Category: Uncategorised

Patellofemoral (AKA Knee Cap) Pain

Do you ever get sore knees during daily activities, exercise or while you climb the stairs? Well if you do, you’re not alone. Knee pain with activity is a common concern reported to physiotherapists. Below is some information regarding patellofemoral joint pain and some advice on how you can help manage your symptoms at home. 

How Does the Knee Work:

The knee is a hinge joint which allows for bending and straightening movement. The patellofemoral joint is the joint between the kneecap (patella) and the intercondylar notch of the femur. This is where the kneecap travels during your bending movements. The tracking of the patella is influenced by the balanced pulling forces of the muscles around the thigh. 

The cause of PFJ knee pain: 

Patella femoral joint pain is a term used to describe symptoms underneath or around the knee cap. It can affect a wide range of people and is often aggravated with activities such as walking, running, up and down stairs, and squatting. As the structures on the inside and outside of the knee cap guide it during activity, this balance can be altered causing pain around the knee. This can be caused by the following:

• Outside muscles being too tight
• Inside structures being weaker than the outside muscles  
• Excessive loads through the knee joint 
• A combination of these factors

2 Ways to Help Your Pain:

1. Stretching:

Stretching is a great way to reduce the tightness which can be contributing to your symptoms. Stretching regularly throughout the day and both before and after exercise can help. You should trial these stretches at home 

• Quad 
  • While standing, raise your foot towards your glute. You should feel the stretch along the front of your thigh. Hold for 20 seconds and repeat three times at a mild to moderate stretch pain free.
• HS
  • While sitting on the floor, have one leg out straight. Lean forward at your hips until you feel a stretch in the back of your thigh / knee. Hold for 20 seconds and repeat three times at a mild to moderate stretch pain free.
• Calf 
  • Stand with one foot in front of the other facing a wall. Keep your back leg straight while leaning into the wall. You should feel a stretch in the back of your leg. Hold for 20 seconds and repeat three times at a mild to moderate stretch pain free.

2. Strengthening:

Strengthening is a greater way to maintain the balance within the knee. Often the reason muscles get tight is due to weakness (tired muscles get tight), so strengthening is a way to get you moving in the right direction. Trial these strengthening exercises at home:

• Knee holds
  • Lay on your back and straighten your knee. Now try and push your knee into the bed and hold for 10 seconds repeat three times. 
• Knee extensions 
  • While sitting on a chair, raise your foot so your knee is completely straight. Then lower your foot back to the floor. Repeated for 10 repetitions, three times.  
• Sit to stands
  • From a seated position, raise to a standing position. Then lower yourself back into the chair. Repeated for 10 repetitions, three times.

Written By

Levi Norsworthy
Physiotherapist

PhysioMotion Cairns
Shop 5/9-11 Stokes Street
Edmonton QLD 4869

(Servicing Edmonton, Gordonvale, Bentley Park, Mount Sheridan Community)

Tennis Elbow

Do you have elbow or forearm pain that gets worse when you try to hold things? Maybe you have recently picked up a new hobby or job that requires you to use your hands a bit more? For example, using a hammer all day or typing on a keyboard for long hours without a break are both repetitive movements, and if it is something your muscles and tendons aren’t regularly doing then you may have overworked them.

Diagnosis/Description:

Tennis elbow or “lateral epicondylalgia/epicondylitis” is commonly caused by repetitive movements or overuse of the muscles and tendons in the elbow.

Gold standard for diagnosis:

• Point tenderness at the lateral epicondyle is nearly consistent
• Tenderness of the epicondylar muscle bodies just distal to this point is frequent
• Pain with wrist extension against resistance
• Absence of pain during maneuvers that load the ECRB + absence of US/MRI abnormalities suggest diagnosis other than tennis elbow.

Symptoms/barriers

Here are some common symptoms that are associated with this issue:

1. Pain from the outside of your elbow and down the back of your forearm
2. Pain or weakness when holding or squeezing objects
3. Pain or weakness when bending your wrist

Relevant anatomy:

There are 4 muscles that attach to the lateral epicondyle of the humerus. Most studies suggest that the tendon lesions and beginning of tennis elbow originate from the Extensor Carpi Radialis Brevis (ECRB). This is because the tendon has to tolerate greater loads than the other tendons.

