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Femoroacetabular Impingement

photo courtesy of Mayo Clinic website

Femoroacetabular impingement- what a mouthful! Really, it’s just a fancy name for when your leg bone or your femur impacts with your hip bone or your acetabular. This occurs because the hip bone or femur is an irregular shape and not smooth causing the joint to impinge. 

Normally your hip bone is the socket and your femur is the ball, fitting perfecting together. However, in individuals with FAI, because of the irregular shape the joint is no longer a perfect fit, causing pain when moving the hip.

People can have FAI all their life and not be symptomatic, however sometimes due to overuse or muscle in balance, symptoms start appearing. These can include hip and groin pain on certain movements as well as clicking, pinching and restricted range of movement. 

FAI can be diagnosed by a physiotherapist in conjunction with MRI images to confirm the type of FAI present and thus determine how to manage it. Sometimes it can be conservatively managed through rest, avoiding aggravating factors and hip strengthening to help support the joint. However, in other cases, surgery is needed to alter the shape of the joint and prevent any further complications from constant impinging. After surgery, a strengthening program prescribed by a physiotherapist is essential to return to sport and everyday activities.

Early diagnosis and intervention is the key, so book an appointment today at Capital Physiotherapy and we can have you back to doing what you love in no time! You may make an online booking or email us at info@capitalphysiotherapy.com.au

House Maid’s Knee

What a funny name for an injury! But what is it? 

This injury is commonly seen in patients who work or spend most their time on their knees. For instance, floorers, carpenters and in more historic times house maids who scrubbed floors thus the name, “House Maid’s Knee”. 

So, what is it?

House maid’s knee occurs when the bursa or fluid-like sac, that sits on top of your kneecap becomes inflamed from repetitive kneeling. Normally the bursa decreases the friction between the skin and kneecap but sometimes it can become inflamed and irritated when there is too much weight-bearing and loading on the kneecap. This can cause swelling, heat and inflammation leading to restricted movement and increased pain at the front of the knee.  

Thankfully, house maid’s knee can be easily treated by a physiotherapist. A course of anti-inflammatories can be taken to help reduce inflammation along with applying ice to the knee to decrease swelling. After this, stretches will be prescribed to reduce friction around the knee along with strengthening exercises to help support joint during movement. 

If are having knee issues or have any concerns, contact Capital Physiotherapy at info@capitalphysiotherapy.com.au and we can have you back to work in know time!

Peroneal Retinaculum Tear

“POP”- went my ankle!

If this happened to you, could have a peroneal retinaculum tear. But what actually is it? 

Your peroneal muscles sit on the outside of your shin bone and run down to the outside of foot. They help stabilise the ankle when walking, running and jumping. Normally the tendons are kept in place alongside the outside of your ankle by a specialised structure called a retinaculum. But sometimes a forceful landing on a flexed foot or twisting action can cause these structures to tear and go “pop”. When these structures are no longer holding the tendons in place, they can move over the outside of your ankle when walking, pointing and flexing your foot. Not only can this be quite painful, but it can also be visible. 

Depending on the severity of tear, sometimes surgery is needed to repair the retinaculum.  After surgery, a cast or boot is used to help stabilise the ankle and allow the new tissue to heal successfully. Once the cast is off, a strengthening program is prescribed by a physiotherapist to help you return back to normal function.

In some cases, conservative treatment is used. This can also include a period of time in a boot or cast for approx. 4-6 weeks or the use of ankle strapping to help stabilise the ankle joint. Additionally, a physiotherapist will provide exercises to strengthen the calf and other foot muscles to in order to support the ankle in the long term and prevent any further complications. 

While it does sound like a scary injury, physiotherapists at Capitol Physiotherapy are here to help. We can help you manage and decide the best course of treatment suited to you and your situation and have back to normal in no time! If you’re near the area in any of our clinics, contact us via online booking or drop us an email at info@capitalphysiotherapy.com.au.

Posterior Ankle Impingement in Dancers

Posterior ankle impingement is a very common injury in dancers that can be managed and treated by physiotherapists. It is caused when the ankle joint is constantly forced into excessive plantarflexion or pointe, thus why its common in ballerinas who dance in pointe shoes. The bones at the back of the foot impinge and compress the tendons and muscles in this area causing pain and restriction when pointing the foot. The repetitive trauma created by the impingement can cause scar tissue to form, thickening the tendons in the area and restricting movement of the ankle further. In some rare cases, posterior ankle impingement is caused by an os trigonum, which is an extra piece of bone attached to the back of the ankle and is present at birth in some individuals. Most of the time people are unaware they have this extra piece of bone until it becomes an issue. 

Common signs and symptoms can include:

  • Localised pain at the back of the ankle during excessive ankle plantarflexion or pointing 
  • Tender to touch at the back of ankle
  • Restricted plantarflexion or pointing 

While this injury can be quite painful and sometimes a significant issue especially in ballerinas, it can be easily treated by a physiotherapist. Initially, some rest and avoidance of painful activities may be needed to reduce inflammation, however a rehabilitation program needs to be developed in order to reduce pain and improve function in the long term. This can include mobilising the joints of the ankle to create more space within the joint, strengthening and stretching the surrounding and deep muscles and improving balance and proprioception in the ankle. 

