muscles are being activated.
  1. Trains neutral stability before end range stability
Clinical Pilates teaches participants the idea of neutral spine and encourages initial training in neutral and non-provocative postures. Spinal Instability occurring through injury or degeneration can contribute to an increase in the range of the neutral zone which is thought to be a primary source of LBP. This increased zone can be reduced to within physiological limits by re-educating the active system, more specifically the local stabilizers, thus relying less on the passive spinal structures to maintain posture.
  1. Progresses static stability to dynamic
This is in line with spinal stabilisation research programs which progress individuals into functional activity and sport specific exercises.
  1. Direction specific
Researchers  showed that performing exercises in a direction that does not reproduce symptoms was met with better outcomes than those exercised in provocative directions or with no direction preference. By employing this preference in Clinical Pilates the therapist is able to effectively “treat” the patient whilst they complete their rehab. For example, a patient with discogenic LBP requires extension biased exercises versus a patient with spondylolithesis with flexion biased exercises. Our Clinical Pilates program focuses on correcting the causative factors which have contributed to acute and recurrent conditions under the supervision of a Physiotherapist. It is a specific and progressive program aimed at Transverse Abdominus, Multifidus, Pelvic floor and Gluteal muscle control to help stabilise the spine, correct posture and improve strength, balance and confidence with movement. Our small groups, which still provide individual attention, are a great option once pain settles and can lead to enhanced compliance, better improvement and a more successful outcome in the long term versus home programs.

Osteoarthritis and supplements

08.10.17

Osteoarthritis and supplements

Osteoarthritis is a common inflammatory condition characterised by joint pain. See below example. osteoarthritis knee Osteoarthritis affects 2.1 million Australians.  The prevalence is higher in women and joint symptoms are experienced by more than 25% of people aged 65 years or older. Osteoarthritis is particularly burdensome, on individuals and on the healthcare system and is the main reason for knee replacement surgery.  This is of great concern considering the projected rise in the aging population.   In recent years, omega 3 fatty acids (from fish oil), glucosamine and chondroiten have increased in popularity. Research into these and osteoarthritis is showing some promising results, however more research is still needed.   Should you take these supplements if you have Osteoarthritis?? You can as there is some worthwhile evidence but it should form only a small part of your management plan. Score your pain on a scale of 1-10 before taking the supplement, then after 3-6 months score your pain again to see if there has been any change. If you are taking chondroitin it is recommended that you take a supplement containing 800mg such as BioOrganics glucosamine 750g and chondroitin 400mg.   There is much stronger evidence to show that dietary induced weight loss (>10% of body weight) and physical exercise such as strength training and aerobic exercise can have a moderate to large improvement in pain, function and quality of life.   In addition, learning effective pain – coping skills have been shown to have positive outcomes not only for pain but also for function, stiffness and disability.  

World Osteoporosis Day – know your bones

08.10.17

What is World Osteoporosis Day?

World Osteoporosis Day  takes place every year on October 20th, launching a year-long campaign dedicated to raising global awareness of the prevention, diagnosis and treatment of osteoporosis and metabolic bone disease.
webmd_rm_photo_of_porous_bones

Normal bone to left - Osteoporosis to right

 

In Australia an estimated 1.2 million people have osteoporosis and a further 6.3 million have low bone density.

  The disease is most common on the older population with 66% of adults over 50 suffering Poor bone health can lead to minimal trauma fractures such as a minor bump or fall The most common fracture sites include: hip, wrist, spine arms and ribs Physiotherapists understand the impact of a fracture on a patient, seeing how disruptive they can be for day to day tasks and quality of life, slowing the road to recovery. Fracture prevention is complicated but studies have shown we can reduce re-fracture rates by up to 80%.   We can devise strength and balance programs specific to you type of fracture, age and level of function which result in improved mobility strength and physical performance A new online tool will assist you and your Physio.  Visit http://www.knowyourbones.org.au/ Australia’s first bone health self assessment.  The assessment provides a general risk summary report.  

Carly’s Birthday Blog

01.09.17

Why do you love Pilates? I love Pilates because it is a form of exercise that can be modified to suit ANYONE. The layers of challenge you can add are endless. I also love that age is no barrier, it's the practice that counts! What's the best thing about being a physio? Being able to help people reach the goals that are most important to them. No matter how big or small, it's really rewarding to be a part of that journey. I also love that physio can take you in so many directions. From the clinic to the sports field, the possibilities are endless! Why work at Pottsville and Cabarita Physiotherapy ? I grew up in Cabarita, so it's nice to be able to come back to my roots. It's an amazing community with a great coastal vibe and being so close to the beach is always a plus. But, most importantly, the team is amazing! Best relaxation tip? A nice long walk along the beach followed by some guided meditation.  There is nothing better. Best lifestyle tip? Find something you love and do it consistently. Challenge yourself in some way each and every day. Favourite activity? Doing some high intensity interval training or boxing. It gets the heart racing and the sweat pouring. It's even better when you have some amazing people to work out with. Favourite recipe? Tacos. Need I say more? A special mention to Kai's choc chip oatmeal cookies. If you haven't tried them, you should! A typical Sunday... A nice long sleep in followed by a Pilates workout. I then like to go to one of my favourite cafes on the Coast and enjoy multiple coffees and a delicious brunch. You might catch me running around the rugby league scene in the afternoon. That's my other passion!Carly    

Common Surfing Injuries – Ankles

25.07.17

Common Surfing Injuries - Ankles

Ankles are one of the most common joints injured whilst surfing and having adequate ankle mobility and stability are very important for surfing performance. Research has found ankle injuries to be increasingly prevalent, particularly amongst competitive surfers due to the demands of aerial surfing and other progressive manouveres.   Important elements of the prevention of ankle injuries include having adequate ankle range of movement. Having good ankle range of motion helps to protect the ankle against injury sustained from forceful landings, and also assists in the prevention of other lower limb injuries such as knee and hip conditions.  

How do I improve my ankle mobility?

There are many ways to increase ankle mobility, stretching is a simple solution that will help with this and lead to increases in ankle mobility.

Soleus stretch: keeping your heel planted, try and touch your front knee to the wall.

kneewallstretch100x100    

Gastrocnemius stretch: hold your leg straight behind you and lunge forward. A00667F01

 

 Ankle Stability

Ankle stability is another important aspect of the prevention of ankle injuries. Proprioception describes the awareness of where the body is in space and is an important aspect of the stability of a joint. Ways to train ankle proprioception include training on unstable surfaces such as the surf set or bosu ball. Other functional ways to increase ankle stability include practicing tasks like landing onto unstable surfaces and maintaining adequate lower limb strength.   Our surf performance Pilates classes focus specifically on training specific movement patterns and functional strength training to match the requirements needed whilst surfing. We integrate dynamic movement patterns and proprioceptive training tasks to increase balance, core stability and help to increase surfing performance and decrease risk of injury. To find out more about our surf performance classes, visit our website CLICK HERE  you can book online or call us on (02) 6676 4000.   http://pottsvillephysio.com.au/services-pilates-fitness-programs/