Why it is generally the extensor carpi radialis brevis (ECRB)

• ECRB is in direct contact with humeroradial joint line (joint loads transferred directly to ECRB)
• At this site, ECRB is tendinous whereas others are muscular = less able to heal after injury
• Greater fragility due to the tendon footprint on the epicondyle being 13 times smaller than ECRL
• Friction on deep surface of ECRB and capitellum during F/E

Severity (grades):

Stage 1. Recent; transient inflammation

Stage 2. Angiofibroblastic hyperplasia characterised by high cell counts, blood vessel hyperplasia, and collagen fibre breakdown

Stage 3. Lesions may progress to partial- or full-thickness tendon tears

Stage 4. Fibrosis and calcification

Demographic/Prevalence:

• 1-3% of adults each year
• 10-50% of tennis players
• Workers who repeatedly exert excessive exertion for an extended period risk developing tennis elbow.

Prognosis:

• Spontaneous recovery without treatment within 1-2 years
• After 1 year = Physiotherapy has slightly better results than no treatment (Smidt et al. Randomised 185 pts to corticosteroid, physio, or no treatment)

Treatment:

• Physio is the first line of treatment with the below modalities being some techniques your Physio may try. 
  • Eccentric exercises
  • Mobilisations
  • Deep friction manual therapy
  • Education
  • Dry Needling

Ref:

Management of Lateral Epicondylitis (Orthopaedic & Traumatology: Surgery and Research)

The 100 most cited articles in lateral epicondylitis research: a bibliometric analysis (Frontiers in Surgery)

Written by

Kalani McKenzie Tonga
Physiotherapist

PhysioMotion Cairns
Shop 5/9-11 Stokes Street
Edmonton QLD 4869

Rotator Cuff (Shoulder) Injuries

Click here to book an appointment!

Created by

Kalani McKenzie Tonga
Physiotherapist
PhysioMotion Cairns
Edmonton QLD 4869

Navigating the Spine: Understanding and Addressing Thoracic Spine Sprains, Strains, and Kyphosis

Thoracic Spine Sprains: The Unseen Disruptors

Picture this: a sudden twist, a moment of overexertion, or the aftermath of a traumatic incident. These are the scenarios that can set the stage for thoracic spine sprains. Ligament injuries in the middle of the spine can be deceptively subtle yet powerfully disruptive.

The consequences of this however, extend beyond the localized pain and stiffness. The intricate ligamentous network disrupted by a sprain prompts protective muscle spasms, compounding the discomfort.

Referred Pain and Adaptations:

The pain from thoracic spine sprains doesn’t always stay confined to its origin. Referred pain may extend into the shoulders and upper back. The limited range of motion triggered by a sprain can prompt compensatory movements, affecting adjacent spinal segments and joints. It’s a domino effect that demands attention.

Breathing Blues:

Consider the thoracic spine as the conductor orchestrating the symphony of breathing. When sprains disrupt this conductor, the entire respiratory ensemble may falter. Thoracic spine sprains can hinder the natural expansion and contraction of the chest, potentially compromising lung function and respiratory efficiency.

Thoracic Spine Strains: Untangling the Web of Muscular Dynamics

Now, let’s pivot to the realm of strains, where muscles and tendons take center stage. Thoracic spine strains introduce a different set of challenges, intricately weaving their impact through the soft tissues of the body.

Muscular Imbalances and Compensation:

Strains in the thoracic spine upset the delicate balance between muscles and tendons. As the body strives to compensate for the injured area, muscular imbalances may emerge. These imbalances not only affect posture but also contribute to additional strain on surrounding structures.

Radiating Pain and Neuromuscular Symphony:

Thoracic spine strains are not confined to a localized discomfort. The pain may radiate, extending into the arms or lower back. This radiating pain can disrupt neuromuscular control, potentially leading to altered patterns of movement and decreased functional efficiency. It’s a symphony of movement that demands harmony.

Kyphosis: Beyond the Hunch

Now let’s enter the world of kyphosis, where the natural curvature of the thoracic spine takes an exaggerated bow. 

Altering the Spinal Landscape:

Kyphosis influences more than just the thoracic spine. The alignment of the entire spinal column, including the cervical and lumbar regions. This may contribute to conditions like cervical strain or lumbar lordosis as the body adapts to the altered curvature.

Impacts on Vital Systems:

The impact of kyphosis extends to vital systems housed within the thoracic cavity. In severe kyphosis, it can compromise respiratory function, reducing lung capacity and cardiovascular efficiency. It’s a reminder that spinal health goes hand in hand with the well-being of the entire body.

Holistic Solutions: A Physiotherapist’s Approach

Navigating the complexities of thoracic spine health requires a holistic approach. As physiotherapists, our role transcends symptom alleviation; it encompasses understanding the root causes and addressing their systemic impacts.