If you are experiencing similar ankle issues or have any concerns, contact us today at info@capitalphysiotherapy.com.au. At Capital Physiotherapy, we have a special interest in dance injuries so book an appointment today and we can have you back in pointe shoes in no time. 

Marathon Preparation

With the Melbourne Marathon less than 4 weeks away (13th Oct, 2019), you are likely to have increased your mileage on your running. However, if you are overtraining and are being repeatedly pushed over your limits without adequate recovery, your chances of injury are dramatically increased. 

The reasons for your injuries are variable and could result from lack of strength, poor running gait, inappropriate shoe attire, not warming up or overtraining (Saragiotto et al, 2014). These “little niggles” in your training can be further explored by a physiotherapist so you can optimise your marathon training regimen. Most importantly, research suggests a strength program can improve performance and reduce injury risk. However, strength training may take a while for it to yield its results, so with the Melbourne Marathon just around the corner, a physiotherapist can help create short-term strategies to overcome the barriers to your run. However, it is important to create a strength program to yield long-term results for your next marathon!

As you prep for your marathon, make sure you keep a few things in mind:

  • Give yourself adequate rest and sleep! Muscle recovery is just as important as being active, so give your body enough breaks. 
  • Eat well. Proper nutrition gives the body adequate fuel during your runs and recovery. If you need help with nutrition, it will be beneficial if you seek assistance from a registered dietician. 
  • Strength and conditioning (S&C) routine 
  • Schedule your runs appropriately

Every person is different on what works best for them. If you need assistance, a physiotherapist at Capital Physiotherapy can help create a plan with your goal in mind! Capital Physiotherapy can also do running assessments, manages sports injuries, and can create a strength program. We are conveniently located at South Yarra, Footscray, and Hawthorn (Formerly at Balwyn). You may call 0401 865 333 or drop an email at info@capitalphysiotherapy.com.au.

Corticosteroid Injection for Tennis Elbow

Tennis/Golfers/Climbers

You may have heard of corticosteroid injection (CSI) or autologous blood injection (ABI) to help relieve pain from your tennis or golfers elbow. CSI is when corticosteroid is injected to your tendons where it has the ability to act as an anti-inflammatory. CSI is a very strong drug in which it can control symptoms of pain, however, there are risks of long-term use of CSI. The risks include:

  • Induced osteoporosis 
  • Impaired ligament repair 
  • Injection site reaction

ABI is a medical procedure whereby your blood is injected into your tendon to stimulate a healing process for the tendon. Although, these procedures may seem promising to reduce your pain, evidence has suggested that CSI provides short-term pain relief (Coombes et al., 2010), but there were worse outcomes a year after CSI (Coombes et al., 2013). Comparatively, ABI has shown to have a better effect than CSI, but only lasting effects of 6 months to one year after multiple injections (Chou et al., 2016; Elmajee et al., 2016).

A more preferable, non-invasive and friendly treatment for tennis/golfer’s elbow is to visit a physiotherapist for the management of your elbow pain. Physiotherapy has more benefits and have fewer to no risks compared to CSI and ABI. Tennis/golfer’s elbow is a condition where the tendons of your elbow are affected and painful. Although, tendons LOVE load, they are very sensitive to change of loads. Change of loads are:

  • Increased activity of the arms above what it is normally used to. For example, if you normally work at a computer job, then you start gardening.  
  • Change of tools. Tools come in different weight and size and a slight change of tools can change the load of the tendons. 
  • Using the arms in a different way 
  • A quick change of arm movement. For example, quickly catching a falling object may be a movement you’re not used to and can be the tipping point of what your tendon can tolerate 

At Capital Physiotherapy, a physiotherapist can help explore management strategies of your elbow pain. If you require advice on CSI, ABI, and physiotherapy, we are conveniently located at South Yarra, Footscray, and Balwyn. You may drop an email at info@capitalphysiotherapy.com.au or do an online booking here.

Stiff Back from Prolong Sitting Can Lead to Shoulder Pain

Shoulder pain is one of the most common issues treated by physiotherapists in this day and age. While there can be many causes of shoulder pain, poor posture is one of the main factors. 

The “hunched” position or curved upper back as a result of prolonged desk and computer work can change the way your shoulder moves in everyday activities and cause our upper back to become stiff. Over time muscles can become tight at the front of the shoulder, pulling it forward. As well as this, muscles at the back become weak and cannot support the shoulder blade correctly and the joints of the upper back become stiff, restricting movement. This changes the position of the shoulder blade and causes impingement and pain during everyday activities such as lifting and dressing.

Common signs and symptoms include:

  • Pain felt at the front of the shoulder 
  • Pain with lifting to the front and side 
  • Decreased range of movement
  • Feeling restricted and stiff in the upper back 

When we have good posture, our shoulders can move freely without pain and restriction. Here at Capital Physiotherapy, we can help strengthen and retrain your posture so your muscles can support your shoulders correctly and allow the shoulder to move correctly. As well as this, we can help release tight muscles at the front of the shoulder and tight joints in the upper back to aid movement and decrease pain. 

