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The Surprising Truth About Osteoarthritis

Sufferers of knee pain know that nothing can kill your optimism for a recovery faster than a diagnosis of Osteoarthritis (OA).

Osteoarthritis is often seen as a kind of death sentence for joints. Many people believe that if you have OA your pain will never improve and will only get worse until a joint replacement can be performed. In fact, joint replacements for hip and knee OA are some of the most common and indeed successful operations performed by orthopedic surgeons.

At least this has been conventional wisdom for decades. Many of us see our bodies like cars – when a part ‘wears out’ it needs replacing with a new one. The truth is much more complicated, mainly due to our bodies’ incredible ability to adapt and change.

Physiotherapists have always known that the pain and disability that comes with arthritis can be improved with a closely targeted exercise program. In some cases, the pain that is attributed to OA is actually due to another, entirely treatable cause. In other cases, strengthening the musculature around the painful joint can have a significant effect by providing the joint with extra support.

The way we move is often affected negatively by pain and this in itself can create a downward spiral. This is not to say that in some cases, surgery is the best and most effective option to improve your quality of life. Rather that there is a strong case to see a physiotherapist to seek treatment for your knee pain first.

Physiotherapists are highly skilled at identifying exactly what is causing your pain and helping you reach the highest level of function. In fact, a recent study has shown that with targeted exercises, directed by physiotherapists – many patients who were scheduled to have surgery were able to improve their quality of life dramatically, avoiding surgery and getting back to their favourite activities.

While exercise is a very powerful treatment, it’s not that any exercise will take away any pain. To be effective, you will need to have a full assessment and have a personalized treatment program created by your physiotherapist. This can involve identifying weak muscles, limitations in flexibility, finding painful trigger points, restoring movement to stiff joints and providing a biomechanical assessment to make a combination of changes that can make a large difference to your pain and activity levels.

Your physiotherapist can also identify any external factors that may be contributing to your pain. Such as unsupportive footwear, workplace set up etc. Talk to us to see how we can help you manage your osteoarthritis.

This information is not a replacement for proper medical advice. For advice on your individual condition, please contact our practice.

Caboolture Physical Therapy Centre – serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.

Where is your pain really coming from?

Have you ever been to see a physiotherapist for pain in one part of your body and, when they treated you, they focused on a completely different area?

While this can be a strange experience, it can be even more puzzling when the treatment actually works.

So what is going on? Shouldn’t pain be treated where it is being felt?

When pain is felt at a different location from where the pain is being caused, this is called ‘referred pain’ and is actually more common than you think. Exactly why this happens is a little complicated, and in fact, we don’t yet understand everything about the way that pain is processed.

Pain is usually felt when something causes damage to the body, sending an electrical impulse to the brain. The brain receives this information and process it to make sense of which part of the body the signal is coming from and what kind of pain it is.

When the brain thinks that the pain is coming from a different area than where the damage or signal is actually coming from, this creates the phenomenon of referred pain.

Referred Pain

Sometimes referred pain is easy to explain, such as when a nerve becomes injured or irritated, causing the pain to be felt along the length of the nerve. This often feels like a sharp, burning pain that runs in a strip, along the skin. Other examples of referred pain are more difficult to explain and in some cases seem to defy explanation. Perhaps you have heard about the strange phenomenon of phantom pain where amputees continue to feel pain as though it was in the place where their limbs used to be.

Muscular trigger points can also cause referred pain. The mechanism behind this is a bit trickier to understand, but is thought to be explained by tight bands of muscle tissues that cause pain to be felt in predictable patterns around the body.

Other tissues of the body can cause pain to be felt in a different location

This includes discs of the spine and internal organs. Many times the internal organs can refer pain in peculiar patterns and this can actually lead to serious illnesses being mistaken for muscular aches and pains.

Kidney pain can be felt in the lower back and tragically, some people fail to recognize that they are having a heart attack because they feel pain in their neck and arm, not in their chest.

We also know that not understanding or being afraid of pain can make pain feel stronger. In rare cases, people who have pain in one hand can feel pain just by seeing their other hand moving in a mirror.

There are many other fascinating aspects to pain, and understanding how it works is an important part of managing your symptoms.

To understand how referred pain may be affecting you, chat with one of our physiotherapists who can help answer your questions.

Caboolture Physical Therapy Centre – serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.

Ankle Sprains: can physiotherapy help?

What is an ankle sprain?

Almost everyone has twisted their ankle at some in their life; in fact, it is one of the most common reasons for people to visit an emergency department.

Technically an ankle sprain has occurred when an ankle twists, causing damage to one of it’s supporting ligaments. The ligaments can be overstretched, partially torn or completely ruptured, depending on the force of the injury. The ligament that is most often involved is the ATFL, or the anterior-talofibular ligament, located on the outside of the ankle.

While there are many ligaments surrounding and supporting the ankle, this ligament is the most vulnerable as it stops the ankle from rolling inwards, which is the way that most ankles are injured. Athletes who jump while moving in different directions, such as basketball players, are the most prone to this injury as they often land on their foot when it is not completely flat, twisting it and injuring the ligaments.

What are the signs and symptoms?

Most people won’t have any problem diagnosing that they have a sprained ankle. The symptoms are pain, swelling and tenderness over the area of damage, usually the outside of the ankle.

Depending on the severity of the injury, there may be bruising, reduced range of movement, instability and pain with weight bearing. In more severe injuries there may even be a loss of function, where you are unable to walk on the ankle and numbness and/or a feeling of coldness in the foot.

Why should I see a physiotherapist?

