Viewing posts categorised under: Knee
The low down on Hip Replacement
The current state of affairsHip replacements are becoming increasingly common. Currently 1.3 people in every 1,000 will undergo a hip replacement operation, and more than 1.2 million are carried out each year worldwide. The biggest risk factors for needing a hip replacement are age and arthritis, with 85% of people having a hip replacement, also having osteoarthritis. In terms of gender, women have a higher risk of needing a hip replacement (58%) compared with men (42%). Hip replacement surgery in patients aged 45-54 has also doubled in the past 10 years.
What can we do, to reduce the risk of needing a hip replacement?Physical activity helps. Running decreases your risk of developing osteoarthritis by 18% and as osteoarthritis is present in 85% of people who undergo a hip replacement, this has a knock-on effect in reducing your risk of needing a hip replacement by 35-50%. And if you’re not up for running that’s OK, walking can also reduce the risk of needing hip surgery, although by a smaller percentage (23%). Almost half of the protective effective of being physically active comes from weight control. The higher your BMI, the greater your risk of needing a hip replacement.
And what can you do if you’re already experiencing hip pain?If you need a hip replacement then the sooner you have it, the better the outcome is likely to be and the quicker you will recover from your operation. This is because the more pain you suffer prior to having surgery, the more compensations and adaptations the muscles and soft tissues will have made around the joint, in an effort to try and protect it and you from that pain, and the harder that will be to re-train once you’ve had the operation. That’s not to say it can’t be done, it will just take a bit longer and need a bit more of an investment in your time and energy. The good news is that outcomes from hip replacements are very good. Developments in materials and surgical techniques, mean that the artificial hips are lasting longer, and success rates are very good, with more than 80% of people experiencing pain relief and functional improvement, meaning their daily lives become easier and they’re able to do more.
We hope you find this information helpful and if you have any questions or queries, please feel free to get in contact with us 6676 4000 or 6676 4577.
We are running the GLA:D program as a preventative for surgery for hips and knees with osteoarthritis.
Don’t Get into Deep Water with Swimming InjuriesSwimming is one of the most popular sports in the world. We swim in the sea, pools, lakes, streams, rivers and even ponds. And given 70% of the Earth’s surface is water, we’re not short of opportunities. And while swimming is considered a ‘low-impact’ sport due to the fact that the water supports a large percentage of, more than 84% of regular swimmers suffer from some type of overuse type injury caused by swimming. Why? The main reason is the high repetition number and forceful nature of the shoulder revolutions which takes our shoulder joint through its full range of motion (which is one of the greatest of all our joints), against resistance, over and over again. And as 50-90% of the power generated to propel you forward comes from the shoulders, you can see why they are the most frequently injured joint. However, swimming also puts stress on your back, to hold you level in the water; on the neck when raising your head out of the water to breathe and if you favour breaststroke as a stroke, there’s added pressure from the unnatural twisting motion on the knees. So, despite it seeming to be a low-impact sport, swimming actually carries a surprisingly high risk of injury. Let’s take a look at those injuries, why they happen and what you can do about them. Swimming injuries generally stem from two sources, and often these sources will combine:
- Muscle imbalances
- Stroke technique issues
Is Osteoarthritis causing you hip or knee pain? GLA:D Evidence based treatment for hip and knee arthritis
Is Osteoarthritis causing you hip or knee pain?
GLA:D Evidence based treatment for hip and knee arthritisGLA:D®, or Good Life with Arthritis: Denmark, is an education and exercise program developed by researchers in Denmark for people with hip or knee osteoarthritis symptoms.
What does GLA:DTM involve?This education and exercise program reflects the latest evidence in osteoarthritis (OA) research. It also includes feedback from people with OA and trainers on what works in the real world to help patients manage OA symptoms.
