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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.

What is an exercise physiologist?

20.01.20

What is an exercise physiologist?

An Accredited Exercise Physiologist (AEP) is a university qualified allied health professional who specialises in the delivery of exercise and lifestyle programs for healthy individuals and those with chronic medical conditions, injuries or disabilities.   AEPs possess extensive knowledge, skills and experience in clinical exercise delivery. They provide health modification counselling for people with chronic disease and injury with a strong focus on behavioural change.   Working across a variety of areas in health, exercise and sport, services delivered by an AEP are also claimable under compensable schemes such as Medicare and covered by most private health insurers. When it comes to the prescription of exercise, they are the most qualified professionals in Australia.   What makes AEPs different to other exercise professionals?
  • They are university qualified
  • They undertake strict accreditation requirements with Exercise and Sports Science Australia (ESSA)
  • They are eligible to register with Medicare Australia, the Department of Veteran’s Affairs and WorkCover, and are recognised by most private health insurers
  • They can treat and work with all people. From those who want to improve their health and well-being, to those with, or at risk of developing a chronic illness
Why should you see an AEP? AEPs are the experts in prescribing the right exercise to help you prevent/manage your chronic disease, help you recover faster from surgery or an injury, or help you to maintain a healthy lifestyle.   AEPs can help treat and/or manage:
  • Diabetes and pre-diabetes
  • Cardiovascular disease
  • Arthritis and osteoporosis
  • Chronic respiratory disease and asthma
  • Depression and mental health conditions
  • Different forms of cancer
  • Musculoskeletal injuries
  • Neuromuscular disease
  • Obesity
  • And much more!
    What makes AEPs even more special is they know how to set goals and maintain motivation, these are two aspects that will most commonly see people fail at exercise. What to expect when seeing an AEP?   During an initial consultation with your AEP, you will undertake a comprehensive assessment in order to develop an exercise plan based on your unique requirements. This session will likely be a fair few questions about your health and history. A lot of people are concerned about what to wear to this appointment. We always say wear comfortable clothing as you may be asked to do a range of movements and bring some comfortable walking shoes as you may need to complete an aerobic assessment. After this session, you will be provided with a plan of action. Working with an AEP can be a truly rewarding process and they can make a hugely positive impact to your life. Our AEP, Sammy, has special interests in the areas of Cancer and Exercise, Osteoporosis and Clinical Pilates. To make a booking with Sammy our AEP  please call 6676 4000 or 6676 4577.  

Don’t Get into Deep Water with Swimming Injuries

10.12.19

Don’t Get into Deep Water with Swimming Injuries

Swimming 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:
  1. Muscle imbalances
  2. Stroke technique issues
Muscle Imbalances Our everyday posture, particularly if you spend a lot of time sitting at desk or in a car, or generally not moving around, creates all sorts of muscle imbalances from short hamstrings, tight muscles around the neck, back and shoulders. We unconsciously adopt a curved forward upper back, round shoulders and chin poke, which not only add to shoulder problems in swimmers but neck pain too. Poor posture is the biggest culprit of short tight trapezius and pectoral muscles and weak anterior (front) neck and upper back muscles. These muscles can be painful and develop trigger points which are hyperactive spots in the muscle, commonly referring pain and causing headaches. Tight muscles may also limit your neck movements. Good posture ensures good alignment of the joints and ligaments which allows for optimal contraction of your muscles and off-loads underlying structures. Stroke Technique This a big topic to cover because it depends what stroke you’re swimming mostly with and what kind of injury you may have but issues include: a wide, swinging arm recovery which requires excessive internal rotation, causing impingement on the joint; thumb in first with hand entry, which again causes excessive internal rotation in the shoulder and a dropped elbow or straight arm pull through which creates a long lever and overloads the shoulder. What does all of this mean to you? You shouldn’t swim? You should reduce your training or change your sport? The bottom line is that the benefits of swimming - whether it’s for general fitness and physical activity, the desire to win competitions, or just to find your quiet place for stress relief - far outweigh the risk of injury.

   

Back Pain: The Chain of Command

26.11.19

Back Pain

The Chain of Command

Your spine is essentially the chain that forms the ‘backbone’ of your entire body. Without it you would be a blob of muscles, organs and soft tissue piled on the floor. Your spine commands respect because it is the pillar that supports your body, allows you to walk, stand and sit, as well as touch and feel; because it forms the canal connecting the nerves from your body and limbs, to your brain. While your heart may be the vital organ that keeps you alive, without your spine you wouldn’t be able to move. There are three natural curves in your spine that give it an "S" shape when viewed from the side. These curves help the spine withstand great amounts of stress by distributing your body weight. Between the bony vertebra are spongy discs that act as shock absorbers. The lumbar spine (or lower back) connects the thoracic spine to the pelvis, and bears the bulk of your body's weight. Your spine is not rigid though. It allows movement through the intervertebral joints connecting the bony vertebra. These joints allow you to twist, to bend forward and backward, and from side to side. Large groups of muscles surrounding the spine, pelvis, hips and upper body all interact to allow for movements like walking, running, jumping, and swimming. However, there are also muscles deep in your body that work constantly just to maintain your posture when you’re sitting and standing. It is essential that all elements of the spinal ‘chain’ work harmoniously together to ensure fluid movement without overloading structures resulting in injury and pain. Any link in the chain that becomes ‘stuck’ will not only affect that spinal level but also the movement and strength of the chain above and below it. If the muscles around the spine are uneven in strength and length (flexibility) this too can affect the ‘chain’, altering the alignment and motion of the links. Taking care of your spine now will help you lower the chances of experiencing back pain later. Many of the steps you can take to improve the overall health of your spine involve nothing more than practicing better body mechanics, or how you move and hold yourself, when you do daily tasks and activities.