Twisted ankles can also cause a fracture of the ankle, not just ligament damage and many times a bad sprain and a fracture cannot be told apart without proper medical assessment and an X-ray. Your physiotherapist is able to identify if your sprain is severe enough to need further investigation to rule out a fracture.

They will also classify the severity of the sprain, providing you with a clear course of treatment. There are many factors that can lead someone to be more prone to fractures, including general hyper flexibility, unsupportive footwear and anatomical structure, however by far the most common reason for an ankle sprain is the existence of a previous sprain without complete rehabilitation.

This is because, following an ankle sprain, many people are left with weakness, instability or stiffness, reduced balance and proprioception – which is a sense of where your body is positioned. These things can mean that the next time your ankle is in a vulnerable position you don’t have the strength, awareness of position, balance or structural control to ensure it is in the correct position before putting all your weight through it, causing another injury.

As well as helping you reduce and recover from the pain and swelling of the injury in the early days. Your physiotherapist is trained to identify which issues are likely to affect you in the future and assist you with a personalized rehabilitation program to ensure your ankle is as strong and stable as possible to prevent future injuries.

The information in this newsletter is not a replacement for proper medical advice. Please contact the Caboolture Physical Therapy Centre for advice on your individual condition.

Caboolture Physical Therapy Centre – serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.
What is referred pain?

Referred pain: What is it and how can I manage it?

What is referred pain?

Referred pain occurs when pain presents in one area but the cause and origin are located elsewhere. This occurs due to sensory nerves being impacted with too high or low a signal being sent through the central nervous system.

The central nervous system sends messages to soft tissue, bones and organs throughout the body, potentially impacting these areas. Referred pain can be reported as; an ache, deep pain, pins and needles, numbness, or as pain in a specific area. Alternatively, you may get referred pain due to muscles or even your organs.

What are the common types of referred pain?

There are common types of complaints which include referred pain, such as; headaches, low back pain and knee arthritis.
Headaches can be referred pain from tight muscles or nerves at the base of the skull, around to the top of the head, temples and the jaw with the symptoms originating from the joints or muscles within the neck.

Experiencing pain in the back of the leg could be due to the irritation of the sciatic nerve in the lower back. Alternatively, low back pain can refer into the hip, groin, leg(s) or further up your back.

Arthritic changes occur when cartilage within the joint wears away. For example; within the knee, pain can be referred around the knee or in other areas of the leg due to the exposure of nerves within these areas.

Muscles may refer pain. Typically from trigger points within the muscle belly due to overuse or underuse. This could be because of poor posture, lack of movement or abnormal movement patters. Trigger points have distinctive referral patterns throughout the body.

Organs within the body can also refer pain. This is often described as a deep ache. This pain often won’t have a set pattern and you can experience pain far away from the affected organ. For example; the heart causing pain in the neck and/ or arm.

To help find the cause or to manage your referred pain talk to your physiotherapist at Caboolture physical therapy centre who can help manage your symptoms and answer any questions that you may have.

Caboolture Physical Therapy Centre – serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.
Caboolture Physio_Hip injuries_Femoroacetabular Impingement

Femoroacetabular Impingement (FAI)

What is it?

When the two surfaces of the hip joint move over each other, they usually move freely without any friction. If there is an alteration to either the socket part of the joint (the acetabulum) or the ball (the head of the femur), irritation may occur as the two surfaces move over each other. This is known as Femoroacetabular impingement, a common disorder of the hip, characterized by pain and stiffness.

Femoroacetabular impingement can be classified as cam, pincer or mixed. A cam FAI occurs when the femoral head junction is flattened or a small bump is present. Pincer type of impingement occurs when the acetabular rim extends slightly, causing the femur to be impacted. Cam impingement is more common in men while pincer impingement is more common in women. However, most cases of FAI (about 85%) are mixed, meaning they both have cam and pincer types of impingement.

What are the symptoms of FAI?

The most common symptom of FAI is pain located in the hip or groin when resting in certain positions of with specific movements. Some patients also report pain in the back, buttock or thigh. Other symptoms include stiffness, loss of movement range (particularly of the hip), locking, clicking or a feeling that the hip is about to give way.

Activities that cause the incongruous surfaces to move over each other repeatedly are naturally the main culprits for causing symptoms. These can include prolonged sitting, twisting, sitting with crossed legs, squatting and climbing stairs can all aggravate the pain caused by femoroacetabular impingement.

What are the causes?

There are many factors that may cause an individual to develop femoroacetabular impingement including;

  • Hip dysplasia or malformation during infancy/childhood
  • Repetitive stress on the hip
  • A femoral neck fracture that did not heal properly (malunion)
  • Small bony growths around the joint called osteophytes
  • Normal anatomical variation

How can physiotherapy help?

Femoroacetabular impingement is a complex condition and researchers are still determining the best possible treatment. It is thought that untreated FAI can lead to osteoarthritis of the hip down the track and there are both surgical and non-surgical options for treatment. Conservative (non-surgical) management for FAI involves core stability training, strengthening exercises for the lower limb specifically the hip and postural balance exercises. This program aims to improve the hip’s neuromuscular function.

A hydrotherapy program can also help as it reduces weight through the joint, making movements more comfortable. Lastly, a home exercise program is made for patients, so they can continue treatment at home. For many people, physiotherapy is enough to resolve their symptoms and prevent future problems, however, others may require surgery.

With surgery, hip arthroscopy is the most common procedure for this disorder and is used to change the shape of the joint slightly so that there are no points of irritation with movement. After surgery, patients are usually referred to physiotherapy for rehabilitation.

The information in this newsletter is not a replacement for proper medical advice. Please contact our reception for advice on your individual condition.

Caboolture Physical Therapy Centre – serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.