GLA:DTM Australia training consists of:
- A first appointment explaining the program and collecting data on your current functional ability
- Two education sessions which teach you about OA, how the GLA:D™ Australia exercises improve joint stability, and how to retain this improved joint stability outside of the program
- Group neuromuscular training sessions twice a week for six weeks to improve muscle control of the joint which leads to reduction in symptoms and improved quality of life
Can I Participate in GLA:DTM Australia?GLA:D™ Australia is a program for all individuals who experience any hip and/or knee osteoarthritis symptoms, regardless of severity. You may participate in the GLA:D™ Australia program if you have a hip or knee joint problem that resulted in visiting a health care provider.
You may not be able to participate in the GLA:D™ Australia program if:
- You have other reasons for your hip and/or knee pain, including; tumor, inflammatory joint disease, result of hip fracture, soft tissue or connective tissue problems
- You have other symptoms that are more pronounced than the osteoarthritis problems (for example chronic generalized pain or fibromyalgia)
- You are unable to understand and communicate in English
OA Treatment in AustraliaOA is the most common lifestyle disease in individuals 65 year of age and older, but can also affect individuals as young as 30 years of age. Current national and international clinical guidelines recommend patient education, exercise and weight loss as first line treatment for osteoarthritis. GLA:DTM Australia program offers a proven and effective exercise and education based framework for the treatment of hip and knee OA.
Background of the GLA:D® ProgramResearch from the GLA:D® program in Denmark found symptom progression reduces by 32%. Other outcomes include a less pain, reduced use of joint related pain killers, and less people on sick leave. GLA:D® participants also reported high levels of satisfaction with the program and increased levels of physical activity 12 months after starting the program.
This program is unique in that the education and exercises provided can be applied to everyday activities. By strengthening and correcting daily movement patterns, participants will train their bodies to move properly, prevent symptom progression and reduce pain.
- GLA:D has been proven to have dramatic effects in reducing pain of OA hip and knee by an average of 32%
- The program is open to anyone with hip or knee OA, even if it is severe.
- GLA:D has been shown to be far superior to other treatments such as anti-inflammatories, injections and arthroscopic surgery
Find out more about GLA:DTMPottsville and Cabarita Physiotherapy P: 02 6676 4000 E: [email protected] W: www.pottsvillephysio.com.au
Day to day Tips
- Pace your activities through the day – don’t tackle all the physical jobs at once.
- Wear low-heeled shoes with soft, thick soles (trainers are ideal). Thicker soles will act as shock absorbers.
- Use a walking stick to reduce the weight and stress on your painful knee.
- Use the handrail for support when climbing stairs.
- Don’t keep your knee still in a bent position for too long, it will stiffen up.
- Think about modifying your home, car or workplace to reduce unnecessary strain on your knee.
- Learn to relax your muscles and let the tension out of your body.
- Use heat/ice packs to help eases pain and stiffness.
- Knee braces for osteoarthritis are available.
- Speak to your doctor or therapist first for recommendations or referrals for any of the above.
Don’t Let Yourself Be Sidelined by Tennis InjuriesTennis 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 FreeBut 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!
Winter Ski Slopes StrategiesThere’s no doubt about it, snow sports are fun. Whether you’re hurtling down the side of a mountain at 40 mph, or exploring backcountry terrain; snow sports always involve excitement, adventure and exhilaration. But snow sports are much more fun when you’re physically fit. There is nothing worse than having to limp in early from the slopes because you’re tired or sore (or even worse, injured). Snow sports are major workouts and if you’re not fully prepared physically for your holiday, not only will you be exhausted for most of it, but you’re also at a much higher risk of injury, let’s face it, nobody wants to come home in a plaster cast. So, the goal of this guide is to get you as fit as possible, in the shortest time possible, and give you the best chance to have an awesome, injury-free holiday. Snow sports demand a combination of both technique as well as muscle strength and flexibility to keep stay safe on the slopes, run after run. Decent stamina (aerobic fitness) is key if you’re going to have enough energy to last the day, and anaerobic fitness is needed for the downhill bursts of activity. So, if you’re spending your hard-earned cash on a trip to the mountains, it’s just a waste if you don’t prepare. Any preparation you can do in the weeks leading up to your holiday will improve your performance and enjoyment, as well as reduce your chance of suffering an injury. Here are our top six strategies for reducing the risk of injury while on the slopes.