Taking Care of Your Spine

Pay attention to early warning signs or pain. Although back pain is very common and nearly every person will experience at least one episode of back pain in a lifetime, it is essential to address any symptoms promptly. It has also been shown in studies that early treatment and rehabilitation can prevent recurrent bouts of back pain and prevent the development of chronic lower back pain which can be very debilitating, stressful and depressing. It can affect your ability to work, play sport, socialise and sleep, all of which can further compound your pain cycle. Your back pain could be due to inflamed ligaments, damaged intervertebral discs, nerve irritation, bony formations on the spine, muscle imbalances such as weakness or a lack of flexibility, leg length differences, or muscle strains, to name just a few. Even the way we move (or don’t move) at work, school or sport can all be an underlying cause to the current pain.

How Pottsville and Cabarita Physiotherapy Can Help with Back Pain

Your physiotherapist can treat the pain or stiffness experienced from back pain using massage, soft tissue mobilisation, spinal manipulation, heat, acupuncture and other devices. It is important that you, together with your physiotherapist work through a rehabilitation program (specific exercises and stretches) to correct underlying muscle weaknesses, flexibility issues, and the  sequence in which the muscles around your spine work to provide stability.  A physiotherapist can also give you advice on correcting posture / technique for work and sport. Chat to us today about what we can do to help Ph: 0266764000 / 02667644577

Back Pain and Sleep Issues

One of the most common issues back pain sufferers experience is sleep disruption so we have put together an interactive Back Pain and Sleep Guide to help you banish those sleepless nights and wake up feeling refreshed. The guide includes:  
  • 6 Strategies for Improving Your Sleep
  • 8 bedtime stretches to relieve back pain (with video links)
  • Sleeping positions that will help relieve pain (with links to videos)
  • 7 Yoga Poses that will help cure most back pain issues
  • A morning stretch routine that will help ease pain from a restless night (with videos)
  Click this link to find out more and download the guide Disclaimer: This information is intended as general guidance and information only and should not be relied upon as a basis for planning individual medical care or as a substitute for specialist medical advice in each individual case. https://www.facebook.com/pottsvillephysiotherapy  

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  

Cancer and Exercise

      The potential benefits of exercise during and after treatment are significant and research has proved its effectiveness. Exercise during chemotherapy can help ease side effects, such as fatigue and nausea, and can help to boost the immune system of those undergoing cancer treatments. Chemotherapy side effects can sometimes make exercising tough, but it’s recommended to try to be as active as possible during treatment. Benefits of an appropriately prescribed exercise program in this population include improved:

  • Muscle mass, strength, power
  • Cardiorespiratory fitness
  • Physical function
  • Physical activity levels
  • Range of motion
  • Immune function
  • Chemotherapy completion rates
  • Reduced anxiety and depression

Chocolate and health benifits

29.11.18

Research shows that over 70% of us treat ourselves to chocolate at least once a week.

  Good quality dark, raw chocolate  (at least 70% cocoa) has impressive health benefits: ·         Boosts energy levels ·         Improves blood flow which is great for your cardiovascular health ·         Releases endorphins which helps with pain relief ·         Relaxes muscles due to the magnesium content ·         Tryptophan (the precursor of serotonin) boosts happiness ·         May improve cognitive performance ·         Anti-oxidants work to fight cellular and oxidative damage resulting in clearer, firmer skin  

8 tips to reduce your risk of Type 2 diabetes

04.11.18

8 tips to reduce your risk of Type 2 diabetes:

1. Manage your weight and avoid excess fat especially around your abdomen

2. Eat a healthy, balanced diet.

3. Reduce your alcohol content

4. Exercise regularly.

5. Avoid cigarettes.

6. See your GP for regular checkups

7. Control your blood pressure

8. Reduce stress in your life

What is Osteoporosis?

22.10.18

What is Osteoporosis?

Osteoporosis is a condition in which the bones lose calcium, become fragile and tend to fracture readily. It is most common in women over 40 years of age. Your doctor may organize a bone density scan to see if you have, or are at risk of developing osteoporosis.

What causes Osteoporosis?

