For All Your Physiotherapy & Health Needs
Visit
4 Annie Street, Caboolture

Achilles Tendon Injuries (Tear, Rupture) Causes, Symptoms, Treatments

What is the Achilles Tendon?

The Achilles tendon is a band of fibrous tissue located at the back of the ankle. Its main role is to connect the calf muscles to the heel of the foot. This is the largest tendon in the body and when it tightens, as the calf muscles contract, it pulls the heel allowing you to stand on tiptoe or to point your foot.

Achilles tendon tears commonly occur in athletes. However, this injury can affect anyone and surprisingly, a complete tear is more common than a partial tear.

Tears usually occur at the section of the tendon where blood flow is poorest – about 6cm above its attachment to the heel.

What are the Symptoms?

Primarily, an Achilles tendon tear will make activities like walking, running and jumping quite difficult. Other signs and symptoms of an Achilles tendon tear include:

  • A loud pop or snap
  • Sudden and severe pain in the back of the calf or ankle
  • Feeling of having been kicked in the calf
  • There is a gap between the tendon and the heel (about 2 inches above the heel)
  • Swelling and stiffness followed by weakness and bruising
  • Difficulty walking, especially during push off
  • Standing on tiptoe may be impossible

What Causes an Achilles Tear?

Anyone can tear their Achilles tendon if the tendon is subject to excessive force or overstretching. But some factors can increase your risk of injury. The most common activities that cause this injury are running and jumping.

The Achilles tendon can thin and weaken, both as we age and if underused. As a result of this weakening, it becomes prone to tear or rupture with less force or stretching required. A tear of the Achilles often occurs in people with pre-existing Achilles tendinitis. Other factors such as certain medications (incl. antibiotics and steroids) and some illnesses (i.e. diabetes and arthritis) can also result in weakness of the tendon, increasing injury risk. Being obese is also a risk factor as excess weight puts excess strain on the tendon.

How Can Physiotherapy Help?

Treatment for Achilles tendon tear will depend on your age, how severe the injury is and your usual level of activity. Young people – especially athletes – opt to have surgery, while older people generally choose conservative treatments like physiotherapy.

Physiotherapy treatment for an Achilles tendon tear will involve exercises to strengthen the calf muscles and the Achilles tendon and exercises for stability. Many people are able to return to their normal activities within 4-6 months. Functional rehabilitation would also be part of the program as this focuses on how you move and coordinate your body. The aim would be to help you return to your highest level of performance.

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.

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.

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.

The Basics of Stretching

The rules around stretching for sport have changed so many times in the medical world, that no wonder sportspeople and coaches sometimes get a little confused about the right way to stretch.

Consider stretching… Why do we stretch? Who should stretch? What sort of stretching? When do we stretch? Is stretching good or bad for you?

We stretch for a few reasons:

  1. To reduce tightness in muscles from spasm or contraction
  2. Because that tightness can decrease our joint range of movement and lead to muscle imbalances and joint injuries
  3. Because passive tightness can occur just from bad posture, genetics, and very likely in our kids from computer game-itis.

Our soccer kids are growing, we can tell by how much we spend on their sports gear and new clothes. With kids, our long bones grow first and then our muscles try to catch up. Add some solid training to that mix, and don’t forget to add up all the sports and playtime, and those muscles are becoming tighter and shorter while the bones are growing longer.

Did you know that the biggest cause of ankle sprains is tight calf muscles? And check the length of your kids’ hamstrings during a grow spurt, that soccer kick will not be as high at that time, forcing them to bend from the hip or back, and ouch… there’s a back injury that might have been prevented.

There are different types of stretching:

  • Ballistic takes the muscle beyond the normal joint range of movement and has been shown cause a few more injuries unless quite specific
  • Static can be helpful in specific cases but only once well warmed up
  • Dynamic can be really helpful in increasing kick height and strength, and for preventing injuries

How often? Well, there’s not much evidence that just stretching at sport helps much at all. But coaches, you are great teachers of stretching, just make sure that you give the kids daily homework.

Chronic stretching is supported by evidence to increase flexibility. Dynamic stretching is also beneficial as part of a warm up, whereas static stretching is better at the end of a workout, and in fact has been shown to be detrimental, making strength poorer immediately after.

Who would think stretching was so complex? The main thing is to look at the individual child… a check up at the Physio is a good idea if you notice reduced flexibility, post-training soreness.

In my experience kids rarely complain of pain, but a loss of interest in the game sometimes suggests that it’s getting hard, and it’s wonderful to see renewed enthusiasm with just the right exercise!

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.

LCL Tears: Symptoms and Recovery

What is the LCL?

The knee is one of the largest joints in the body and has only one plane of movement. This means it bends and straightens but does not twist (much) or move from side to side. To keep the knee from moving in other directions, the knee is supported by many strong ligaments, with two of these being found on either side of the knee. The inside ligament is the ‘Medial Collateral Ligament’ (MCL) and the outside one is the ‘Lateral Collateral Ligament’ (LCL). The primary role of the LCL is to prevent the lower leg from moving too far towards the midline in relation to the upper leg.  Both the LCL and MCL are extremely strong ligaments and provide lots of support to the knee during movement, however, they are still vulnerable to injury.

How do tears happen?

The LCL is injured less often than the MCL, however, tears do still occur. The most common way the ligament is damaged is through a force causing the knee to move inwards in relation to the upper leg, or a twisting of the knee. This can be seen in sports that involve changing directions or with a direct force, such as a rugby tackle. This injury can also occur from a simple fall and as with all sporting injuries, it is not only athletes who can be affected, anyone can tear their LCL in the right circumstances.

What are the symptoms?

Following an injury to the LCL, common signs and symptoms are a ‘popping’ sound at the time of injury, immediate pain with weight bearing and swelling and a feeling instability. The severity of the injury will impact how much each of these symptoms is felt and LCL tears are classified as either Grade I, II or III, which helps to direct treatment. A grade I tear is where a few fibres of the ligament are stretched and damaged, a grade II is where this a partial rupture of the ligament with some instability of the knee and Grade III is a complete tear.

How are LCL tears diagnosed?

Your physiotherapist is able to perform clinical tests to evaluate if there is any instability of the knee from an LCL tear. An MRI can confirm this diagnosis and an X-ray may be required to rule out any associated fracture. It is possible for nerve damage to occur at the same time as an LCL Tear, which will result in weakness and loss of sensation in the lower leg. Severe injuries are more likely to involve injury to other parts of the knee and your physiotherapist will make a full evaluation of all your injuries on assessment.

Most LCL tears are managed well with just physiotherapy and support of the joint, however severe tears and associated nerve damage may require surgery. Your physiotherapist and medical team will work together to help determine the best course of action for each individual injury. 

How can physiotherapy help?

For tears that don’t require surgery, your therapist will advise you on how to best support and protect the injured joint. In the first 48 hours, RICE protocol (Rest, ice, compression, and elevation) is applied to reduce any pain, swelling, and inflammation. Following this period, you will be advised on how best to mobilise the joint whilst preventing any further damage. Return to sport will be dictated by healing times with a full recovery expected by 6-12 weeks.

Following ligament damage, balance, strength, and proprioception are often impacted and your physiotherapist will develop a program to address this, which is an important part of preventing further injury. Tears that are repaired surgically will require a longer program of rehabilitation and close liaison with the medical team.

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.