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Osteoporosis – What is it and how can your Physiotherapist help?

Osteoporosis is a condition characterised by very low bone mass or density. Low bone mass can occur when the body loses too much bone, doesn’t make enough – or both. Osteoporotic bones become weak and fragile and can break from small forces that would normally be harmless.

 

 

But as well as loss of bone density and mass, osteoporotic bones may also be affected by abnormal changes to the structure of the bone matrix, which further contributes to weakness.

Osteoporosis is an extremely common bone disease, and women are more affected than men. As it is a progressive disorder that worsens with age, while the disease process might begin earlier, the effects are usually only noticed and diagnosed in people who are 50 years and older.

What are the Signs and Symptoms?

Often called a silent disease, many people will have no idea that they have the disease, as there are no obvious symptoms. In fact, sometimes the first sign that an individual has osteoporosis is when the first bone breaks. Along with fractures, which are the most serious signs of this disease, osteoporosis can cause the upper back to become excessively hunched (itself often a result of spinal wedge fractures) and there may be widespread pain as bony tissue is increasingly unable to withstand normal forces.

Fractures are a serious problem, especially in seniors. Bone breaks due to osteoporosis occur most frequently in the wrist, spine or hip. When the spine is affected by osteoporosis, people may develop a hunched or stooped posture. This can lead to respiratory issues and place pressure on the internal organs. Osteoporosis can severely impact a person’s mobility and independence, which can have an enormous impact on quality of life.

What Causes It?

As this is primarily a metabolic disorder, there are a variety of things that can cause osteoporosis if they either interfere with the body’s ability to either produce bone tissue or encourage excessive breakdown. This can be anything from gastrointestinal conditions that prevent absorption of calcium, lack of dietary calcium or low levels vitamin D, which is essential for absorption of calcium.

Certain medications may also cause bone loss especially if they are taken for a long time or in high doses. A good example is the long-term use of steroids. Although steroids are used to treat various conditions, it has been proven that steroids can cause bone loss and eventually, osteoporosis.

As bones respond to force and weight bearing by building more bone, having a sedentary lifestyle or doing activities with low impact (i.e. swimming, cycling) can also lead to osteoporosis.

How Can Physiotherapy Help?

Physiotherapy can help you avoid or recover from fractures and improve your overall bone health. Physiotherapy exercises can direct you to safely increase your weight bearing, which can help build bone mass. Balance training is also an important factor as this can reduce the risk of falls. Your physiotherapist can also educate you on how to adjust your lifestyle, at home or at work, to protect your bones and improve your posture.

This information is not a replacement for proper medical advice. Always see a medical professional 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.

The Hidden Risks Of A Sedentary Lifestyle

By now it should come as no surprise that prolonged periods of inactivity are bad for your health. It seems that the science is in, and the bad news is that long periods of sitting or inactivity is a risk factor for many diseases, independent of other factors such as obesity.

What does this mean?

This means that if you are hitting the gym for an hour a day, but are sitting down for long periods during the rest of the day without moving, you may not be avoiding the health risks that come with sitting.

So why is sitting so bad?

There is evidence that shows that when sitting for long periods, our bodies show unhealthy changes in blood pressure and blood sugar levels that over long periods of time can lead to increased risk of diabetes, dementia and obesity. How much sitting is considered too much and how long it takes for these changes to take place is up for debate. What we do know is that regularly breaking up your periods of sitting is a healthy lifestyle choice you can make for yourself in the same way that drinking water, regular cardio exercise and eating vegetables are.

The insidiousness of the issue is that it’s likely that you are sitting much more than you used to without even realising it. Car commutes to work are getting longer, working days are often spent at a desk and with the rise of online T.V, you might be guilty of three or more hours stuck in one spot catching up with your favourite characters before you know it.

I have an office job, what can I do?

The first step to changing this habit is to start being aware of exactly how long you are sitting for an uninterrupted period of more than 20 minutes. Once you start noticing your daily patterns you can identify moments where changes can be made. We’ve heard of incidental exercise, but we’ll call this ‘incidental standing’. Consider standing on the train instead of sitting or standing when you have a document to read.