Our approach involves a thorough assessment to unravel the intricacies of each case. Whether it’s a sprain, strain, or kyphosis, a personalized intervention plan is crafted. Manual therapy, targeted exercises, and posture correction strategies form the pillars of rehabilitation.

Lifestyle Modifications for Long-Term Health:

Beyond immediate interventions, we emphasize lifestyle modifications. Ergonomics, mindful movement practices, and postural awareness become powerful tools for individuals to take charge of their spinal health.

Empowering Beyond the Clinic:

Our goal extends beyond the clinic walls. It’s about empowering individuals with the knowledge and tools to proactively manage their thoracic spine health. By adopting a holistic perspective, we not only manage specific conditions but also foster overall musculoskeletal harmony.

In conclusion, the thoracic spine is more than just a segment of bones; it’s a central player in the symphony of movement that defines our daily lives. Thoracic spine sprains, strains, and kyphosis are not isolated challenges; they are interconnected threads that weave through the entire musculoskeletal canvas. By understanding these intricacies and embracing a holistic approach, we embark on a journey toward a resilient, harmonious spine.

Written By

Jessica Beer
Senior Physiotherapist

PhysioMotion Cairns
5/9-11 Stokes Street
Edmonton QLD 4869

All About Headaches

I’m sure we have all had a headache at one point in our life. That intense feeling that you just can’t shake no matter what you try. Headaches are commonly experienced by people of all ages and can come with varying presentations.  

What types of headaches do Physios most commonly see? 

Physiotherapy has shown to be very effective in treating certain types of headaches. Two certain types of headaches that we commonly treat are tension headaches and cervicogenic headaches. 

What are these headaches and what do they involve?

Both of these types of headaches are often related to a dysfunction or tightness in the joints and muscles of the neck and upper back. These types of headaches can be referred to as a dull or pressure headache and often start in the back of the head and can radiate around to your forehead or behind your eyes. 

As physiotherapists, we are trained in assessing and treating clients with headaches and may often prescribe light stretching or strengthening exercises to help any tight joints and muscles relax, thus reducing symptoms. 

What you can do at home to manage your headaches?

• Drink lots of water to stay hydrated
• Try and get some quality sleep. Consider how your pillow may be affecting your sleep quality alongside your neck position. 
• Take time out of your day to relax/ do something you enjoy in order to reduce stress levels
• Consider if environmental factors set off your headaches – Is it the food you are eating? Bright lights? Certain smells? 
• Take regular breaks when doing one task for a while – take time to stretch your neck and shoulders 

Can poor posture give me headaches? 

Poor posture is one of the biggest factors that we see that can lead to headaches. In particular tension in your shoulders can cause you to hitch your shoulders leading to tightness and pain. Additionally, with the dependency on using technology, in particular computers, often we find most people will poke their neck out in order to get closer to the screen. This sustained neck poke can cause straining in the muscles at the back of your neck. That’s why regular stretching is important, especially with jobs that are sedentary, stressful or require a lot of neck movement. 

What do Physiotherapists do for headaches? 

Physiotherapists work on releasing both stiff or tight joints and muscles. This is often through hands-on manual therapy with joint mobilisations, massage and maybe even some dry needling. Physiotherapists not only physically treat your neck, but we look for ways to reduce your headaches in the future. This may include but isn’t limited to looking at your work set up, sleeping position or stretches that may benefit you. 

Stretches 

Regular stretching can significantly help reduce the intensity and frequency of your headaches by  reducing tightness in your muscles and joints. Try these three stretches at home regularly and see how they work for you.  

1. Looking straight forward, bring your ear to your shoulder and tilt your head to the side, hold for 20 seconds. You may use your hand for overpressure. 
2. Look down towards your armpit and hold for 30 seconds. You may use your hand again to apply overpressure. 
3. Look up and down multiple times making sure to keep your chin tucked in 

Self massage  

• Hold your fingers on your temples and lightly push – this can help relieve pressure in that area as well as feelings of tightness behind the eyes
• Place your fingers at the back of your head along the top of your neck/bottom of your skull. Apply some pressure here and hold it for 10 seconds, this can ease your headache.

When to seek extra help?

Please speak to your doctor if you experiencing the following:

• Fainting
• Nausea or bouts of intense dizziness 
• Trouble speaking or swallowing 
• Visual disturbances such as double vision 

If these symptoms resonate with you, contact one of our friendly team members today to have an assessment and develop a management plan. Click here to book an appointment!

Written by
Amelia Sant
Physiotherapist

PhysioMotion Cairns
Shop 5/9-11 Stokes Street
Edmonton QLD 4869