Strategy 1 - HealthAnything that gets you out of breath will be strengthening your heart, and improving your lung capacity. Walking, running, stair climber, rowing, cycling and swimming are all great ways to work your cardiovascular system. Because snow sports involve stamina as well as short-burst aerobics, the most effective preparation is a combination of high-intensity training and longer, more sustained efforts called interval training. Interval training is the best way to build cardiovascular endurance; the key to the training is to maintain a high heart rate, concentrating on short sprints. Aim for two to three, 20-30 minute interval training sessions a week, working harder to increase the heart rate for one or two minutes, then working less hard to drop it right down for 2 – 4 minutes before repeating the same sequence, throughout the session. This routine can be incorporated into any of your favourite cardio workouts from running to swimming. Remember to build up the exercise slowly and incrementally. So, if you’re starting from a relatively low fitness level, have longer rest periods in between the sprints, and shorter sprint periods, and slowly build these up. If you’re not sure where to start, a physical therapist or personal trainer will be able to help you find a training schedule that will suit you. The other reason that good fitness is a major advantage is because ski resorts are usually found at higher altitudes than where you would normally live. This means there’s less oxygen in the air, meaning you need to breathe harder to get the same oxygen levels as you would at sea level and it can take a few days to acclimatise. Being physically fit can help combat side effects of a high altitude. A SESSION MIGHT LOOK SOMETHING LIKE THIS: 5 MINUTE WARM UP 1-2 MINUTES SPRINT (high heart rate) 2-4 MINUTES INTERVAL (lower heart rate) 1-2 MINUTES SPRINT (high heart rate) 2-4 MINUTES INTERVAL (lower heart rate) 1-2 MINUTES SPRINT (high heart rate) 2-4 MINUTES INTERVAL (lower heart rate) 5 MINUTE WARM DOWN
Strategy 2 - StrengthSkiing and snowboarding require a strong abdomen, and powerful legs, and in the case of snowboarding, good upper body strength too. The stronger you are, the less likely you are to get tired. If fatigue creeps in, your form can start to deteriorate, making it difficult to last the day as well as increasing your risk of a fall. Stronger muscles better support your joints, and absorb the forces from impacts and vibrations, and this can also help prevent injury. The quadriceps muscles (front of thigh) work in two ways on the slopes, helping as you both bend and straighten the knees. The controlled lengthening of the quadriceps from straight to bent is called eccentric training and is fundamental to snow sports. Squats, lunges, deadlifts and plyometric jumps are all good exercises to specifically strengthen your quadriceps and hamstrings (back of thighs) and glute (buttocks) muscles essential for snow sports. Good core strength (your deep abdominal muscles) is required to sustain postures for prolonged periods, maintain balance and control and support your back from injury. Planking exercises, bridging, using a Swiss ball, mountain climber and Pilates are all excellent exercises to improve core strength. Your physical therapist can give you specific skiing or snowboarding exercises to strengthen your legs and core
Strategy 3 - BalanceBalance is important in all aspects of snowboarding and skiing. Good balance will ensure better technique and efficiency when on the slopes but also help prevent falls and possible injury. Yoga and Pilates are two great forms of exercise for developing balance. Simple balancing home drills include: Stand on one leg with eyes closed for two minutes twice a day. When this gets easy, add some small movements, such as little knee bends or brushing your teeth. You can advance this by standing on something wobbly or uneven (a Bosu ball at gym or a soft pillow at home). Stand on one leg whilst swinging the other leg around with your eyes closed; or practice picking up small objects off the floor whilst balancing on one leg.
Strategy 4 - Warm upWarming up increases blood flow through your muscles, preparing them to respond to the demands of snow sports, and reducing your risk of injury. Stretching as part of warm up also helps improve flexibility in your joints and muscles. Walking briskly, a jog, swinging your legs doing some walking lunges will all help. Warm up again following a lunch break or long wait at a ski lift when you’re out on the slopes. A cool down and light stretch helps remove lactic acid from your muscles and keeps them subtle, which will make getting out of bed the next day easier! Once you come off the slopes, before sitting at your favourite après ski spot, walk around for 5-15 minutes, and do some stretches.