Here are a few other tips to get you moving;

  • Set an alarm to go off every half an hour that reminds you to get up and get a drink (this might also help to keep you hydrated)
  • Try out a standing desk
  • Stand up to take phone calls or get up to go ask a colleague a question instead of calling them
  • Take a walking lunch break

Speak to your physiotherapist for more ideas tailored to suit your individual lifestyle.

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.

Medical Collateral Ligament Injury of the Knee (MCL Tear)

What is it?

Your knee moves freely backwards and forwards; however, the thought of it moving from side to side probably makes you cringe. This is because the knee joint has sturdy ligaments on either side that prevent sideways movement and we instinctively know that a lot of force would be required to shift it in this direction.

The ligaments on either side of the knee are called the Medial Collateral Ligament (found on the inside of the knee) and the Lateral Collateral Ligament (found on the outside of the knee) and they each work to provide stability and restrict the knee’s movement in a sideways direction.

How does this injury occur?

The typical mechanism for this injury is a force that drives the lower leg sideways away from the upper leg. This can occur from an awkward landing from a height, or when twisting with a foot fixed on the ground or from an external force hitting the outside of the knee, such as with a rugby tackle.

What are the symptoms?

MCL tears have quite a distinctive set of symptoms, with pain and swelling noticed quite specifically to the inside of the knee. The severity of the pain and swelling will be related to the number of ligament fibres damaged. Larger tears will also make the knee feel unstable or loose.

To classify the severity of the injury and help to guide treatment, a grading system is used. With grade 1 indicating that a few ligament fibres have been torn and grade 3 used for a complete tear of the ligament with associated joint laxity. Very severe MCL tears often also involve injury to the medial meniscus and ACL and can require surgical repair. However, most MCL sprains can be managed well with physiotherapy. Grade 1 and 2 MCL sprains take between 2-8 weeks to fully heal and a complete rehabilitation program is strongly recommended to prevent future injury. 

How can Physiotherapy help?

In the early stages of the injury, treatment is focused on pain and swelling management, while allowing the body to start the healing process through inflammation. This is best managed through the R.I.C.E. principles (Rest, Ice, Compression and Elevation).

Following any injury, it is natural for muscles to waste a little and the damaged tissues to lose what we call proprioception, the ability to sense their own position in space. This loss of muscle strength and proprioception can contribute to further injury if not restored with a proper rehabilitation program.

Physiotherapy also aims to restore movement to the joint and support the ligament while healing to ensure that it is strong and healthy, and the scar tissue forms in an organized fashion, which makes the new ligament as strong as it can be and protects against future tears.

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.

Stiff Joints: Why They Hurt & How To Treat Them

Pain and stiffness often go together, but joint stiffness can occur its own.  Joint stiffness can limit your ability to perform usual tasks like turning your neck to check behind you while driving.  Stiffness can also be a warning sign that part of the body is vulnerable to future injury.

So what are the causes of stiffness?

     1. Disuse and Lack of Movement

Our bodies are made to move.

When we’re not regularly moving to our full range, we can begin to feel ‘tight’. The cause of this may be a combination of the capsule that surrounds the joint tightening up and the muscles that surround the joint shortening and losing flexibility.

Stiff and tight muscles can cause you to feel as though your joints are stiff, even if it’s only the muscle length that’s restricting the movement. Joint mobilisations, manipulation and muscle stretches/massage can have a significant effect in improving the symptoms.

Joint mobilisations, manipulation and muscle stretches/massage can have a significant effect in improving the symptomsThe most important way to maintain full movement is to regularly move joints through their full range. This also helps to keep muscles and joints healthy. Your physiotherapist can advise you on how to best approach this with a targeted set of exercises.

     2. Osteoarthritis (OA)

OA is a degenerative disease characterised by a breakdown of joint surface cartilage and the growth of bony osteophytes around areas of stress. While OA is increasingly common as we age, it is thought that the primary cause is abnormal load and stress to joint surfaces and not simply ageing itself.