  Throughout life bone tissue is very active and is constantly being ‘remodelled’. Microscopic amounts of bone are continually being removed and reformed. The bone continues to thicken until your early 20’s, this is your peak bone mass. After about 40 or 50 years more bone is removed then laid down, and gradually the density decreases. During menopause the decline in oestrogen levels results in an accelerated bone loss.  

Who is at risk?

 
  • Over 40 years old
  • Family history
  • Caucasian
  • Women after menopause
  • Smokers
  • High intake of alcohol, salt, caffeine
  • Sedentary lifestyle
  • If you have dieted during your life and limited intake of calcium rich foods.
 

Exercise and Osteoporosis

  Research shows that regular lifelong weight bearing exercise and light weight training has a positive effect on bone density. Swimming and cycling although good for your fitness are not as beneficial as walking, dancing, tennis or gentle weight bearing circuit classes. Bone is a living tissue and responds to the stress of weight bearing exercise by becoming stronger. You need to aim for at least three sessions per week. IT IS NEVER TOO LATE TO START, even if you are past your peak bone mass, exercise will reduce bone loss and help delay the progress of Osteoporosis. Pottsville Physiotherapy Fit for Life circuit classes incorporate weight bearing exercise, light resistance training and balance / coordination training to help maintain your bone density, improve your posture and balance and help prevent falls. Exercise to avoid: If you have been diagnosed with osteoporosis you will need to avoid excessive twisting, bending, heavy lifting, jolting, dynamic sit ups, and high impact activities such as running and jumping.

Exercise Tips

 
  • Warm up first
  • Slow and controlled movement
  • Don’t hold your breath
  • Do not push into pain

Other Treatments

 
  • Your doctor may prescribe medications i.e.- hormone replacement therapy
  • Diet and or supplements to ensure adequate calcium intake (your doctor or a dietician can advise you on this)
  • Lifestyle factors—quit smoking, decrease salt, alcohol and caffeine intake (these all limit calcium absorption)

How much calcium do I need?

  Young adults - 800-1200mg per day Menstruating women800-1000mg per day  Men800  Pregnant/lactating women  - 1200mg per day Post menopausal women(no oestrogen) - 1500mg per day Post menopausal women(oestrogen) - 1000 - 1200mg  per day Adults over 65 years -  1500mg per day     Food                                                       Amount                                              Calcium (mg)   Low fat milk                                         1 glass (250ml)                                                 405 Soya beverage                                   1 glass                                                                  365 Yoghurt                                                200g                                                                      330 Whole milk                                         1 glass                                                                  300 Hard cheese                                       1 slice (30g)                                                        285 Canned sardines inc bones           (50g)                                                                     275 Processed cheese                            30g                                                                        190 Oysters                                                10                                                                          190 Tofu                                                       100g                                                                     130 Almonds                                              50g                                                                        125 Baked beans                                       1 cup (240g)                                                       108 Canned salmon, inc bones            100g                                                                      90 Cottage cheese                                 100g                                                                      60mg Broccoli                                                60g                                                                        15mg   Pottsville and Cabarita Physiotherapy 6676 4000 visit www.osteoporosis.org.au

Osteoporosis

15.10.18

Osteoporosis is a condition where bones are weakened so they are more likely to fracture.
This is due to bone tissue loss that is a result of ageing.  Gradual bone loss begins around 30-40 years of age.  The rate of loss accelerates for women at the time of menopause as oestrogen is protective of bone up to that time.
Lifestyle factors such as inactivity and inadequate dietary calcium and vitamin D all increase the risk of osteoporosis.
Loss of muscle strength and balance with age as well as disuse increase the risk of falling.  Many osteoporotic fractures (including over 90% of hip fractures) occur as a direct result of a fall. The spine, hip and wrist are the most common fracture sites but any bone can be affected.
Osteoporosis often remains undetected until a person suffers a fracture.  The standard accepted method to diagnosis osteoporosis is dual-energy x-ray absorptiometry (DXA), a very low-dose x-ray examination. Scans are usually performed at the hip and spine and provide a T-Score which indicates how an individual’s bone mass compares to the average bone mass of others of the same race and sex at age 20. Weight bearing exercise is the best way to prevent osteoporosis in those with normal or slightly low bone mass.

DXA Bone Density scan

A person with very low bone mass however is at increased risk of low trauma fracture and so should perform lower impact exercises such as Clinical Pilates, Tai Chi, line dancing, stair climbing, and low-moderate impact aerobics.
Exercises to strengthen the back muscles are beneficial, however correct technique should be emphasised.  
Any new exercise program should be initiated carefully, monitored closely and progress gradually.  Gains in bone from exercise in adulthood will be lost if the exercise is stopped.  High impact activities may not be practical for individuals with painful joints but gradual introduction is likely to be beneficial
Osteoporotic men and women should:  
  • Aim to exercise 4–5 times per week for 40 minutes
  • Engage in a variety of lower intensity exercises designed to optimise balance, muscle strength and endurance to prevent falls
  • Clinical Pilates based programme's  that include back muscle strengthening and balance activities like standing on one leg, heel-to-toe walking along a line, stepping sideways over objects and walking on tip toe are ideal