Strategy 5 - EquipmentApart from physically preparing your body to cope with the demands of snow sports, some equipment can help protect it from injury. Helmets are designed to resist impact and absorb energy to minimize damage to the brain. Helmets have been shown to decrease head injury risk and severity by 2260%. Wearing a helmet really is a no brainer (pun intended!). Badly fitting bindings and rented equipment have been associated with increased injury risk. Make sure you have your bindings fitted and adjusted (even if you own your own equipment) by a certified technician. Ensure you also rent skis according to your skill level. Be realistic and don’t over estimate your ability as this may increase your risk of injury. The use of hip pads and wrist guards whilst snowboarding have been shown to be beneficial in lowering overall injury risk too.
Strategy 6 - SafteyExperience and education are key. People with low skill levels are more likely to be injured but don’t assume that experience and skill level go hand in hand. If you’re inexperienced, lack confidence or feel a bit rusty – it’s worth taking the time to attend ski/snowboarding school or get some private instruction for the first few days of your holiday. Take time to re-familarise yourself with the snow, easing onto the green and blue runs before heading off to anything more challenging. A higher proportion of people are injured in the afternoon. This may be due to a wide range of factors, including fatigue, business on the slopes, heavy lunches, or alcohol intake, as well as changes in snow conditions. Take regular breaks through the day or carry snacks to keep your energy levels up. Ensure you stay hydrated. Just because its cold doesn’t mean you aren’t sweating from physical exertion. Dehydration can result in mental and physical fatigue. Staying hydrated can help combat the effects of high altitude. Finally, it’s your responsibility and behavior that can keep you safe on the Applying these six strategies will significantly increase your chances of returning from your snow sports holiday uninjured and intact. Keep an eye on our Facebook page for more snow sports fun and advice. And have a great holiday! slopes. Most injuries can be prevented, know the snow responsibility code and follow it: the snow responsibility code and follow it: 1.STAY IN CONTROL AT ALL TIMES 2.PEOPLE BELOW YOU HAVE RIGHT OF WAY 3.OBEY THE SIGNS LOOK BEFORE YOU LEAP 4.STOP WHERE ITS SAFE (ON THE SIDE OF THE PISTE),AND WHERE YOU CAN BE SEEN 5.STAY ON THE SCENE AFTER AN ACCIDENT Credit - Co -Kinetic Journal
Chronic PainPain is NORMAL. It is the body’s way of alerting us to what it thinks is DANGER. The interesting thing about pain is that we don’t actually experience pain until our brain interprets a signal from the body as being pain. It is important to accept that YOUR PAIN IS REAL – IT IS NOT IN YOUR HEAD!! There are many things that contribute toward the brain signalling pain: Thoughts Fears Past experiences Family issues; My mother has cancer could this be what is happening to me?, Who will look after the family? Work issues; Will I have to have time off? , How much money will I lose? Anxiety/stress can increase the sensitivity of the nervous system Exercise can help turn down pain signals by releasing chemicals that help to quieten the nervous system. All of these things make a difference as to whether or not your brain will interpret the signals from the body as pain. The important thing to understand is that the brain can still signal pain long after the original injury in the tissues has healed. When you initially have an injury, signals are sent to the brain to alert it to danger. The brain then interprets the signal, remember factors mentioned above will play a role in the brain interpreting the signal, and this is where the pain experience starts. This is all necessary so that you don’t go and do anything which may injure you further. However these messages can persist and lead to chronic pain.
