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 HANDOUTFollow 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:
- 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
- Redness – is due to the increase in blood to the area
- 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
- Swelling – is the result of this accumulation of extra fluid.
THE ART OF THE BREATH Breathing correctly promotes a sense of calm, helps us to de-stress and also promotes physical healing. We are all breathing all day everyday but most of us are not breathing correctly! Some common mistakes are: -breathing too quickly -breathing too shallow using our neck muscles rather than our diaphragm -breathing unevenly with lots of sighs and yawns -breathing through our mouth Start learning to breath properly again by focusing on the following: 1. Be sure to breathe through your nose - in and out all the time, even when exercising. Your nose is designed to filter air and make it the perfect temperature and humidity. 2. Focus on each breath becoming smoother and slower. We should aim to breathe 12 times per minute (many of us are breathing 16+ times per minute) 3. Your breathe should be even and silent - avoid noisy sighs and yawns 4. use your diaphragm and belly muscles to breathe. Your shoulders should not move up and down to breathe. Learning to improve your breathing will help improve so many physical and psychological ailments.
Exercise and Mental HealthStaying active is not only critical for maintaining physical fitness during the COVID-19 restrictions, but also for providing important mental health benefits during the current period of social isolation. Physical activity is a key factor for the prevention and management of mental health issues such as anxiety, depression, Post-traumatic stress disorder (PTSD), Bipolar affective disorder (BPAD) and eating disorders. Physical activity, even in low doses, could lower the risk of mental illness in the community. The current Australian guidelines for exercise are 150 minutes of moderate-intensity aerobic activity and two sessions of resistance-based exercises per week, but for mental health a little bit of activity is better than doing nothing at all. Even one session per week has been shown to have great improvements. Mental disorders are already among the leading causes of disease and disability globally. There is mounting evidence that suggests that exercise is an effective component of treatment for people living with acute and chronic mental illness. With exercise making a big difference in mood and promoting a positive mental health, whilst also helping to reduce the symptoms of mental illness, there is a significant need for exercise to be a fundamental part of mental health treatment, particularly whilst we are in isolation. While gyms and fitness classes are now shut down, exercise is still considered an essential activity. Here are some tips for maintaining or building movement into your day:
- Keep motivated by scheduling exercise into your diary as you would for a gym class
- Put on your favourite music and do some simple body weight exercises such as squats, lunges, and push ups
- Make use of online exercise classes to guide your home exercise. You can find some great online Pilates classes here
- Get outside into the fresh air if you can, take a walk along the beach or kick the football in the backyard
- Book in for an online consultation or alternatively a one-on-one session with our Accredited Exercise Physiologist for clinical exercise advice and treatment here
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.
Rosie is our Remedial Muscle Therapist, and Swedish Relaxation Therapist.
Rosie has completed an advanced diploma in Soft Tissue Therapy at Kingscliff Tafe. These studies have laid down a solid foundation of awareness in the anatomy and functionality of the body. Rosie works with assessment and tactile massage tools to support the body. With these tools she can support you on getting out of pain, relieving tension, correcting compensation imbalances, and overall maintenance for physical and mental health.Over the last year Rosie has also undertaken another bodywork course in Zenthai Shiatsu to help further deepen her understanding of the body and how it works/heals. This bodywork therapy looks through the lens of Ancient Traditional Chinese Medicine and Temple Thai massage, and works a lot more on the facial connective tissue (meridians) throughout the body. This modality has enabled Rosie to support others in healing that is not only physical but also psycho-emotional, nervous system balancing and stress relieving. Rosie also has studied 200hour multi-style yoga teacher training, which adds layers again onto her ability to understand the body and it’s movements, posture and alignment. Feel free to ask Rosie for some simple take-home yoga stretches/postures that will specifically support you and your body on your healing/health journey. Rosie is also happy to work hand-in-hand with your physio to obtain best results. For many cases the combination of physiotherapy and remedial massage therapy together, can accelerate your healing journey, and/or bring ease to maintaining and healthy functioning body (and mind). Call 6676 4000 to find out her availability!
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
- 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
- And much more!
Headache If you’re one of the 47% of the global population who experiences regular headaches, you’ll know they’re no laughing matter. For some people, they’re just a minor inconvenience, for others they can be utterly debilitating, condemning you to a dark, quiet room for hours, and sometimes even days. The trouble is that successfully diagnosing a headache gets complicated, because more than 130 distinct disorders have been identified along with over 300 triggers, which makes a headache almost as unique as an individual. Luckily at Pottsville and Cabarita Physio we specialise in treating headache and can confidently determine if Physiotherapy will help you within the first session. Headache is a unique condition in that you can also simultaneously suffer one, two or more types of headache or a migraine at the same time, where one may cause another, or overlap with each other. These are known as mixed or multi-source headaches and can take longer to resolve as your therapist works through treating the different causes. For example, a dysfunctional painful neck can cause an increase in surrounding muscle spasm, which will increase your blood pressure. In this scenario, you could have a cervicogenic (neck) headache, with a tension headache and a resultant migraine! The most commonly diagnosed headaches are:
- Migraines (12%)
- Tension headache (75%)
- Cervicogenic headache (originating from the neck) (18%)
- Sinus headaches
- Some foods
- Skipped meals
- Lack of sleep
- Muscular tension
- High blood pressure
- Hormonal influences
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
Festive Follies Survival StrategiesForget boot camp, with shopping mayhem and rampaging relatives, financial stress, late nights, too much TV and over-indulging – the festive season can be the most grueling event on the calendar. It’s no wonder that nearly every one of us emerges from it with a New Year’s resolution of detoxing, getting fit and losing weight! Surviving is all about preparation. The festive season is usually particularly problematic for those of us who take their nutrition and exercise seriously or even for those who just want to come out of the other side, with any luck, not worse off than when they started. Whether it’s the big high calorie meals, the parties, alcohol or general lack of structure in your week, it’s very easy to lose your way in December which is why we put together some resources to help you minimise the festive ‘damage’ and help you maintain your physique and health, while still enjoying the party season. Our newsletter looks at three things:
- What you can do to keep your eating on track
- What you can do to keep your fitness on track
- What you can do to keep your alcohol intake on track
- Booze Busters explores the impact of alcohol on your body and how you can reduce the toll it takes on you physically
- Hangover Food Super-Heroes looks at how to replenish lost nourishment the day after a heavy night
- Hangover-Smashing Smoothies – three specially concocted smoothies to help get you back on your feet, the morning after the night before.
The Chain of CommandYour 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 SpinePay 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 PainYour 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 IssuesOne 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)