To learn more about our physiotherapy programs and exercises, email us at info@capitalphysiotherapy.com.au or make online booking at https://www.capitalphysiotherapy.com.au/online-booking/.

Shoulder Impingement

The shoulder is a “ball and socket” joint, which means the shoulder can move in all kinds of directions. The cause of shoulder pain is not only isolated only to the shoulder, as many different factors may play a role in shoulder pain such as the neck, your posture, and how you use your arms.

A common shoulder condition in physiotherapy is called Rotator Cuff Impingement, which can be presented as pain in the front, back, or top of the shoulder. The rotator cuff are muscles that act to keep your shoulder joint centred in the socket of the shoulder blade, allowing your shoulder to move in many different ways. The tendons of the rotator cuff travel through and around the shoulder, which may be susceptible to impingement. When there is weakness to the rotator cuff, it can cause the shoulder joint to be off centred and move in the direction where it may irritate the tendons of the rotator cuff.

As mentioned above, muscle imbalance is one of the many ways to develop a shoulder impingement. Your posture, neck, and how you use your arms in your daily life can affect how impingement happens.

You may consult with a physiotherapist at Capital Physiotherapy to discuss about your shoulder pain and investigate if you have a Rotator Cuff Impingement. The physiotherapists at Capital Physiotherapy are trained to assess and treat shoulder conditions like impingement. We are conveniently located at South Yarra, Footscray, and Balwyn. You may drop an email at info@capitalphysiotherapy.com.au or do an online booking here.

Cervicogenic Headaches

Are you experiencing headaches? A large proportion of headaches are migraines and tension-type headaches; however, a common type of headache physiotherapists can assess and treat are cervicogenic headaches. Neck pain and headaches are frequently associated with headaches (Ashina et al., 2015), indicating the structures around the neck and shoulder may contribute to the headaches.  

Cervicogenic headaches are characterised by 

  • Pain and headache starting in neck and behind head and travels to the front
  • Usually only on one side 
  • Headache does not move from left to right 
  • Headaches are associated with posture, sustained positions such as sitting at a computer for too long, or turning neck in a particular position 
  • Neck pain 
  • Tight neck movement 

The development of cervicogenic headaches may involve your joints and muscles, which have pain generators that can create a headache. Your daily habits, posture, trauma to the head, or stress are ways you can develop a cervicogenic headache. Physiotherapists can trial different treatments to help relieve your headache, which may include:

  • Exercise: An important factor in long-term effects to help with strength and endurance of postural muscles and optimally using your muscles. High quality evidence has supported the use of exercise to help with long-term effects of headaches    
  • Dry Needling: A technique in which acupuncture needles are strategically placed to relieve tight muscles and improve range. This technique is short term and should be reinforced with stretching and exercise
  • Deep tissue massage: A technique that uses firm pressure to help relieve pain generators that travels up to create a headache. 
  • Joint Mobilisation: A technique that focuses on loosening up the neck joints to improve movement. This technique should be reinforced with active treatments such as self-mobilisation, massage, stretching and exercise
  • Taping: A short-term technique to help with postural awareness  

If you are experiencing headaches, you can visit Capital Physiotherapy to further assess and treat your condition. At Capital Physiotherapy, there are a wide range of treatments that can be done to help relieve and allow your take control of your condition. We are conveniently located at South Yarra, Footscray, and Balwyn. You may drop an email at info@capitalphysiotherapy.com.au

Runner’s Knee Pain (ITB Syndrome)

ITB Syndrome (Iliotibial friction syndrome) is one of the most common causes of “Runner’s Knee”. Being an overuse injury, it is caused by repeated trauma rather than a specific incident.
It arises at its proximal end from the tendons of the tensor fasciae latae and gluteus maximus muscles. From its origin, the Iliotibial tract travels along the lateral side of the thigh and across the knee joint, inserting on the lateral epicondyle of the tibia.

Sign and Symptom:

  • Pain with activities that require repetitive activities involving knee flexion-extension
  • Burning pain at the outer aspect of the knee.
  • The pain tends to be worse when running or coming down stairs.
  • There may be an audible snapping sensation the knee bends due to the band flicks over the bony tubercle.
  • There may also be some swelling on the outer side of the knee.
  • Pain is also exacerbated when running a long distance.
  • The onset occurred most frequently at the lateral knee after 2-3 km of running, or hiking over 16km.

At Capital Physiotherapy, all our physiotherapist is able to assess your running and come up with strategies to help you during your run. At capital physiotherapy, we have clinicians who have ample experience returning athletes back to sport. If you’ve got lingering pain that is sticking around longer than expected, book in with one of our friendly physiotherapists and get some recommendations on what to do. We are conveniently located at South Yarra, Footscray and Hawthorn (Formerly at Balwyn) so choose a clinic most convenient for you. You may drop an email at info@capitalphysiotherapy.com.au or do an online booking here.