Chronic pain is when you continue to experience pain long after the original injury has healedThis is due to central sensitisation. This is when the brain sends chemicals to the spinal cord to meet the signals coming from the tissues. These chemicals can be excitatory, which means they multiply the signals coming from the tissues and therefore send a much stronger signal to the brain then the original signal from the tissues. The brain can also send messages to the tissues to release more inflammatory substances – the body thinks it can heals faster this way, but doesn’t know when to turn off this inflammatory process. This type of inflammation is not helped by medication and explains why there can still be inflammation present many months later. This causes the nerves to become hypersensitive and send earlier and more signals to the brain, again this is an over sensitivity of the nervous system. Over time, the cycle continues which results in increasing sensitivity of the brain and therefore more and more pain. Pain can become a habit – your body anticipates and remembers it and it takes very little to trigger it, sometimes when things are really bad even thinking about moving can trigger the pain. The brain has lost its ability to differentiate between painful and non painful input, so just to be safe it triggers everything as pain. The brain has also lost its ability to distinguish between body parts so you may find your pain spreading or moving. The good news here is there is no damage in the tissues causing the pain, it is just that the brain is so used to feeling the pain that it continues to signal even though the damage has healed. It is the sensitivity of the nervous system that is causing this. The important things to understand is that PAIN DOES NOT EQUAL DAMAGE!! The solution is to make the brain understand that there is no longer any damage in the tissues and it is time to desensitise. We can do this through a graduated return to normal activity.
TAKE CONTROL1. Any new injury or disease requires a prompt medical examination. 2. Understand any prescribed help. Ask for appropriate scientific evidence supporting what is offered to you. 3. Make goals that both you and your clinician understand. Aim for physical, social and work goals, which allow your progress to be measured.
Patello-femoral Knee PainAching knees affect 25 % of the population and are commonly caused by dysfunction at the patella-femoral joint (under the kneecap). It is typically aggravated by bending movements such as sitting, walking up and down stairs or hills, jumping and running. It is also common during adolescence as the long bones are growing faster than the muscles, tendons and ligaments putting abnormal stress on the joints.
- Unfortunately genetics have a part to play and this can’t be changes
- Faulty bio mechanics due to muscle imbalances
TreatmentTreatment is very successful and we will look at correcting muscle imbalances throughout your lower back, hip, pelvis and leg. This is done by manual techniques to the knee cap, massage, acupuncture, exercise and taping.
Experiencing knee pain while walking, running, squatting, kneeling, going up or down stairs or slopes?
You may have a condition known as Patellofemoral pain syndrome.Patellofemoral pain syndrome is one of the most common knee complaints of both the young active sportsperson and the elderly. Patellofemoral pain syndrome is the medical term for pain felt behind your kneecap, where your patella (kneecap) articulates with your thigh bone (femur). This joint is known as your patellofemoral joint Patellofemoral pain syndrome, is mainly due to excessive patellofemoral joint pressure from poor kneecap alignment, which in time, affects the joint surface behind the kneecap (retropatellar joint). Physiotherapy inventions help strengthen one’s quadriceps and hips, which subsequently aids in restoring the biomechanics of the patellofemoral joint. Physiotherapists are able to advise and design customised exercise programs to improve the strength of your knee and leg muscles and help you maintain good general fitness. If you are experiencing patellofemoral pain, or any pain in your knee and joints, it is important to have your condition assessed by a physiotherapist. Patellofemoral pain typically develops because of 1 of 3 different reasons 1. Excessive pronation of the foot (flattening of the arch). It doesn't matter if you have high arches or flat feet, it depends on how much your arch flattens from non-weight baring to weight baring. This can be addressed in the short term with the use of orthotics but a strengthening program of the muscles that support your arch is recommended. 2. Weak quadriceps (weak thigh muscles). The quads are the largest muscle group in the body that we use to extend our knee. Important for walking, running, squatting, and climbing stairs. We can test your maximum isometric contraction and compare it to your unaffected side to see if this is a contributing factor and address any deficit with an appropriate strengthening program. 3. Weak hip abductors (gluteal muscles). Gluteus medius and minimus help to keep our pelvis level while walking and running. If your opposite hip dips then the knee you are standing on will drift inwards causing poor alignment of the patellofemoral joint. This deficit can be picked up with good observation skills and strength testing.