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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.
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.

Patella Dislocations: What are they and how can your physio help?

What is it?

The knee joint is composed of the thigh bone, (femur) and leg bone (tibia) and a small floating bone at the front, commonly known as the kneecap (patella). The interaction between these bones allows for smooth movement of the knee as it bends and straightens.

During movement, the kneecap sits in a groove at the front of the knee and acts as a mechanical see-saw. This protects the knee joint and improves the efficiency of the muscles working to move it. When the patella moves out of this groove it is called a subluxation. If the patella moves far enough out of this groove it becomes a dislocation.

What are the symptoms?

The first time the patella dislocates is usually the most traumatic and painful. The knee may give way, and a visible lump can be noticed where the patella has dislocated. There will often be bruising, swelling and the knee may feel unstable. First-time dislocations may also cause a heamarthrosis or bleeding within the knee joint. If there is damage to the ligaments of the knee, subsequent dislocations can happen more easily, and from everyday activities, causing the knee to give way suddenly.

What are the causes?

First-time dislocations often occur due to a traumatic event. The most common cause of patellar dislocation is a non-contact injury to the knee with a twist of the leg (the thigh bone rotates internally on a fixed leg and foot). In addition, a direct blow to the side of the knee can also dislocate the patella.

If there is some instability of the joint, dislocations can occur more regularly and from smaller forces.

Dislocations usually occur when the knee is bent and the kneecap slips back into place when the knee is straightened again. While the kneecap can be dislocated in both directions, it usually dislocates towards the outside of the knee.

Certain factors can make dislocation more likely, including overall hyper-flexibility, damage to the ligaments of the knee and muscular imbalance of the quadriceps. The structure and angle of the knee joint itself can also make dislocation more likely. This can be seen in the increased prevalence of dislocations for women as they have a slightly different angle of femur compared to the tibia than men. A traumatic dislocation can cause instability that can lead to future dislocations.

How can physiotherapy help?

An acute patellar dislocation should be treated like any traumatic injury and assessed by a medical professional to reduce pain and swelling, make an accurate diagnosis and check for fractures. While the kneecap may relocate itself quickly, ensuring that it is able to heal correctly to prevent further dislocations may require immobilization for up to six weeks.

Your physiotherapist will be able to identify any factors that may predispose you to further dislocations and provide you with a personalized treatment program to address any stiffness, weakness or instability surrounding the knee. Balance and proprioception (your sense of where your body is in space) are often reduced following an injury and your physiotherapist will help to rehabilitate these. Your therapist may provide you with education and advice regarding bracing or taping. In severe cases of instability, surgery may be recommended to stabilize the knee however this is usually not considered unless there has been a fracture or until a full rehabilitation with physiotherapy has been completed.

This info is not a replacement for proper medical advice. Please get in touch with one of our expert physios 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.
Shin Splints

A focus on Shin Splints

What are Shin Splints?

Medically known as Medial Tibial Stress Syndrome, ‘shin splints’ is a term used to refer to pain along the inside of the tibia or shin bone. The exact pathology that causes the pain of shin splints is unclear and imaging such as ultrasound produces similar results when compared to persons who don’t have shin splints. The pain of shin splints is usually felt over the area where two particular muscles insert into the tibia. These are Tibialis Posterior and Flexor Digitorum Longus, these muscles act to extend the foot and toes respectively.

Despite having an unclear pathology, this can be a debilitating condition that can impact activity levels significantly. The pain can be quite limiting and may even be an early warning sign of a stress fracture and this will need to be ruled out by a medical professional.

What are the symptoms?

Shin splints are typified by persistent leg pain, usually the inside of the shin, halfway down the lower leg. The pain might be felt during exercise or directly after. Some people experience a dull ache over their shin that lasts for quite a while after exercise stops, while for others the pain may be sharp and fades quickly.

The pain is often progressive, becoming worse with shorter distances. Eventually, shin splints can severely impact activity levels as the pain becomes too severe to continue exercise.

What are the causes?

Shin splints are predominantly seen in runners who increase their distances quickly, often while training for an event. Activities that require repetitive weight bearing of any kind, such as marching or high impact sports have also been shown to cause shin splints. Although the pathology of shin splints is unclear, studies have been able to identify certain risk factors that may predispose someone to shin splints. These include:

  • An abrupt increase in activity level
  • Improper footwear and support
  • Higher BMI
  • Training on hard or uneven surfaces
  • Tight calf muscles
  • Flat feet
  • Females are more likely to develop shin splints than males
  • Increased external rotation range of the hips
  • Prior history of shin splints
  • Wearing or having worn orthotics

How can physiotherapy help?

The first step for your physiotherapist will be to address any contributing factors and help to adapt your training program to a level that is optimum for you. A period of relative rest may be recommended along with a targeted strengthening and stretching program for any tight or weak muscles.

Switching to low-impact activities such as swimming, cycling and yoga may also help to maintain fitness during recovery. Your running technique will be analyzed and any training errors may be corrected. When getting back into your training routine, it is usually recommended that distances are not increased by more than 10% per week as this allows the tissues of the body to react to the increased demands and adapt accordingly.

The information in this article is not a replacement for proper medical advice. Please speak to one of our physiotherapists 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.