As the joint space between two joint surfaces become uneven, joints affected by OA can feel stiff or even ‘blocked’. A person with OA will usually feel stiff for around 15-20 minutes after being still.

Physiotherapy programs that help strengthen the muscles surrounding the joints, to help absorb weight-bearing forces, have positive results on OA symptoms.

     3. Inflammatory Related Stiffness

The inflammatory process is characterised by swelling and pain around a specific area. Usually, this is a response to damage to the body. As an area swells, this will allow less space for movement and a sensation of stiffness, as anyone who has had sprained an ankle can attest to. Acute inflammation will cause swelling that increases over 24-48 hours and subsides gradually. Autoimmune disorders can cause the body to mistakenly have an inflammatory reaction where there has been no injury, with resulting pain and stiffness. Rheumatoid arthritis and ankylosing spondylitis are two examples of such disorders.

As an area swells, there’s less space for movement and hence we experience stiffness – as anyone who has had sprained an ankle can attest to. Acute inflammation will cause swelling that increases over 24-48 hours and subsides gradually. Autoimmune disorders can cause the body to mistakenly have an inflammatory reaction where there has been no injury, with resulting pain and stiffness. Rheumatoid arthritis and ankylosing spondylitis are two examples of such disorders.

Stiffness caused by inflammatory disorders is characterised by a feeling of stiffness after rest, particularly in the morning, which can take more than 30 mins to subside. Inflammatory disorders unrelated to injuries are complex in cause and require collaboration with medical teams for best treatment outcomes. Acute injuries are best managed by following RICE protocols (Rest, Ice, Compression, Elevation). Speak to your physiotherapist for more info regarding a specific 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.

On AC Joint Sprains (separated shoulder)

WHAT IS IT?

The AC (Acromio-clavicular) is a thick, fibrous joint that connects the top of the shoulder blade to the outer end of the collarbone. It’s required to be strong and supportive, and is the main way that weight bearing forces are transferred from the upper limb to the rest of the skeleton. The joint is connected by three strong ligaments: the Acromioclavicular, Coracoclavicular and Coracoacromial [as in the image below].

HOW DOES THIS INJURY OCCUR?

The main way this joint and its ligaments get injured is impact by a force that separates the shoulder away from the collarbone (usually in a downwards direction). This can occur from a fall where the top of the shoulder hits the ground first, a rugby tackle or a fall onto an outstretched hand. As with all injuries, there are many variations in severity and a grading system has been developed to classify AC joint injuries.

WHAT ARE THE SYMPTOMS?

After an AC joint injury, there is usually immediate pain on the top of the shoulder, swelling and bruising. There is often loss of movement in the shoulder, and pain from putting weight on the arm, or carrying heavy objects. In severe cases, there is a visible lump on top of the shoulder, known as a ‘step deformity’, which is where an obvious difference in height can be seen between the top of the shoulder and the collarbone. Pain may be felt when reaching across the body, like when putting on a seatbelt.

To confirm the diagnosis, your physiotherapist can perform some clinical tests and an X-ray can help to grade the severity of the injury. The classification that would be given to you by your physiotherapist or doctor help determine the optimal course of action.

There are different classification systems, some use three grades and other six. Injuries with a smaller number of ligament fibres being torn are given a lower grade classification, going upwards as further damage is incurred. Injuries classified as higher grades will require surgical repair.

HOW CAN PHYSIOTHERAPY HELP?

Your physio will be able to help ensure the joint is supported and given a chance to heal naturally, while maintaining the strength and normal movement of the shoulder girdle. They’ll do this initially by providing support to the joint. You may need to have your arm supported in a sling or brace for some of this time and your physiotherapist can show you some taping techniques to add support.

Most AC joint sprains take six weeks to fully heal, although many patients report shoulder problems in future years. For this reason, a comprehensive rehabilitation program is very important. More severe sprains are often treated with surgery to stabilise the joint and treat any possible fractures. Surgical repair will also require a proper rehabilitation program.

For more information, please contact Caboolture Physical Therapy Centre. Always see a medical professional for advice on your individual injury.

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.